Medicaid pays for nursing home care for individuals with limited financial resources. Some people want to live at home or in assisted living but still need financial aid. Medicaid will pay for care at home or in assisted living facilities if it costs less than a nursing home. It does this through “Medicaid waivers,” or Home and Community Based Services (HCBS) waivers.
The Indiana Aged and Disabled Medicaid Waiver is intended to help elderly and disabled persons who require the level and type of care offered in a nursing home. The waiver offers its support and services so that these individuals can live at home. By offering waivers, the state can improve the quality of life of the individual and save money by decreasing nursing home costs.
There are four main eligibility requirements:
The applicant must be a resident of the state of Indiana.
Waivers are for applicants who are willing to live in an approved location besides a nursing home. The applicant can live at home or in an assisted living facility. There are certain Medicaid-approved assisted living residences or adult family care homes that will qualify for waiver services. The waiver can also assist individuals currently residing in a nursing home to transition back to the community.
The individual must be assessed and found to require the level of care offered at a nursing home.
The applicant must meet financial guidelines. For an individual applicant, the income level cannot exceed 300% of the Social Security Income (SSI) rate. For 2016, this means an individual cannot have an income that exceeds $2,199/month. Also, for 2016, an individual applicant cannot have more than $2,000 in countable resources. A married couple may be able to keep up to $119,220 in countable resources, as long as it is allocated to the non-applicant spouse. Countable resources do not include the home if it is lived in by the applicant, spouse, or a minor or adult disabled child and if the value of the owner’s equity does not exceed $551,000.
Medicaid waivers pays for services that are specifically aimed at helping the individual remain living outside a nursing home. Applicants are assessed individually and have their own customized plan of services. Associated with the waiver is a self-directed care option called Consumer-Directed Attendant Care (CDAC) program. Applicants who choose this option are able to select their own personal care providers, monitor them, and fire them. Family members and friends can be hired to provide these services. Some Medicaid waiver services offered include:
Adult day care
Adult family care (caregivers cannot be related)
Structured family caregiving (caregivers must be related)
Assisted living
Attendant care
Case management
Community transition
Environmental modifications and assessment
Home delivered meals
Homemaker services
Medical equipment and supplies
Respite care
Transportation assistance
Vehicle modifications
Nutritional supplements
Pest control
Families who do not currently qualify for Medicaid services (perhaps due to income or assets) can seek legal assistance to help them qualify. The professional Medicaid planners at our office can help potential applicants arrange their financial situation so that they qualify for Medicaid services. Excess income and assets can be allocated into a Trust or converted into non-countable assets. Contact our office before filing the application so that we can best help you and your loved ones.