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What Types of Long-Term Care Services Does Medicaid Cover in Orlando, Florida?

Having the resources to afford long-term care is a valid concern for many senior citizens. The monthly cost for a nursing home or assisted living facility is thousands of dollars. If you opt for in-home care, it can be easily as expensive, if not more. Most people cannot afford the monthly cost on their own, which is where Medicaid coverage can be crucial. However, there are very stringent eligibility guidelines, including income and assets under a certain amount. To learn more about Medicaid in Florida, contact our Orlando elder law attorneys at the Law Offices of Shea A. Fugate, P.A. today.


Coverage for Nursing Home Stays


People who need nursing home care could benefit from Medicaid if they meet the requirements. Medicaid applicants need to have a medical necessity that requires nursing home care to maintain their well-being. For example, Medicaid requires you to have a significant functional disability and need continued assistance of others to take care of themselves and complete their daily living activities.


Assisted-Living Facilities


Assisted living facilities (ALFs) are also called personal care homes (PCHs) in some places but are generally not covered by Medicaid benefits. These are typically less expensive than nursing homes. One reason why is they are not as medically intensive as nursing homes are. Medicaid won’t cover the room and board for an ALF, but they may help with other costs related to your stay. For example, if you needed therapy sessions or medical equipment not covered by your monthly room and board fees, Medicaid might pay for this. If someone is receiving SSI benefits, there may be a way that Medicaid would provide a supplement that is paid directly to the facility to afford the ALF.


Medicaid Waiver and In-Home Health Care


For someone who doesn’t want to be in a nursing home, Medicaid might provide coverage if they have a Medicaid waiver. Florida’s Medicaid waiver will help the permanently disabled and the elderly. Its purpose is to allow someone who is at risk to be moved to a nursing home to remain in their home or live in the home of their caregiver and receive assistance there.


This option can provide a wide variety of support and benefits to the person needing assistance, as well as to their family members and primary caregivers. These include personal care and adult daycare. There may be a home modification budget allowance as well.


The Medicaid waiver is similar to Florida’s Nursing Home Diversion (NHD) Waiver, but with two distinct differences. The state provides Medicaid benefits, whereas NHD services are through managed care organizations. The Medicaid waiver is open to anyone under 65 provided they have a disability, whereas the NHD waiver has a strict eligibility requirement of 65 and older.


Contact an Orlando Elder Law Attorney


If you have questions on long-term care planning in Florida, let our skilled Orlando elder law attorneys help. Contact the Law Offices of Shea A. Fugate, P.A., today to schedule an initial consultation.

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