Medicaid Waiver Program for Home Care
Better Care Home Health Services is a family-owned agency dedicated to providing excellent and comprehensive home health care to individuals and families of Philadelphia, Delaware, Montgomery and Bucks counties. We are honored that God has blessed us with the opportunity to positively impact and change people’s lives. It is our mission to ensure that we provide the very best of care to our clients.
We offer an exceptional combination of home care and community-based social services. Our goal is to help your loved ones to continue to live safely and confidently in a familiar place they call home. Better Care provides care through caregivers who are trained and/or certified. We offer long-term, short-term, and live-in care.
Caring for an aging or disabled loved one at home can be immensely rewarding. But it also comes with challenges – from lifting and bathing to managing medications. You likely need support but don’t know where to start. Pennsylvania’s Medicaid waiver program provides a little-known option to access home care. This guide breaks down everything you need to know about enrolling your loved one and receiving services.
An Overview of Medicaid Waivers for Home Care
Medicaid waivers allow states to “waive” normal Medicaid rules to cover long-term care services at home or in the community. These programs aim to support individuals who prefer living at home versus in a nursing facility.
Pennsylvania’s Community HealthChoices (CHC) waiver combines three former waivers into one coordinated program. It serves older adults, individuals with physical disabilities, and those dually eligible for Medicaid and Medicare. All enrollees must demonstrate functional needs equivalent to nursing home level care.
CHC connects members to a managed care organization which oversees care planning and coordinates services, including personal assistance and nursing care at home. This model strives to improve access to services while reducing costs.
At Better Care Home Health Services, our team helps families navigate applying for CHC waivers. We answer questions and explain the process to access home care funding. Read on to learn more about eligibility, enrollment, and services covered.
Determining Your Loved One's Eligibility
To qualify for CHC waiver services, your loved one must meet clinical and financial eligibility criteria. Let’s break these down:
Clinical Eligibility
Your loved one will undergo an evaluation by a registered nurse to determine their need for a nursing facility level of care. The nurse will assess:
- Medical diagnoses and related functional limitations
- Ability to independently perform activities like bathing, eating, dressing
- Need for assistance with skilled nursing care or managing complex health conditions
Financial Eligibility
They must also meet Pennsylvania’s Medicaid income and asset limits:
- Income less than $2,349/month for an individual or $4,551/month for a married couple
- Assets less than $8,000 for an individual or $12,000 for a couple after allowances
If your loved one exceeds these limits, some options like spend downs are available. We can advise whether they may still qualify.
Providing Medicaid Waiver Services in Philadelphia, Germantown, Glenside, Elkins Park, Bryn Mawr, Roxborough, Wyncote, Broomall, Upper Darby, Yeadon, Lansdowne, Narberth, Wynnewood, Penn Wynne, Fairmount, Ardmore, and Chestnut Hill. We service all of Delaware, Bucks, and Montgomery Counties.
Becoming an Approved Family Caregiver
If your loved one qualifies for CHC waiver services, you may have the option to become their paid caregiver if you meet requirements:
- Must be 18+ years old
- Pass background checks
- Complete training on care tasks
- Cannot be the spouse or legal guardian
Approved family caregivers are hired and paid by a home care agency. The agency bills the CHC program for services you provide. This gives you ongoing support while bringing in income.
Better Care Home Health Services is a family-owned agency dedicated to providing excellent and comprehensive home health care to individuals and families.
Better Care Home Health Services offers an exceptional combination of home care and community-based social services. Our goal is to help your loved ones to continue to live safely and confidently in a familiar place they call home.
Long-Term Care Options Through Managed Care
Pennsylvania contracts with three managed care organizations to provide CHC waiver services:
AmeriHealth Caritas
- Care management to coordinate services
- 24/7 nurse hotline
- Large network of providers
PA Health & Wellness
- Personal community guide to assist with accessing care
- Caregiver support and education programs
- Transportation assistance
UPMC
- Option for seniors to keep current doctors
- Extensive telehealth services
- Prescription home delivery
Review the unique benefits of each plan to make the best selection for your loved one. The chosen plan will manage and authorize services, so select one you feel most comfortable with.
Becoming an Agency Provider With the Waiver Program
At Better Care Home Health Services, we are proud to be contracted providers with Pennsylvania’s CHC waiver program. This allows us to deliver high quality care to members and receive reimbursement for services covered by their plan.
To become an approved provider, our agency completed these steps:
- Applied and was credentialed with the three CHC health plans
- Passed background checks and quality standards
- Signed provider agreements
- Received training on CHC program protocols
- Set up billing procedures through each health plan
We are now able to directly provide personal care, home health aide assistance, nursing care, and more to CHC members. Our team regularly engages with each member’s care manager for coordination.
As an approved provider, we can deliver services reimbursed by the waiver program and simplify access to care.
The Process Step-by-Step
Follow this process to become an approved family caregiver through CHC:
- Loved one enrolls in the CHC waiver program
- Get hired by a home care agency as caregiver
- Complete training and onboarding
- Agency adds you to care team
- You provide approved care hours
- Agency bills CHC plan for your services
- You receive paychecks for hours worked
The Benefits of Becoming a Paid Family Caregiver
Opting to provide paid care through CHC offers many benefits:
- Income to offset lost wages from caregiving
- One-on-one time with your loved one
- Training to improve care skills
- Oversight from agency case managers
- Peer support and resources
- Scheduled breaks when needing time for yourself
- Knowledge that you’re making a difference as a compassionate caregiver
At Better Care Home Health Services, we empower family caregivers to provide fulfilling care while getting support.
Finding the Right Services for Your Situation
If your loved one requires at-home care but you feel overwhelmed navigating options, Better Care Home Health Services can help. Our team guides families through every step of understanding eligibility, enrolling in the waiver program, and coordinating approved services.
We simplify the process so your loved one can access the care they need. Our personalized assistance also provides you respite and peace of mind. Don’t hesitate to reach out to us to learn more about Pennsylvania’s Medicaid waiver program for home care.
We start a client relationship by providing a free consultation where together we can explore your individual needs and offer the most helpful and appropriate care plan.
