At some point or another, many of us will either need to consider home health care for ourselves or for a loved one. Choosing home health care may be an easy choice for some, since it allows the person to remain in their own home and continue a certain level of autonomy while providing the attention and health care necessary. However, there are many other details included when it comes to implementing a home health care system. One of the biggest issues is the cost of home health care and how to pay for it. A common question is whether Medicaid or Medicare pays for home care.
Medicaid versus Medicare
There is much confusion over the difference between Medicaid and Medicare. Both programs were created in 1965 and provide health care benefits. Medicare provides health insurance to those over the age of 65 and Medicaid provides health benefits to low income individuals typically over the age of 65 but also to children and the disabled. In a number of instances, a person may be dual eligible and be covered under both programs. Even though the programs have similar names, they are vastly different.
Medicaid
Medicaid is a social welfare benefit that is administered jointly by the Federal and State governments. Although there are common issues throughout the states, each state runs their program differently. Medicaid is designed to cover long term care and provide a safety net for the aged and disabled population with limited resources. To qualify for the program, an individual must qualify financially and qualify due to “need”. Depending on needs, Medicaid can cover in home care services.
Medicare
Medicare is a Federal government administered insurance plan for individuals over the age of 65. Anyone over the age of 65 is automatically covered by Medicare and there is no need to qualify financially. Medicare covers medical expenses and is not intended to cover long term care needs. Medicare covers home health care, not home care although a number of insurance companies are offering Medicare Advantage plans which may cover home care for a certain period of time. It is best to think of it similar to private health insurance, just administered by the Federal government.
Idaho Eligibility Guidelines
There are two steps in determining if your loved one can obtain services through Idaho Medicaid. First, the candidate must meet financial requirements. Financial ability is determined through the Idaho Department of Health and Welfare Division of Self Reliance. There is an application process which can take up to a few weeks to complete and become approved. Once a candidate has been approved through self reliance, a request is made to the regional office of the Idaho Department of Health and Welfare to make an assessment. A nurse reviewer will meet with the candidate in their home and determine if and what type of services are needed. Generally, waiver candidates must require nursing home level care, be legal Idaho residents and be 65+ years old. If between the ages of 18-64, they may still qualify but require a designation of disabled by the SSA. For the disabled, the program is known as the DD waiver. We can help answer any questions you may have regarding services under the Medicaid waiver programs. Just give us a call and ask to speak to a care manager. Additional information can be found at The Idaho Health and Welfare website.
Washington Eligibility Guidelines
Generally, anyone who qualifies for long term care under the Medicaid program can choose to live at home and receive services which allow them to age in place. Home care services are called Home and Community Based Services. You can apply online, in person, or by mail. Once you fill out your application and financial review, it will be reviewed by the Department of Health and Social Services. If approved personal care needs assessment will be done to determine your functional eligibility by a state case manager from your region. The Washington Medicaid program assists people with disabilities, people 65 and older, children with disabilities, and their caretakers to get help with things like cooking, shopping, transportation to appointments, bathing, dressing, laundry and housekeeping. We can help answer any questions you may have regarding services under the Medicaid waiver programs. Just give us a call and ask to speak to a care manager. Additional information can be found at the Washington Department of Social and Health Services website.
Spokane Senior Home Care experts at Havenwood Caregiver Services are available to talk with you about your home care needs including how to reduce caregiver stress while providing better, affordable care. We are an elder care agency providing home care in Spokane, WA. For more information about home care call us at (509) 535-1546.
Boise Senior Home Care experts at Havenwood Caregiver Services are available to talk with you about your home care needs including how to reduce caregiver stress while providing better, affordable care. We are an elder care agency providing home care in Boise, ID. For more information about home care call us at (208) 327-1011.
Twin Falls Senior Home Care experts at Havenwood Caregiver Services are available to talk with you about your home care needs including how to reduce caregiver stress while providing better, affordable care. We are an elder care agency providing home care in Twin Falls, ID. For more information about home care call us at (208) 358-4772.