Are you interested in home care for yourself or a loved one? Do you live in PA and have significant needs? The state may approve you or your family member for around the clock home care paid by Medicaid waiver plans. Plus, family members or friends could get paid to provide care for their loved one in need. Already approved for or receiving around the clock home care? Find an agency to care for yourself or your client in Philadelphia.
This blog is brought to you by Chosen Family Home Care . Chosen Family Home Care is Philadelphia’s highest paying home care agency for family caregivers and home health aides across the Philadelphia region. We also serve Harrisburg, Allentown, Lancaster, and Reading in Pennsylvania.
Does Medicaid Pay For Home Care In Pennsylvania?
Regular Medicaid will not pay for home care services in Pennsylvania. However, clients that apply for and are approved for Medicaid waiver almost always get home care services as a part of the goals of the program. These are in place to help keep individuals at home and living independently. Unsure if you have the Medicaid waiver? You might also know it under its managed healthcare plan name which is Community Health Choices (CHC) or you may know it by your healthcare provider name, including PA Health and Wellness home care services, UPMC home care services, and Keystone First home care under Community Health Choices (CHC).
How do these Medicaid Waiver programs work?
If someone wants to get onto the program, then they need to sign up for Medicaid waiver to start. Our guide here outlines the process in full from A to Z which is called Get Paid to Care For A Loved One In PA: A Guide . This details how one gets onto the program, which includes filling out a COMPASS application .
Once one applies, they will have to go through a variety of steps which include a doctor’s visit and in which the doctor needs to fill out a certification form. The applicant will need to submit financial information to ensure that they qualify for the program. They will also need to undergo several assessments along the way. Once they get through this, they will need to pick a healthcare plan that will administer benefits.
What are the health care plans in Philadelphia, PA?
The healthcare plans in PA that administer the program are all contracted under Community HealthChoices. These healthcare plans are going to either be Keystone First , which is the name of the plan administered by Amerihealth Caritas throughout the Philadelphia area (including Bucks, Chester, Montgomery, and Delaware county). In other regions of Pennsylvania, this is simply referred to as Amerihealth Caritas.
The other two plans will either be UPMC health plan or PA Health and Wellness .
What is Community Health Choices?
Community Health Choices, also known as CHC, is a Medicaid managed care program that will include physical health benefits and long-term services and supports (LTSS). Long term services and supports include a variety of supports such as home care services.
What are the health plans under Community Health Choices?
Health plans under CHC include the following: Keystone First services Philadelphia and the surrounding areas. Keystone First is also the most common plan utilized by home care clients and their family caregivers in Philadelphia, PA. Additional plans under Community HealthChoices include UPMC as well as PA Health and Wellness.
What healthcare plans does Chosen Family Home Care accept?
Chosen Family Home Care accepts PA Health and Wellness, UPMC, and Keystone First health plan in Philadelphia, Chester County, Delaware County, Montgomery County, and Bucks County.
Can I receive 24 hour home care services and have my family members be paid to care for me in Pennsylvania?
In many cases, yes. Individuals can get 24-hour home care services and have their family members get paid for it. That also includes friends or other paid caregivers. The choice is up to the person receiving services. Exclusions include spouses, legal guardians, and powers of attorney.
Will Medicaid Pay For 24 Hour Home Care in Philadelphia, Pennsylvania?
(This is also known as around the clock care in Pennsylvania).
Medicaid does authorize and approve 24 hour home care for its clients when it is deemed medically necessary. These clients include clients that have Medicaid home care services 24 hours a day and have family caregivers. They also include Medicaid clients in Philadelphia, PA that have home health aides or other caregivers assigned to work for them and provide them their care. However, you must keep in mind that most clients will not be approved for home care services at 24 hours per day. Clients that are approved for care are usually those clients that have significant care needs.
Is it hard to get approved for 24-hour care in Pennsylvania?
Generally speaking, it is a difficult process to get approved for 24-hour home care services in Pennsylvania under the Community HealthChoices program. However, the health plans can and do approve people to receive round the clock care. This is true even if you hire paid family caregivers to care for you.
This is true with anyone who has home care services. It is easier to get approved for a lower number of hours than it is a higher number of hours of home care services. For example, if someone is approved to get home care service, it will be easier to get 35 hours a week approved of paid care than it will be to get 84 hours a week of care.
