Does Medicaid in Fayetteville Pay for In-Home Care?

The costs of long-term care can be staggering for many Arkansas families. Generally, families must pay for long-term care through their own funds, long term care insurance or government benefits such as Medicaid or Medicare. However, some families must spend their personal money before benefiting from certain income-based government programs.

What is Medicaid in Fayetteville?

Medicaid is an assistance program that serves low-income individuals regardless of age. Medical bills are paid through federal, state and local tax funds and the patients usually do not pay any of the costs for covered medical expenses. A small co-payment may be required in some instances.  Medicaid is a federal-state program, meaning that it is run by state and local governments within federal guidelines.  Therefore, the specific requirements of the program vary from state to state, including the rules for eligibility and the types of benefits offered. Most states offer coverage for adults with children below a certain income level, pregnant women, certain seniors and people with disabilities.

What is considered home health care?

Home health care is generally less expensive, more convenient and equally as effective as the medical care you can receive in a hospital or skilled nursing facility.  Home health care covers a wide range of services and can often delay the need for long-term nursing home care, which is a plus.

Additionally, home health care can often include occupational and physical therapy, speech therapy and even skilled nursing. It may involve helping the elderly with activities of daily living such as bathing, dressing and eating. Or it may include assistance with cooking, cleaning, other housekeeping jobs and monitoring one’s daily regimen of prescription and over-the-counter medications.  All of these services allow seniors the opportunity to live independently for as long as possible, despite the limits of their medical condition.

Medicaid Covered Services

Although Medicaid pays for a wide range of medical services, it does not cover all services.  Also, many benefits have limits, especially for adults, which can be either annual or monthly.  In order to qualify for certain services, you may need approval or authorization from your primary care physician (PCP).

Home Health Services Through Medicaid

Medicaid will pay for some services to be provided in your home by a home health care worker or nurse, but only if a doctor says the home care services are actually needed for specific medical reasons.  It is your doctor who will determine what level of care you require. In some cases, Medicaid needs to approve the services ahead of time, and imposes limits on home services and supplies.  In Arkansas, coverage is limited to 50 visits per year.  Only specified medical equipment is covered and medical supplies are covered up to $250 each month.

Hospice Care Through Medicaid

Hospice services are for people who are very ill and are not expected to live much longer. Instead of trying to make a person well, hospice care makes the person as comfortable as possible. This type of care is usually provided in the patient’s home, or sometimes in a hospital or nursing home. Medicaid does pay for hospice services.