How Health Care Reform Can Help Pay for In-Home Care

by ElderCarelink

Love it or hate it, the Affordable Care Act is opening up new ways for seniors to receive Medicaid coverage for in-home care.

The law includes a provision for the Community First Choice Option, a state plan designed to provide community- and home-based services for Medicaid-eligible recipients.

Although not exhaustive, the general eligibility guidelines are rather simple.

Seniors must have incomes that make them Medicaid-eligible. Depending on the state, that amount could be as high as 150 percent of the federal poverty limit.

Seniors must meet a state determination that they would require skilled nursing care in a facility if they did not receive in-home care or community-based services.

States that participate in Community First must provide the following services among others:

• Assistance with daily living tasks such as bathing, dressing and eating
• Assistance with other living tasks such as cleaning and shopping
• Training for care attendants
• Back-up systems (e.g. beepers) to maintain a continuity of care for seniors
• States may also provide optional services such as funds to cover transition costs from a nursing facility to community-based or in-home care.

Home care and community-based services can be provided not only by agencies but family members as well. However, family members must meet definitions outlined by the Department of Health and Human Services.

Because this is a state-based plan, not all states may participate in the program. Be sure to check with your state's Medicaid office to learn more about the Community First Choice Option. Then, go to ElderCarelink.com to find home care workers in your area.