Medicaid Home Health Services

Medicaid is a health care program in the United States specifically targeted for low-income families.  There are specific conditions for eligibility for you to qualify for coverage.  It is under the Centers for Medicare and Medicaid Services, a division of the United States Department of Health and Human Services.  It is funded by the federal government, but the states have their own leeway in terms of rules regarding eligibility, scope of services, rates, and programs.  The groups served by Medicaid include citizens of the United States and resident aliens, including their children, and people with disabilities.  One of the biggest aspects of Medicaid is home health services.

Home care or home health services is health care provided in the patient’s home by healthcare professionals.  Its objective is to mainly make the disabled or the elderly remain at home instead of remaining in an institution.  It is estimated that most home care is rendered by family members, while there are others who have nurses or therapists to take care of them.   This can be paid for by Medicaid, long term insurance, or out of the patient’s own pockets.  Under Medicaid, states are mandated to cover nursing home care for eligible persons over the age of 21.   Again, they must be found eligible for this coverage under the state’s terms.  Federal regulations require that home health care include services such as nursing, home health aides, medical supplies and equipment, and appliances suitable for use in the home.

It has been noted that in recent years, the United States has experienced significant growth in terms of formal (care given by healthcare professionals) and informal (care given by family members) home care services for persons with mental and physical disabilities.  This growth can mainly be attributed to policy changes by the government regarding hospitalization stays, and the consumer’s preference on where to receive care as well.  Due to advancements in medical technology, patients are released from the hospital sooner, but follow-up care is necessary.

Section 2176 of the Omnibus Reconciliation Act (OBRA) of 1981, authorized waivers to provide expanded home care to Medicaid recipients with disabilities, especially when this condition would cause them more costly care.  This then, gave Medicaid the flexibility to come up with programs that enabled their consumers to remain in their own communities.  Although this has helped Medicaid to reach out to most of their insured, it is not without problems. Since states are given the freedom to come up with their own programs, they have often placed limitations on the amount of home care each Medicaid recipient may receive. Another problem is the availability of people who will administer health care.  Medicaid may be a major player in paying for health care needs, but lower reimbursement rates limit the number of professionals willing to provide care for those covered by Medicaid.

Persons with disabilities do need specialized home care, and community-based services.  Although Medicaid covers these services, there are still needs that need to be addressed in each state.  The people who provide care to these elderly and disabled are heroes in their own right, and help extended by Medicaid would let them be able to take a much needed break from rendering their services to these people.