Michigan Medicaid Health Plans UnitedHealthcare Community Plan: Medicare & Medicaid Health Plans

Table of Content

• I. What You Should Expect to Pay for Home Care in Michigan
• State-by-State Medicaid For Home Care Everything You Want To Know
• Featured Programs
• Eligibility Criteria For Michigan Medicaid’s Long Term Care Programs
• Children’s Special Health Care Services (CSHCS)
• Popular on michigan.gov
• Experts In Home Health Management, Inc.

This rate varies by state and program, and is generally a few dollars per hour lower than is the market rate. For additional information about the Home Health Program, click here and here. The Michigan Department of Health and Human Services administers the Home Help Program.

If the program participant chooses to self-direct, a financial management services agency will be provided to handle the monetary aspects of employing a caregiver, such as withholding taxes and making payments. Each MI Choice Waiver beneficiary will be evaluated and receive benefits specific to their needs and circumstances. Benefits can include adult day care, home modifications, nursing services, specialized medical equipment, transportation and personal care help with the Activities of Daily Living . These benefits are delivered by Michigan’s 20 waiver agencies, which are spread across the state and have a network of care providers. This state website can help you find the waiver agency closes to you. MI Choice Waiver Program participants also have a self-determination option that allows them to choose their own caregivers for some services, like personal care and housekeeping.

I. What You Should Expect to Pay for Home Care in Michigan

Benefits are intended to delay nursing home admissions and may be provided at home, adult day care, adult foster care, or in assisted living. ADLs are everyday tasks that are necessary to take care of oneself. This includes bathing and grooming, dressing and undressing, using the toilet and cleaning up oneself, the ability to move from one room to another room within one’s home, and eating.

Michigan Medicaid will conduct an assessment of ABD Medicaid applicants and their ability to perform Activities of Daily Living to determine the kind of services the beneficiary needs and the state will cover. If you are enrolled in Medicaid or MI Choice , your regular benefits will cover some of your expenses while you live in an assisted living facility, like physical therapy or prescription costs. However, Michigan does not have a Medicaid program that will pay for room and board in an assisted living facility. Medicare doesn’t pay for non-medical home care, but it can cover the cost of the medical version of home care, called “Home Healthcare” in some situations. In order to be eligible, you need to be homebound and have a referral from your doctor for the specific type of medical care that is needed.

State-by-State Medicaid For Home Care Everything You Want To Know

All assets of a married couple are considered jointly owned regardless of the long-term care Medicaid program for which one is applying. However, spousal impoverishment rules permit the non-applicant spouse of a nursing home or Waiver applicant a Community Spouse Resource Allowance . In 2022, the community spouse (the non-applicant spouse) can retain 50% of the couples’ joint assets, up to a maximum of $137,400, as the chart indicates above. If the non-applicant’s half of the assets falls under $27,480, 100% of the assets, up to $27,480 can be retained by the community spouse. While one’s home is generally exempt from Medicaid’s asset limit, it is not exempt from Medicaid’s estate recovery program.

Some states offer long-term services and supports via this type of waiver. While this option may eliminate waitlists for services, this is not always the case. Yes, Medicaid will pay for in-home care, and does so in one form or another, in all 50 states. Traditionally, Medicaid has, and still continues to, pay for nursing home care for persons who demonstrate a functional and financial need. However, in-home care provides an alternative for seniors who require assistance to remain living at home, but prefer not to relocate to nursing home residences. In-home care via Medicaid not only helps elderly persons to maintain their independence and age at home, but is also a more cost-efficient option for the state than is paying for institutionalization.

Featured Programs

Personal care assistance (help with bathing, dressing, eating and other non-medical care) in the home, which is not federally mandated, is also offered by many states’ regular Medicaid plans. In-home care services may be available via one’s regular state Medicaid plan, but may also be offered through Home and Community Based Services Medicaid waivers or Section 1115 demonstration waivers. An individual provider is defined by MDHHS as the direct care worker. The individual provider provides personal care services to an MDHHS Home Help beneficiary.

Reflects Medicaid state plan coverage of the eligibility group for parents and other caretaker relatives. Parents and caretaker relatives with income over the income standard for coverage under this group may be eligible for coverage in the adult group in states that have expanded to cover the adult group. During the process of determining financial eligibility, it’s important to start gathering documentation that clearly details the financial situation for the Michigan Medicaid applicant.

The need for help can be due to aging, illness or cognitive issues caused by Alzheimer’s Disease or other dementias. MI Health Link HCBS Waiver beneficiaries must need a Nursing Facility of of Care. To see if this level of care is required, the state uses the Michigan Medicaid Nursing Facility Level of Care Determination.

We have the Medicaid benefits and extras that can make a real difference in your life. Whatever plan you choose, UnitedHealthcare will help you get the care you need. The Meridian Transition of Care Program aims to ease the transition from hospital to home by providing support and education for the member, family and caregiver. The Meridian Smoking Cessation Program offers education materials, a personal Smoking Cessation Coordinator and coaching calls to help members quit smoking. The Risk for Kidney Failure Program provides educational outreach intended to help provide resources to those who are at risk for developing end stage renal disease .

When applying for Medicaid in Michigan, it is extremely important that seniors are certain that they meet all of the eligibility criteria, as discussed in detail above. If one has income and / or assets over the limit, or are unclear as to whether the requirements are met, Medicaid planning becomes crucial. Applying for Medicaid can be complicated and time consuming, and if the application is completed incorrectly and all required documentation is not provided, Medicaid benefits may be denied or delayed. 1) MI Choice Waiver Program – This “HCBS Waiver” for the elderly and disabled provides supportive services to help nursing home qualified persons avoid nursing home placement.

Your loved one will have a customized plan of care specific to their need. All of the things that make living at home more manageable for our clients. Caregiving Experts provides care for clients anywhere they call home. For some, it is in Senior Living Communities such as Assisted Living, and Memory Care.

1) Institutional / Nursing Home Medicaid – This is an entitlement program; Anyone who is eligible will receive assistance. Persons can live in their own home or the home of a loved one and receive benefits through the Home Help Program. Unfortunately, persons cannot reside in an adult foster care home or an adult care home .

MI Health Link is a managed care program for Michigan residents who are eligible for both Medicaid and Medicare that combines the benefits of both programs into one plan. A functional need threshold, also referred to as medical need, must also be met for one to be eligible for in-home care. For the state Medicaid plan , persons often must demonstrate the need for assistance with activities of daily living and / or instrumental activities of daily living. This includes requiring help with mobility, transferring from a bed to a chair, toiletry, eating, bathing, doing laundry, and meal preparation. However, as an example, eligibility requirements may require that an applicant need assistance with one ADL or IADL, assistance with a minimum of two ADLs, or assistance with three IADLs. Inadequate planning or improperly implementing a Medicaid planning strategy can result in a denial or delay of Medicaid benefits.

Popular on michigan.gov

People 65 and older with Medicaid may also be eligible for a Dual Eligible Special Needs Plan, or D-SNP. Thanks for working with Priority Health to give our members the right care at the right time. To apply for Home Help Services, contact your local office of the Department of Health & Human Services. Consumer directed caregivers are paid an hourly rate, which is approved by Medicaid for in-home care.