Financing/Coverage

Welcome everybody to the Wellsprings Home Care Podcast. I’m your host, Justin Currie, my two four legged co-hosts are not with me today even though we’re working from home during this quarantine.  

I wanted to jump into announcing our Best of Home Chttps://wellspringshomecare.com/home-care-services/dementia-careare Award because we’re still really excited about it. SeniorAdvisor.com actually gave us one of the 2020 Best of Home Care Awards. And what that is, is that it actually recognizes the top 2 to 3% of home care agencies nationwide. So we’re obviously really excited and really proud to receive that award, and we’re really happy we have such a great team on board and great caregivers and great clients. And just for those of you who don’t know, we are a Non-medical Home Care service provider and we’re based in Exton, Pennsylvania and we serve the counties of Chester, Montgomery, and Delaware County in Pennsylvania. 

Some of the services we offer here at Wellsprings are Personal Care. So things like toileting, bathing, Personal Hygiene Services being tasks like oral care, oral hygiene, incontinence care and shaving.  

We also have caregivers that are specifically trained in Dementia and Alzheimer’s. So they’re able to come in and track progress and or decline, depending on the situation. They’re really helpful to have in the home. 

One of the other things we offer is Companionship. So if your loved one just need somebody to talk to, we can either do that by telephone or we can have somebody come in and just be a friend and be there for them.  

Mobility Assistance is another service we can offer, so if somebody comes home from skilled nursing maybe they’re there and rehabilitation will actually help them. We’ll do full transfer assists right up to standby assist where they’re just maybe not as sure of their balance as they once were. So we’ll come in and help out and just sort of help them build that confidence back.  

So what we’re going to be talking about today is How to Apply for Medicaid in Pennsylvania. For those of you that don’t know, Medicaid in the U.S. is actually a state and a federal program and it really helps out people with limited resources and limited income, and it can offer benefits to pay for things like home care.  

So before we jump into how we can apply for Medicaid, I want to talk a little bit about individuals who are automatically enrolled. The state PA rolled out a program called Community Health Choices. And what that is, is it’s Medicaid falls under that banner. And because of the change, there’s people that you know are currently getting services that will automatically be approved for Medicaid waivers. The number one reason is somebody who is receiving both Medicare and Medicaid, they’re automatically enrolled in community health choices. Somebody who’s receiving long-term Social Security in the Attendant care, Independence, Comcare or Aging waivers, they’re automatically enrolled in Community Health Choices. Somebody who is receiving services as per the OBRA waiver and also clinically ineligible to be in a nursing facility. Also Anyone who is receiving care in a nursing home that is paid by Medicaid, they’ll automatically be enrolled in community health choices. And also anybody who participates in the ACT 150 waiver who is both eligible for Medicaid and Medicare, that individual will also be enrolled in community health choices. 

So those are some of the ways that someone can automatically be enrolled and that’s sort of like I guess grandfathering in, they were already a part of certain programs before Community Health Choices was rolled out so they’re automatically enrolled.  

Now I just want to state also individuals that would not be eligible for CHC (Community Health Choices). So if you fall under any of these four items then you would not be able to apply for a Community Health Choices waiver with Medicaid.  

1. Someone who is receiving long-term social security under the OBRA waiver  

2. Are not nursing facility eligible.  

3. An ACT 150 program participant who is both eligible for Medicaid and Medicare. 

4. Anyone who is in a state operated nursing facility including the state veterans homes. 

So any individuals that fall under those, those four items are not eligible for community health choices. 

So now that we’ve discussed ineligibility, I just want to jump into some of the different ways that you can actually apply for Medicaid. There are four different ways that someone can apply for Medicaid: 

1. On Paper – You can actually download an application. So if you go to dhs.pa.gov and you follow the tabs to medical assistance, then you can actually download an application there and submit usually by fax. 

2. In Person – You can actually contact your County Assistance Office and you can do that by just kind of doing a quick search online for your CAO, which is your County Assistance Office and there’ll be an address there that you can actually go to and talk to them and you know, they’ll help you apply that way. 

3. By Telephone – Call the Consumer Service Center for health coverage and the number for the Department of Health in Pennsylvania is 1-866-550-4355 and you can chat with them and they’ll kind of guide you through the process. 

4. Online Application – Just go to https://www.dhs.pa.gov and they’ll guide you through the process on there but you might want to help have a family member or someone else help out. 

You can call us, we can help you guide through the process as well and applying for any Medicaid waiver, it’s like any insurance program, it is a bit of an arduous process. It’s gonna take some time. It’s gonna take a lot of paperwork off the start digging through some of your old records providing assets, incomes, things like that. So it does take some time to get started, but once you have that information and you have that approval, it’s a very good benefit to be on because some Medicaid waivers, they can be fairly long-term and they can help out for a long time. They’re definitely beneficial to somebody that does have that limited income. They can have somebody come in there and help out and they typically adjust hours according to the health background of the individual. So if you do see any decline or you know throughout the term, then you know, they’re likely to add more hours as well. 

Medicaid is definitely a worth putting in the time and effort off the start and Wellsprings Home Care and our affiliates can help out with that as well. We’re a Medicaid approved provider and we’re approved for all three MCOs. So that’s Keystone first, UPM, CPA Health and Wellness – any MCO (Managed Care Organization) that the beneficiary picks, we can provide care services for.  

So that’s about all the information I have on how to apply for Medicaid in Pennsylvania, I really hope that helps guide some people through the process. I know it can be tricky, especially when you’re not that tech savvy. Even myself, I struggle with that a little bit as I’m sure most people do but we’re definitely here to help.  

Get in touch with us anytime at www.wellspringshomecare.com and our phone number is 610-463-0880 and we can help you out anytime. So thanks a lot for stopping by and we’ll see you next time! 

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