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How Has New York’s Medicaid Program Evolved?
New York boasts a comprehensive Medicaid program, serving over 7 million residents on a budget of more than $9 billion. The state is shifting toward a managed care model to reduce costs while improving efficiency. The approach seeks to integrate healthcare services, minimize administrative burdens, and enhance patient outcomes.
Through the transition, the state has established plans like the Consumer Directed Personal Assistance Program (CDPAP) that allow beneficiaries to manage their care more independently. Putnam County estate planning attorneys say these programs provide more flexibility in choosing caregivers for better patient management.
How Does Medicaid Work in Relation to Home Care?
New York established its health home care program in 2012 as part of a state-wide amendment program to provide a variety of Home- and Community-Based Services (HCBS). The aim was to enable those eligible for the program to remain at home and actively engaged in the community.
Medicaid planning lawyers in Putnam County say the support offered mainly depends on an individual’s needs. Services covered under the program include:
- Skilled nursing care: These are medically necessary services licensed nurses provide in the short term.
- Non-medical home care services: They provide assistance with daily activities, such as meal preparation, hygiene, housekeeping, companionship, and cleaning.
How Has the Medicaid Program Changed the Home Care Model?
The new Medicaid Home Care program encompasses various long-term care programs with specific eligibility requirements and limitations. Putnam County Medicaid planning attorneys provide an overview of the long-term care options:
Consumer-Directed Personal Assistant Program
If you’re eligible for this program, you can choose your caregivers from among family members, friends, or other loved ones who can receive compensation for their work. The program allows you to exercise control of your care while receiving financial and other assistance you need.
Personal Care
The program is also known as Medicaid-funded home care and involves using housekeeping and home attendant services for individuals facing challenges with one or more activities of daily living (ADLs). These include nutrition, personal hygiene, and more. If you choose this option, you must be eligible for Medicaid and exempt from managed long-term care.
Assisted Living Program
The program offers long-term, non-medical residential services through adult care facilities (ACFs). One eligibility criterion is that you must be unable to live alone due to physical, mental, or other limitations. You also do not need continued medical care or nursing services in nursing homes or hospitals. ACFs are not licensed to provide such support.
Managed Long-Term Care Program
The program covers various home care services, such as home health aides, home attendant services, case management, nursing, home care services, and physical therapy for eligible individuals. You can enroll in the program if you’re eligible for Medicaid and Medicare.
Long-Term Home Health Program
If you participate in this program, Medicaid planning attorneys in Putnam County advise that you create a plan for medical, nursing, and rehabilitative care to be provided at home. You must be medically eligible for placement in a nursing home, but the care costs should be lower than the nursing home costs.
Certified Home Health Program
Certified Home Health Agencies (CHHAs) provide skilled services like physical therapy, nursing, and occupational therapy to home-bound patients recently discharged from rehabilitation centers or hospitals. They also offer home health aides to complement their skilled services. However, they don’t employ home attendants but can contract licensed home care service agencies to provide them.
Given the comprehensive health insurance coverage, it’s crucial to include Medicaid planning in your estate plan. You can enroll any time during the year through the New York State of Health. Although there are no monthly premium payments for the program, some services may have small co-payments, which can be waived if you can’t afford them.
What is the Importance of Medicaid in Home Care Services?
Medicaid’s importance for individuals requiring home care services can’t be overemphasized. Estate planning lawyers in Putnam County say the program provides much-needed financial support and access to necessary care, making the burden easier for individuals and their loved ones.
If you can’t afford private home care services, Medicaid is a vital lifeline that covers partial or all of the costs associated with home care. It can enable you to receive care without significant financial strain. Knowing that healthcare assistance is readily available can give you and your loved ones some peace of mind.
Medicaid Home Care Waivers
Medicaid provides various options to enhance in-home care services by providing specific waivers. These allow states to offer additional benefits beyond traditional Medicaid coverage to promote independent living while improving the quality of care for individuals. Some of the available waivers are:
- Home and community-based services waivers for case management, home modifications, personal care assistance, and transportation services.
- Section 1115 demonstration waivers to expand eligibility for home care services, including adult day and respite care coverage, and promote integrated care models for medical and non-medical services.
However, specific Medicaid coverage, benefits, and waivers for homecare services may vary depending on your eligibility, geographic location, and other program guidelines. Consult skilled Medicaid planning lawyers in Putnam County to help you evaluate the deeper details and requirements.
A Skilled Estate Planning Lawyer Demystifying Medicaid for Home Care Services
When creating an estate plan, one of the crucial aspects of your life to plan for is your health. It’s essential to find out as much as possible about Medicaid and how it can enhance your home care options. Skilled Medicaid planning lawyers in Putnam County can guide and help you make an informed choice.
The Feller Group, P.C. has a dedicated team of Medicaid planning attorneys in Putnam County. We can evaluate your case specifics to empower your decisions as you create an estate plan and protect your future. Call us at 845-682-5572 to schedule a FREE 30-minute case evaluation.
