What is a Medicaid Waiver?

Jun 27, 2016

What is a Medicaid Waiver?

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A Medicaid program essentially provides people who would otherwise be in an institution, nursing home, or hospital to receive long-term care in the community. These waivers are filled out by Americans of all ages and can make life a lot easier. These waivers are essentially “applications” that are filled out so you or your loved one can gain benefits and financial support from the Medicare program.

Each state has a different waiver with varying requirements and benefits, so it’s important to fill out the waiver for the state you or your elder will be residing in.

Types of Medicaid Waivers

  • Section 1115 Research & Demonstration Projects: States can apply for program flexibility to test new or existing approaches to financing and delivering Medicaid and CHIP.
  • Section 1915(b) Managed Care Waivers: States can apply for waivers to provide services through managed care delivery systems or otherwise limit people’s choice of providers.
  • Section 1915(c) Home and Community-Based Services Waivers: States can apply for waivers to provide long-term care services in home and community settings rather than institutional settings.
  • Concurrent Section 1915(b) and 1915(c) Waivers: States can apply to simultaneously implement two types of waivers to provide a continuum of services to the elderly and people with disabilities, as long as all Federal requirements for both programs are met.

Medicaid Waivers by State

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Frequently Asked Questions

Will Medicare pay for long-term care services like nursing homes?

For things like rehabilitation that will last no more than 100 days, then it is possible for Medicare to cover the costs. Keep in mind that you must also have had a prior hospital stay of at least three days, and are admitted to a Medicare-certified nursing facility within 30 days of this stay. Medicare will cover 100% of the cost for the first 20 days, however, you’ll have to pick up the cost starting the 21st day.

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Due to our financial situation, I simply cannot afford to put my parents in a home, but having them live with me isn’t exactly ideal. Are there any other affordable options?

We realize that senior care communities can be costly, but there are a few things to be considered. Many healthcare providers will help offset the costs of moving to a senior care community. If that’s still not financially possible, look into having a home care aid come to your parents' house a few times a week. These home care aids can be hired through an agency or independently and can provide a variety of services to take care of senior loved ones. Don’t let money get in the way of providing the care your parents deserve.

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Finding the perfect senior care community is only part of making your loved one’s senior living transition smooth. At SeniorCaring, we know that it is also equally important to be aware of what other community services and resources are available to your family’s senior. Choose your location and find local resources for your senior.