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Medicaid waiver programs cover in-home care costs for eligible Nebraskans

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Deborah Van Fleet

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(Nebraska News Connection) Many Nebraskans age 65 and older with health limitations, as well as younger people living with a disability, want to remain in their own homes.

Medicaid's Home and Community Based Services Waiver programs can make it possible.

Stephanie Hoyt, who supervises the Medicaid Aged and Disabled Waiver program at the Eastern Nebraska Office on Aging, said it waives the fees for in-home support. Medicaid-eligible Nebraskans ages 18 to 64 with a disability, and those over 65 who require nursing home-level care, are eligible based on certain qualifications.

"It's a combination of personal care assistance, cognition, risk factors, and medical," Hoyt outlined. "Those are the four different areas that make up needing nursing facility-level care."

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Hoyt pointed out the services used most often include a medical alert system and basic personal care assistance, such as help with bathing, dressing, eating and mobility. Some people can receive cleaning, laundry, shopping and meal prep assistance. Applications are made with the Nebraska Department of Health and Human Services, and the state's Area Agencies on Aging administer the program.

Medicaid waivers are also available for developmental disability and traumatic brain injury. Hoyt explained someone whose spouse or other family member provides support can still qualify for the waiver program.

"If the spouse is there and able to do it, but also wants to be able to go and have lunch with friends one day, or to be able to go to their doctor's appointments, then there's still a need because one person can't do everything for another person," Hoyt observed. "They still have to be able to take care of themselves, or they're no longer support."

She pointed out married couples may have to go through a spousal impoverishment process in order for the spouse needing care to qualify for Medicaid.

Hoyt added some non-spouse family members even qualify to receive pay for their caregiving.

"Sometimes they'll quit their work and get approved as an Aged and Disabled Waiver Provider," Hoyt noted. "Then they get paid to provide a certain amount of hours to supplement some of that income if they've had to leave work."

Medicaid waivers can also help people with the cost of assisted living once they qualify for Medicaid if the facility accepts the waiver. Hoyt said sometimes people improve enough while in a long-term care facility to move back home with Medicaid Waiver services.