PROGRAMS (Waivers)

Favorite Home Care can help you obtain a waiver for home care services.

As of January the 1st 2020, the so called ‘Waiver programs’ have been substituted and handed over to the insurance companies. The good news is that they provide the same services and perhaps in a friendlier customer service manner.

The waiver programs have been voided, and no longer exist in the system of the Department of Home and Community Based Services:

  • Act 150;
  • Aging Waiver;
  • Commcare Waiver;
  • Obra Waiver;
  • Attendant Care Waiver and Independence Waiver;
  • ODP Program.

The below described insurance companies are the key players on the market in the State of Pennsylvania. We encourage our clients to visit their websites and better understand the eligibility criteria. We also are there to help you navigate comprehensive processes and provide detailed explanations. Each insurance company has a plan that matches the client’s needs and assessment. Our staff at Favorite Home Care Agency is experienced and knows in-depth the requirements and advantages of each individual care-plan(s). For more information, please visit:

Eligible Insurance Providers

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FAQ

Home care encompasses a variety of services designed to support clients of all ages, spanning from children to seniors, as they enjoy the familiarity and comfort of their own homes. Whether recuperating from a hospital stay or proactively seeking to avoid hospitalization, our certified caregivers deliver personalized care, empowering patients to sustain their independence and uphold their desired quality of life.

Home care waivers, also referred to as waiver funded services, are state-level programs tailored for individuals seeking long-term care while preferring to stay within the familiar confines of their own home. These programs, supported by Medicaid, necessitate adherence to specific eligibility criteria and completion of an application process.

A person must:

  • Have a medical need for long-term care services — A doctor must complete a form telling the department of the medical need. This form is then reviewed by a department-approved agent. The agent will tell the county assistance office if services are needed.
  • Be a U.S. citizen or a qualified non-citizen
  • Be a resident of Pennsylvania
  • Have a social security number

For one person:

  • If your income is below or equal to 300 percent of the FBR (currently $2,130), the resource limit is $2,000 with an additional $6,000 resource disregard.
  • If your income is above 300 percent of the FBR (currently $2,130), the resource limit is $2,400.
  • Many individuals pay for LTC with personal funds and eventually reduce their resources to the Medicaid LTC limits.

Most income is counted, including:

  • Social security
  • Pensions
  • Interest and dividends from savings and investments
  • Rental income
  • Withdrawals from an IRA
  • Income Limits (for one person)
  • For non-money payment (NMP) categories, the limit is 300 percent of the federal benefit rate (FBR), which changes annually. For 2013, the individual income limit is $2,130.
  • For medically needy only (MNO) categories, the limit is $2,550 (semi-annual net income)
  • If your income exceeds 300 percent of the FBR limit, the anticipated cost of long-term care facility services for a 6-month period is an allowable medical expense deduction to reduce monthly income.

Examples of resources that are counted:

  • Bank accounts
  • Stocks, bonds, and mutual funds
  • IRA and Keogh accounts
  • Non-resident property
  • Cash value of life insurance — if the face value of all policies is greater than $1,500 per person (the first $1,000 of cash value is excluded)

Examples of resources not counted:

The home:

  • If the value of the home is less than or equal to $525,000 and you intend to return to the home or are residing in it
  • If a spouse or dependent resides in the home
    One motor vehicle
    All burial spaces/plots including those with a marker
    Revocable and irrevocable burial reserves subject to specified limits


NOTE: The resources of a parent who is applying for or receiving HCBS and is living with their child who is under the age of 21 are excluded.

Any asset that was transferred, sold, or given away within the past 60 months (look-back period) must be reviewed by the county assistance office when a person applies for Medicaid long-term care. The look-back period is determined by the date a person is admitted to an LTC facility or assessed eligible for HCBS and has applied for Medicaid long-term care.

For more information about home care qualifications please visit the Department of Human Services website here.

Also, if you are not sure if you qualify for Medicaid the American Council on Aging now offers a free, quick and easy Medicaid eligibility test for seniors that you can take here.

Not all consumers receive the same number of hours. In fact, there are often vast differences between consumers in the number of hours for which they are approved. Usually, your Medicaid Managed Care Organization (MCO) will make the final determination on how many hours of care you will receive coverage for.