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Medicaid LTC (Long Term Care)

Medicaid LTC (Long Term Care)

Medicaid Long Term Care For Florida State

The accurate planning for your health is necessary, therefore you’ll need to know about what is covered and what is not covered in the particular Medicaid Plans. There are various schemes or plans offered under the Medicaid Long Term Care and we will be discussing it in this article.

What’s Covered?

  • What is Medicaid?
  • Services Provided in Medicaid Long Term Care In Florida State
  • How To Get Yourself Enrolled Into This Program?
  • How Do I Choose A Long Term Care Plan?
  • The Eligibility Criteria for Enrolling Into Medicaid Programs

What Is Medicaid?

Medicaid in simple words is a joint federal and state government program for helping people with lower income, which may help them by paying some or all of their medical bills.

Medicaid covers the following things:

However, Medicaid is available for those families or individuals who meet the specified criteria below:

  1. Legal and permanent resident of the United States
  2. The family may include low-income adults and their dependents
  3. People with specific disabilities

Also, it is important to know that, Medicaid eligibility rules and services vary from state to state.

As we are based in Florida, we will focus on the eligibility rules and services covered by the Florida State.

In Florida, Medicaid recipients are enrolled in the statewide Medicaid Managed Care Program and it has three parts namely,

  • Long Term Care (LTC)

    This program provides Medicaid LTC services like care in a nursing facility, assisted living, or at home. To get LTC you must be at least 18 years old and meet nursing home level of care

  • Managed Medical Assistance (MMA)

    It provides Medicaid covered medical services like doctor visits, prescribed drugs, hospital care, mental health care, and transportation to these services.

  • Dental

    It covers all Medicaid dental services for children and adults. All people on Medicaid program must enroll in Dental plan.

Find Out If You Are Eligible For Medicaid Program In Florida?

Florida, is one of the income cap states, meaning in order to be eligible for the Medicaid Long Term Care benefits there is an income limit. Therefore, the income cap state requires the amount to be no higher than the limit specified at the time of application.

The three basic groups are eligible for the Medicaid Program,

  1. Children and families, including pregnant women
  2. Seniors (Aged 65 or Older) and People who are blind or disabled
  3. Recipients of Supplemental Security Income

Florida Medicaid Long Term Care provides two types of programs, namely,

  1. Medicaid for Aged and Disabled (MEDS-AD)
  2. Institutional Care Program

In order to qualify for Medicaid Program, you must be,

  • You must be a resident of the state of Florida
  • U.S National, Citizen or Have Satisfactory Immigration Status
  • Your financial situation must be categorized as very low income or low income.
  • Over the age of 64 (or)
  • Be Pregnant or child 18 or under (or)
  • Be disabled or blind (or) Have a child, spouse or parent in the household who is blind or disabled.

However, apart from this, you must have an annual household income (before taxes) must be less than or equal to the given amounts in the chart below to qualify for the program in Florida State:

Max. Annual Household Income for Medicaid Eligible.

For those households with more than 8 people then you can add an additional $5,878 per person. However, you can check up with the managing agency for more accurate guidelines.

What Services Are Provided Under Long Term Care Program in Florida?

The minimum covered services under this Florida Long Term Care Program are as follows:

  • Adult companion care
  • Intermittent and skilled nursing
  • Adult day health care
  • Medical equipment and supplies
  • Assisted living
  • Medication administration
  • Assistive care services
  • Medication management
  • Attendant nursing care
  • Nursing facility Behavioral management
  • Nutritional assessment/ risk reduction
  • Care coordination/ Case management
  • Personal care
  • Caregiver training
  • Personal emergency response system
  • Home accessibility adaptation
  • Respite care
  • Home-delivered meals
  • Therapies: occupational, physical, respiratory and speech
  • Homemaker Transportation, Non-emergency Hospice

To find out specified services covered under the Medicaid program in Florida state, you can go to the Agency For Health Care Administration page to check for the particular services covered.

How Do I Get Myself Enrolled Into This Program?

If you meet the specified criteria of Long Term Care Program then you’re automatically enrolled in the Long Term Care Program and you’ll receive available plans under this program from Choice Counselor by mail.

However, space is limited for the individuals who are wishing to receive services at home. If you’re one of those individuals aged above 18 years of age then you must be screened and placed on the waitlist of the long term care program before you’re enrolled in the program.

You can do the short screening over the phone easily by the Aging and Disability resource center which will give out a score and helps you in ranking you on the waitlist. Once you’re ranked and selected, the Aging and Disability resource center will call you for the enrollment process further.

How Do I Choose A Long Term Care Plan?

A choice counselor will help you in selecting the best care plan available as per your needs. To get details about the plan, you can simply head to Florida’s Medicaid Managed Care site to talk to the choice counselor or you can request an in-person visit from a choice counselor as well.

Keeping all aside, there are two requirements necessary to qualify for Medicaid.

  • General Requirements
  • Financial Requirements

Apart from these, you need additional functional requirements to qualify for Long Term Care Services.

Medicaid covers nursing home services for all eligible people aged above 21 years. Medicaid also covers services that help you remain in your house, such as personal care services, and help with laundry and cleaning, however, Medicaid will not pay for your rent, mortgage, food or utilities.

Conclusion

From this article, you learned the basic eligibility for the Medicaid Program in the Florida State. You also learned the ways to get yourself enrolled and the services offered by various plans of the Medicaid program. There is also an income chart attached, so you can know exactly if you’re eligible for the Medicaid program.

However, it is recommended to contact the customer service for Florida State Medicaid Program and know your eligibility right away more accurately.

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