People need health care support for various reasons. Many individuals are unaware that they may be eligible for Medicaid benefits, including long-term care services provided in their homes. Medicaid Home Care is for eligible people who need assistance with the Activities of Daily Living (“ADLs”) but who otherwise can remain safely in their own homes. ADLs include dressing, bathing, eating, toileting, and “transferring” (moving from one place to another such as from your bed to a chair). Medicaid is also health insurance for eligible people if they don’t have Medicare.
Medicaid programs, including Medicaid Home Care services, are often complex. Working with skilled Medicare and Medicaid planning attorneys can help you understand various programs and their qualification requirements, so you can plan proactively to protect your assets and income to the extent allowed by current laws. The knowledgeable, experienced legal professionals at Lamson & Cutner help clients with a variety of Elder Law matters, including Medicaid and in-home care, long-term care planning, estate planning, and more.
Advance planning for Community Medicaid programs such as Home Care is particularly important now, as Medicaid’s eligibility rules are changing. There will be a new “look back” and other new requirements as well. Some of the new rules became effective on October 1, 2020, and others commence soon thereafter. These new rules make achieving eligibility more challenging, and planning more complex.
If you meet Medicaid financial requirements for eligibility and have been approved for Medicaid, there is a specific process that must be followed. First, to determine whether you need Medicaid Home Care services, you must have a “Conflict-Free Evaluation,” conducted by a New York State Department of Health subcontractor called Maximus NYMC (New York Medicaid Choice). If Maximus determines that you need home health services that Medicaid covers, your next step is to choose a Managed Long Term Care (MLTC) agency. The agency will evaluate you and pre-qualify you for a certain number of hours of care, depending on what services you need. You can apply to more than one MLTC if you wish, since each MLTC might evaluate your Medicaid and in-home care needs a bit differently. Once you have a determination from one or more MLTCs, you can choose to enroll with the one you prefer.
Medicaid financial requirements are complex, because eligibility takes into account various factors such as your age, marital status, any assets you hold singly or with others, and sometimes your income. Click here to learn more about the rules that apply to your specific situation.
With offices in New York City and Westchester County, the skilled Elder Law professionals at Lamson & Cutner are prepared to assist you with Medicare and Medicaid planning — including Medicaid Home Care benefits in NYC, Westchester, & the NY metro area. To learn more and to schedule an initial consultation, contact us today.