14 Jan Will Medicaid Pay For 24 Hour Home Care in PA?
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.
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 HealthChoices (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 HealthChoices (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 HealthChoices?
Community HealthChoices, 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 HealthChoices?
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.
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.
What types of clients get 24 hour home care paid by Medicaid in Pennsylvania?
The following is an example of the types of clients that could get approved for 24 hour around the clock home care in PA through Medicaid. This list is just an example and just because an example is listed below does not mean the client will be approved.
- 24 hour care for dementia clients
- 24 hour care for bedridden clients
- 24 hour care for cancer patients
- 24 hour care for Alzheimer’s patients
- 24 hour care for disabled individuals and disabled adults
- 24 hour care for the elderly and seniors
How many home care hours could I be approved for by Medicaid in PA?
Medicaid (Community HealthChoices) can approve a wide range of hours in Pennsylvania. Clients may receive as little as a few hours per week and as many as 24 hours per day. While it is far from guaranteed, clients are often approved in one of the increments listed below:
- 21 hours per week of home care (3 hours of home care services per day)
- 25 hours of home care per week
- 28 hours of home care per week (4 hours of home care per day)
- 30 hours of home care per week
- 35 hours of home care per week (5 hours of home care per day)
- 40 hours of home care per week
- 42 hours of home care per week (6 hours of home care per day)
- 49 hours of home care per week (7 hours of home care per day)
- 56 hours of home care per week (8 hours of home care per day)
- 63 hours of home care per week (9 hours of home care per day)
- 70 hours of home care per week (10 hours of home care per day)
- 84 hours of home care per week (12 hours of home care per day)
- 126 hours of home care per week (18 hours of home care per day)
- 168 hours of home care per week (24 hours of home care per day)
Do I have to use a home care agency? Will Medicaid pay for home care services directly to a caregiver (including family caregivers)?
Medicaid with Community HealthChoices will not pay home care services directly to a caregiver or home health aide.
Since Medicaid or the major health plans will not pay a family caregiver or home health aide, a family caregiver or home health aide must choose a home care agency such as Chosen Family Home Care (which pays $15 an hour as the best paying home care agency in Philadelphia) and be employed by that home care agency.
Do the Community HealthChoices health plans pay home health aides or family caregivers directly?
Community HealthChoices is an extension of the state of PA as they are contracted to administer home care services to participants. Therefore, they follow the same guidelines as the state. Home care agencies are therefore contracted directly under local health plans. In Philadelphia, those include Keystone First, UPMC, and PA Health and Wellness. Therefore, as previously mentioned, family caregivers and home health aides are hired directly through an agency.
How much do home care agencies pay to family caregivers in Philadelphia, PA?
Home care agencies in Philadelphia pay an average of $11 to $15 per hour in the Philadelphia, PA region. Chosen Family Home Care has researched this extensively to come up with the pay range of home care agencies in Philadelphia.
Do home care agencies in Philadelphia, PA pay overtime?
Some home care agencies will allow overtime. Others will not allow overtime. However, if a family caregiver has a regular schedule of more than 40 hours per week, agencies will adjust pay rates to accommodate for having to pay an overtime rate which is 1.5 times the regular pay rate.
What is the best paying home care agency in Philadelphia, PA?
Chosen Family Home Care did plenty of research across Philadelphia to make sure they were the highest paying home care agency in Philadelphia. The $15 guarantee means that Chosen Family Home Care pays $15 per hour. If the caregiver works a regular schedule of more than 40 hours per week, that caregiver will earn an adjusted rate (lower regular rate plus overtime rate at 1.5 times the pay rate) which averages $15 per hour. Call or text Chosen Family Home Care at 267.457.4122.
Does Chosen Family Home Care allow overtime?
If the family caregiver home health aide or client has approved hours that exceed 40 hours per week, that caregiver will earn an average of $15 per hour. That means that their regular rate will be lower than $15 per hour but that the caregivers will make 1.5 times their regular rate for overtime hours (hours that exceed 40 hours per week), effectively increasing the overall pay rate.
Does Chosen Family Home Care and other agencies offer benefits?
The best home care agencies will offer an extensive set of benefits. Be sure to check with an agency directly to see whatever they offer. However, the best agency in Philadelphia, Chosen Family Home Care, offers benefits that include paid time off, paid holidays, major medical healthcare insurance, a sign on bonus when starting services, weekly pay, and a 401k retirement plan. Contact Chosen Family Home Care today at 267.457.4122 and start the switch to our agency today!
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