Is the Nursing Home My Only Option?

For most older adults and their families, making the decision to leave home and move into a care community is difficult and emotionally draining, even under the best circumstances. The situation is only made worse when the decision is made in the midst of financial pressures. When a person's care needs are overwhelming, living alone may not seem like a viable option. In fact, many seniors believe that moving into a long-term care facility is their only option.

Fortunately, thanks to the Georgia Medicaid waiver program, seniors now have another option.

Most states offer Medicaid waiver programs, which help people who are elderly or have disabilities and need help to live in their home or community instead of an institution such as a nursing home or intermediate care facility for people with intellectual or developmental disabilities.

The state of Georgia's Medicaid waiver program is called the Elder and Disabled Waiver Program, and it's designed to help older adults remain living in their homes by providing home care services. The type of services that the Elder and Disabled Waiver Program provides is determined on a case-by-case basis, and program participants are given the ability to select from whom they receive these care services – as long as providers are qualified and willing to accept Medicaid payment. Among other services, a participant may receive adult day care, home delivered meals, home health care, respite care, and/or personal support services like housecleaning, shopping, meal preparation, etc.

Like with everything in life, eligibility for this program does not come without a catch. To qualify, you must meet strict income and asset limitations. These income and asset limits correspond with those required to qualify for nursing home Medicaid. If you are single, you must have less than $2,000 in assets in your name. If you are a couple, then you may have up to $125,600 in assets ($130,380 for the community spouse and $2,000 for the ill spouse). The main difference between the Elder and Disabled Waiver Program and nursing home Medicaid when it comes to finances is that the Elder and Disabled Waiver Program will allow you to keep more of your income each month than you can with nursing home Medicaid. The reason for this is obvious when you look at the living situations. In the nursing home, all of your expenses are covered (rent, utilities, etc.); however, when someone remains at home, the state of Georgia understands that you need more than just care to survive.

Finally, not everyone who meets the financial criteria is qualified. You must also require a nursing home type level of care. This means that you must show that you need help with at least two activities of daily living (such as bathing or dressing). The tricky part here is that this need must be caused by an underlying health condition, not just old age. Alternatively, a cognitive impairment such as dementia may qualify you for the Elder and Disabled Waiver Program services.

If you believe that you meet these criteria, you do not wish to leave your home, and you have a strong support system, the Elder and Disabled Waiver Program may be a great match for you. To learn more about how to make this program work for you, please come see us at Kimbrough Law.