Luther gets a job making $500 per month, plus he will continue to receive $1,270 of SSDI. His MAGI-based income is $1,770 per month, which is over the income limit for this group. As a result, the state would need to find him eligible under a different Medicaid eligibility group to maintain Medicaid. shouldn’t only identify those who could be eligible for this group, but should also be familiar with other Medicaid eligibility groups in their state that could benefit workers with disabilities, such as the Medicaid Buy-in group (if available). Home and Community-Based Services (HCBS) Waivers Historically, Medicaid only funded long-term care services in an institutional setting. Long-term care (LTC) services include support with activities of daily living (ADLs), such as bathing, dressing, and eating. LTC services have also included support with instrumental activities of daily living (IADLs), such as taking medications as prescribed, managing money, shopping for groceries, and transportation within the community. If an individual needed this type of support, in the past Medicaid would only provide those services in nursing facilities, intermediate care facilitates (ICF), intermediate care facilities for those with intellectual disabilities (formerly called ICF or MR), or hospitals. Example of LTC services: Denise was in a car accident that caused total paralysis below her waist. She was in the hospital for several weeks, which her parents’ insurance covered. Afterwards, she entered a nursing facility, where she had access to nursing care, physical therapy, and occupational therapy. Her parents’ insurance had covered much of her care, but there were limitations on the amount of rehabilitation care. She signed up for Medicaid, which covered the services her parents’ insurance didn’t cover. After three months of services in the nursing facility, Denise began asking when she could move back to her apartment. She met with the facility’s social worker, and they created a plan. Denise applied for a program through the state Medicaid agency that provided LTC services to people in their own homes (they also provided support to people in foster homes
Luther gets a job making $500 per month, plus he will continue to receive $1,270 of SSDI. His MAGI-based income is $1,770 per month, which is over the income limit for this group. As a result, the state would need to find him eligible under a different Medicaid eligibility group to maintain Medicaid. shouldn’t only identify those who could be eligible for this group, but should also be familiar with other Medicaid eligibility groups in their state that could benefit workers with disabilities, such as the Medicaid Buy-in group (if available). Home and Community-Based Services (HCBS) Waivers Historically, Medicaid only funded long-term care services in an institutional setting. Long-term care (LTC) services include support with activities of daily living (ADLs), such as bathing, dressing, and eating. LTC services have also included support with instrumental activities of daily living (IADLs), such as taking medications as prescribed, managing money, shopping for groceries, and transportation within the community. If an individual needed this type of support, in the past Medicaid would only provide those services in nursing facilities, intermediate care facilitates (ICF), intermediate care facilities for those with intellectual disabilities (formerly called ICF or MR), or hospitals. Example of LTC services: Denise was in a car accident that caused total paralysis below her waist. She was in the hospital for several weeks, which her parents’ insurance covered. Afterwards, she entered a nursing facility, where she had access to nursing care, physical therapy, and occupational therapy. Her parents’ insurance had covered much of her care, but there were limitations on the amount of rehabilitation care. She signed up for Medicaid, which covered the services her parents’ insurance didn’t cover. After three months of services in the nursing facility, Denise began asking when she could move back to her apartment. She met with the facility’s social worker, and they created a plan. Denise applied for a program through the state Medicaid agency that provided LTC services to people in their own homes (they also provided support to people in foster homes
2017_WIPA_Manual_Module_4_S.docx