Ability to Get Care Costs Provided at Home Hastened by the Affordable Care Act

Most people who need chronic care would usually prefer to live at home than in a nursing home. However, the Medicaid program is “institutionally biased” as it is easier to get care provided by Medicaid in a nursing home than at home or in an assisted living facility. There is different Medicaid programs (each with its own rules) for coverage in the community. However, there is often a one to three year wait to get coverage (and that also assumes Medicaid eligibility).

To bypass this lengthy waiting period, some Texans use the “Money Follows the Person” program which previously allowed a nursing home resident who lived in the facility for six months and qualified for Medicaid to bypass the lengthy waiting period. Under the Affordable Care Act (“Obamacare”), the bypass period under the “Money Follows the Person” program has been reduced from six months to 90 days. So, if one is willing to live in a nursing home assuming such person is qualified for Medicaid, then the person can return home after getting qualified for Medicaid and living in the nursing home for as short as 90 days and obtain Medicaid coverage at home whereby the state pays someone to come to the Medicaid recipient’s residence to provide care in addition to getting drug coverage. It also is applicable if the nursing home Medicaid recipient transfers to an assisted living facility that accepts Medicaid.

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