What programs are available that may help pay for your services?

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What programs are available that may help pay for your services?

Medicare and Private Health Insurance Policies (Blue Cross, Geissinger….)

Medicare and private insurances pay for in home care only when there is an acute issue that they can treat. Services are provided by a Registered Nurse, Physical Therapist, Occupational Therapist or Speech Therapist with intermittent support by a personal care aide if necessary. These services are temporary (until the acute issue has resolved) and the patient is capable of managing their condition long term on their own. The services are rendered under a doctor’s order. The patient must be homebound. These services never include homemaking, laundry, errands, meal preparation and the like. Lori’s Angels is not a skilled agency and does not provide home care services covered by Medicare or private health insurance policies.

Schuylkill County Office of Senior Services http://www.co.schuylkill.pa.us/offices/humanservices/seniorservices/seniorservices.asp

The Office of Senior Services provides a variety of services including information and referral, care management, caregiver support, pre-admission assessment, placement services, protective services, ombudsmen, employment, outreach, senior center services at 5 sites, transportation, home delivered meals, adult day care, legal services, health insurance information and assistance and volunteer services as well as in home assistance. The in home assistance program is known as the Options Program. Options services are considered long term care and include personal care services and often homemaking support. While Options is based on physical need, it is also based on financial eligibility. Whether or not you qualify for financial assistance for in home assistance, it is always good to meet with OSS to learn what services are available to you. Lori’s Angels is a contracted provider of Options services in Schuylkill County. It is always the consumer’s choice as to which agency provides their care. We hope you will select Lori’s Angels as your service provider!

The Schuylkill County Office of Senior Services, 570-622-3103 or toll free 1-800-832-3313, is the best place to start if you are looking for assistance with payment for services.

Medicaid Waiver Program

The Medicaid Waiver Program is a program for nursing home eligible consumers who choose to have their care provided in their own home. Consumers must have Medicaid as their primary insurance or Medicare as their primary insurance with Medicaid as their secondary insurance. The programs are “Means tested” meaning your income and assets will be assessed to determine your eligibility for the MA Waiver programs. The term Medicaid Waiver comes from the fact that all Pennsylvanians are “entitled” to nursing home care but not home care. By being eligible for nursing home care, the consumers, under this program, waive their right to nursing home placement and choose instead to have care provided in their own home. There are several MA Waiver programs available to residents of PA. Aging, Independence, OBRA, CommCare, Attendant Care/Act 150, Consolidated and Fee for Service are programs that Lori’s Angels participates in.

MA Waiver services are programs managed through the PA Dept. of Human Services (DHS) and PA Dept. of Aging (DPW) under the umbrella of the Office of Long Term Living (OLTL) Home and Community Based Services (HCBS). To begin the Medicaid Waiver application process and request to apply for services call the PA Independent Enrollment Broker (IEB) at 1-877-550-4227. This is a private company contracted with OLTL to initiate the admission process.

  • The IEB will schedule an intake visit at your home within 7 days.. They will assist you in the completion of the application. They will then contact your doctor to certify the application. You will also be given the opportunity to select a service coordinator (SC) at this time.

  • Within 90 days the IEP will coordinate with your doctor, the county assistance office (CAO) and OLTL to approve or deny your application. The IEB will provide this notice to you in writing.

  • If you are approved, the SC that you selected will contact you to discuss your eligibility and assist you in establishing a plan of care and choosing an independent service provider for that care. Lori’s Angels is an approved independent service provider for home and community based services. It is always the consumer’s choice as to which agency provides their care and we hope that you will select Lori’s Angels as your provider.

  • If you select Lori’s Angels, please call us at 570-385-8450 or toll free at 1-877-264-3505 or you may have your service coordinator (SC) contact our office for you. We will schedule the services you want at the times you request. You will always have direct control over your services.

Independent Enrollment Broker (IEB) Application & Approval

Service Coordinator (SC) Coordinator of Benefits

Provider (Lori’s Angels) Provides aides for in-home care

Veterans Services

The Veterans Administration will, under certain circumstances, pay for long term home and community based services. These services include non-medical home care for the veteran or their spouse. For information on the services they can provide and how to apply for those services call toll-free, 1-877-222-VETS (8387), Monday through Friday, 7 a.m. to 7 p.m. (CST). Or, contact your VA social worker. Lori’s Angels can provide non-medical home care services for veterans through this program.

#Services #Payment #Programs #Waiver

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