Medicaid’s use as a funding source for long-term care is increasing, and that has led states to do what they can to reduce associated costs. This has dovetailed nicely with the desire of many people who need care to stay at home, rather than go into a nursing facility. While long-term care is typically provided in special facilities, Medicaid waiver programs allow patients to continue to receive care and funds while staying at home. This reduces costs for Medicaid because there are no facility charges, and it lets patients remain in a comfortable setting in which they still have some independence.
Medicaid funds used for in-home care are not that simple to get because the requirements vary from state to state. In Illinois, the patient must be in need of care that is beyond what a family member or friend could reasonably provide. The patient’s health must also be strong enough so that a home stay is safe.
The Medicaid-funded in-home care program in Illinois is called the Community Care Program, and it is available to seniors whether or not they are enrolled in Medicaid. However, all participants must be eligible for Medicaid funding. Participants are required to apply, but not actually enroll in, Medicaid in order to receive funding. Potential recipients must undergo an assessment known as Determination of Need. The results of the assessment must show that the patient would have to go into a nursing home or similar facility if home care were not available.
The CCP provides in-home and emergency-response services for at-home patients. These services include meal preparation, personal and household care, and emergency communications. Caregivers must be specially trained; unlike in other states, Illinois’ in-home Medicaid program doesn’t simply place responsibility in the hands of a family member.
People who expect to apply for the CCP will need to ensure that their assets are in line with Medicaid eligibility requirements. This can be difficult to achieve if a person has more assets than is allowed because giving away assets will not automatically make the person eligible. In fact, giving away assets within the five year period prior to application for Medicaid will become an issue when your application is reviewed.. In most cases, the value of those asset transfers is imputed back into your estate. An attorney familiar with Medicaid and long-term care can plot out strategies for protecting the estate of someone planning to apply for the CCP or Medicaid.
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