If you have an elderly parent or relative that is low-income and suffers from a chronic condition or is in need of long-term care, they may qualify for assistance under Medicaid, the federal and state program that provides health coverage for low-income individuals and families. But, often, families hesitate to apply for Medicaid benefits even if they believe they would qualify. Health insurance can be confusing and complex, and some people worry that applying for and using Medicaid will only make the already complicated task of caring for an elderly family member even more difficult, or they worry that Medicaid will limit their choices and force them to put their elderly loved one in a nursing home. But the truth is, Medicaid is more than just a system that pays for prescriptions and doctor's visits. Several aspects of the program are specifically aimed at making life easier and more pleasant for patients and families and offering options other than institutional care. Take a look at a few benefits that you never knew were available under Medicaid.
One of the most difficult things about managing health care for elderly persons is that they often have to see a variety of different doctors and are prescribed a variety of different drugs. This is especially true for patients who have several chronic conditions. They may need to see different specialists, and each doctor may prescribe one or several medications.
If you're a caretaker, this can be very worrying. It's hard to keep up with multiple prescriptions, and it's difficult for a non-medical person to know if any drugs or treatments that a patient is receiving from one doctor may interact with drugs or treatments prescribed by another doctor. This is where Medicaid's case coordination management programs come in.
The purpose of care coordination is to ensure that everyone is on the same page. A case manager oversees the patient's care and ensures that their doctors are aware of any drug interactions, know of all the patient's diagnoses, and aren't scheduling duplicate tests or procedures. This kind of case management safeguards patients and helps make certain they receive quality care.
Home and Community Based Services
Many elderly patients, and their families, resist the idea of long-term nursing home care. The home and community based services plan helps these patients receive the care they need at home if possible. The program is meant to provide things like in-home personal care, home modifications, and transportation services, as well as respite care, adult daycare, and even payment for assisted living programs in some locations.
The Medicaid program is administered by the individual states, so each state is able to design a program that they feel best meets the needs of its citizens. That means that your loved one may not receive the exact same benefits as a friend in another state. Your local aging and disability resource center can help you determine what sort of home and community based services your loved one is eligible for.
Money Follows the Person Plan
Sometimes, institutional care is necessary. For example, if your loved one needs a hip replacement, they will have the surgery done in the hospital, and then they may need some intensive rehab before they're able to return home, even with in-home assistance. In cases like these, Medicaid would pay for your loved one to receive in-patient therapy in a nursing home or skilled nursing facility.
But what happens when the rehab is finished? In some cases, patients in these circumstances transition from rehabilitation to long-term institutional care. But the goal of the Money Follows the Person program is to increase the use of home and community based services and decrease the use of institutional services. In order to achieve that goal, the program provides money to help a person transition out of a nursing facility and back into their community with home-based care. At this time, the program is available in 43 states and the District of Columbia.
Even if you're not sure that your loved one will qualify for Medicaid, it's a good idea to apply. You may be surprised to find that they're approved, and Medicaid's programs can greatly improve your loved one's quality of life and care. If you need help with the application, an elder law attorney or senior advocate, such as those at Senior Solutions of Long Island, Inc., in your area can help you complete the application.