At Granny’s Helpful Hands,LLC we understand that seeking professional care for you or a loved one can be difficult, and navigating the Medicaid system can be overwhelming. We are here to help. Granny’s Helpful Hands, LLC has earned a reputation for our dedication to customer service and for the quality of our healthcare professionals. We’re committed to making healthcare more responsive and effective every day.
What is Medicaid?
Medicaid is a state administered health program for eligible individuals and families with low incomes and resources that are jointly funded by both the state and federal government through The Center for Medicare & Medicaid Services. It offers coverage for necessary inpatient and outpatient medical care, nursing facility services for children under age 21, rehabilitation and physical therapy services, and home and community-based care to certain persons with chronic conditions.
Who is Eligible for Medicaid?
• Low-income individuals and families who fit into select eligibility groups as recognized by federal and state law, including:
• Pregnant Women
• Children and Teenagers
• Individuals 65 and older
• Individuals who may be blind and/or disabled
• Individuals leaving welfare
• Families with children under the age of 18 as well as limited income and resources
• Individuals/families with high medical bills that cannot be paid (must also meet other Medicaid eligibility)
The regulations for counting your income and resources vary from state to state and from group to group. There are special rules for those who live in nursing homes and for children with disabilities living at home.
What is Covered?
“Mandatory” Items and Services Covered under Medicaid:
• Physician services
• Laboratory and x-ray services
• Inpatient hospital services
• Outpatient hospital services
• Early and periodic screen diagnostic, and treatment (EPSDT) services for individuals under 21
• Family planning
• Rural and federally-qualified health center (FQHC) services
• Nurse midwife services
• Nursing facility (NF) services for individuals 21 or over
“Optional” Items and Services Covered under Medicaid:
• Prescription drugs
• Clinic services
• Dental services and dentures
• Physical therapy and rehab services
• Prosthetic devices, eyeglasses
• Primary care case management
• Intermediate care services facilitated for the mentally retarded (ICF/MR)
• Inpatient psychiatric care for individuals under 21
• Home healthcare services
• Personal care services
• Hospice services
PRIVATE PAY(Out of Clients Pocket)
Insurance plans often have restrictions and limits. If your insurance does not cover the services you need, or discontinues payment for services sooner than you are ready for or expect, you are generally left to pay the difference ‘out-of-pocket.’ Private Pay, also referred to as ‘out-of-pocket payments’, helps to cover the difference in situations such as this.
Outside help paying for in-home care services is limited and usually covers only short-term home health care needs. Paying privately for home healthcare services is often a necessary option for individuals who want to remain living independently in their homes. Since Medicaid and Medicare typically do not pay for Long-Term Care, the burden of payment becomes that of the individual or their extended family. Individuals using insurance, such as Long-Term Care Insurance, are considered ‘private pay’ since they are not being covered by a government program.