It should come as no surprise that healthcare in the United States is expensive. This is why when it comes to long-term care for older adults, healthcare will no doubt be a financial burden for many families. However, this does not mean there is no help given to lessen this load for our loved ones. Across the country, there are many programs and financial aid provided to ensure that everyone has access to medical care and assistance in order to lead fulfilling lives. One of the more popular programs is the Medicaid Waiver Program, which is targeted at older adults looking to spend their retirement years in the comfort of their very own home instead of a nursing home. In this post, we look into the background of the Medicaid Waiver program and the different types available.
What Is Medicaid Waiver?
Most people may know about Medicare, but may not be as familiar with Medicaid. The thing is, Medicaid and Medicare are not the same. Medical is a federal program that allows people above the age of 65 to access healthcare services, whereas Medicaid is both a federal and state program that is only granted to individuals who belong to the low-income group and have limited resources to access medical services. Since Medicaid is a state program, the eligibility requirements may differ from state to state, so it is highly advised to research the program beforehand.
Now that you have a better understanding of the Medicaid program, a Medicaid Waiver simply refers to a practice that enables the government to waive certain rules in order to better meet the needs and requirements of specific individuals. For example, some older adults are looking to reduce medical costs, expand their healthcare coverage, or have the option to go for in-home care.
Types of Medicaid Waiver
There are four different types of Medicaid Waiver that everyone should know about. Do note that all states fall under two waivers – Sections 1115 and 1915.
- Section 1115
Section 1115 is commonly regarded as the Research and Demonstration waiver as this waiver enables states to come up with and experiment with new approaches to deliver Medicaid care to older adults. Before this waiver is approved, the budget should be neutral for the federal government, which means that the government should not have to fund more than if the waiver is not in place. Since the establishment of the Affordable Care Act, this type of waiver is especially popular among the people.
- Section 1915(c)
Section 1915(c) is known as the Home and Community-Based Services waiver. As the name suggests, this type of waiver allows states to provide in-home and community-based care to older adults, especially if they need or are under long-term care. Instead of spending their retirement years in a nursing home, older adults can look forward to residing at home or in a community-based setting like retirement communities.
- Section 1915(b)
Termed the Freedom of Choice waiver, section 1915(b) provides care to individuals through managed care delivery systems. These systems are managed by organizations that have contracts with state Medicaid agencies and are funded by the state Medicaid fund.
- Combined Section 1915(b) and Section 1915(c)
This is the unique waiver as by combining sections 1915(b) and 1915(c) together, states are given the authority to provide in-home and community-based care for qualifying adults by contracting with the managed care organizations as mentioned above.
