At some point during your retirement years, you may experience physical and/or mental deterioration that makes independent living difficult. You may not yet need the type of around the clock care offered by a nursing home though. Understandably, you may wish to remain in your home as long as possible. Moreover, you may be able to do so with the assistance of in-home care. The cost of that care, however, can be prohibitive if you are forced to pay out of pocket. The Indianapolis Medicaid attorneys at Frank & Kraft explain how Medicaid may help cover the cost of in-home care.
Although Medicaid is considered a federal health care program, the funds for Medicaid come from both the federal government and the individual state governments. Consequently, the rules governing Medicaid also come from both the federal government and the individual states governments. The federal government sets certain standards and requires state Medicaid programs to cover certain types of care and services; however, it also gives the states considerable flexibility with regard to the services they provide, particularly in the area of in-home care.
Medicaid In-Home Care in Indiana
The Indiana Aged and Disabled (A&D) Medicaid Waiver is intended to help elderly or disabled state residents that require the types and level of care provided in nursing homes by offering services and support to help these individuals live at home.
What Services Are Covered?
The range of services that are paid for by this waiver have been specifically chosen to help individuals remain living outside of nursing homes. Applicants are evaluated individually, and in addition to case management, their customized plan of services may include any of the following:
- Adult Day Services / Adult Day Care
- Adult Family Care / Adult Foster Care – caregivers cannot be related to the care recipient
- Structured Family Caregiving – caregiver can be related to the care recipient. Learn more.
- Assisted Living
- Attendant Care – Assistance with activities of daily living, such as mobility, dressing, toileting, etc.
- Case Management
- Community Transition – Up to $1,500 (lifetime cap) reimbursement for transition costs when relocating from a nursing home facility back into the community
- Environmental Modifications and Assessment – Addition of walk-in tubs, grab bars, widening of doorways, etc.
- Home Delivered Meals
- Homemaker Services – Laundry, housecleaning, meal preparation, etc.
- Medical Equipment and Supplies
- Personal Emergency Response System (PERS)
- Respite Care – In-home and out-of-home
- Transportation Assistance
- Vehicle Modifications
- Nutritional Supplements
- Pest Control
Who Is Eligible?
To be eligible for the Medicaid waiver program that covers in-home care you must meet the following main criteria:
- Residency – must be a resident of the state of Indiana.
- Place of Residence – must be willing to live in an approved assisted living residence, home of a family member, or one’s own home, instead of in a nursing home.
- Functional – must be assessed and found to require at least the level of care provided in nursing homes (assistance with 3 activities of daily living, such as bathing, grooming, and mobility).
- Monthly Income – to be eligible for the A&D Waiver, the candidate must fall within the financial guidelines for Indiana Medicaid long term care. In 2019, single applicants are allowed monthly income up to $2,313.
- Countable Assets –as of 2019, a single applicant’s countable assets must not exceed $2,000 in value.
Note: If you are married, and applying for Medicaid, the income and asset rules can become very complicated. Make sure you consult with an experienced Medicaid planning attorney before applying for benefits to ensure that you understand the rules and that you do not put assets at risk.
The Consumer-Directed Attendant Care Program (CDAC Program)
The Consumer-Directed Attendant Care Program, or CDAC Program, is a self-directed care option that gives you the flexibility to select your own personal care providers, monitor them, as well as fire them. Since no medical training is required to provide most forms of personal care, a broad range of individuals can be hired to provide these services, including friends and some family members. The hourly rate that caregivers are paid is determined by the state Medicaid office and typically is between 60% and 80% of the average hourly rate private caregivers receive in Indiana. Therefore, in 2019, caregivers can expect hourly payments of between $12.50 and $18.50 per hour.
Contact Indianapolis Medicaid Attorneys
For more information, please download our FREE estate planning worksheet. If you have specific questions about the Medicaid in-home waiver program, or about Medicaid planning in general, contact the experienced Indiana Medicaid planning attorneys at Frank & Kraft by calling (317) 684-1100 to schedule an appointment.