In a perfect world, every Medicaid waiver beneficiary would have access to all necessary services regardless of the cost. Although that’s not the case, if you can successfully manage your Medicaid budget, you can stretch your services farther than you might think. Read on as we break down all you need to know about LA Medicaid waiver payments, budgeting, and more so you can maximize your benefits.
Understanding Your Medicaid Waiver Budget
First, it’s important to know that not all Louisiana Medicaid waivers are budget-dependent. On top of that, every individual’s benefits will be a bit different from the next waiver recipient’s. So, the first step in maximizing your benefits is to fully understand your Medicaid waiver budget. If you have a budget limit, note that. It’s also important to know what services you’re allowed to allocate your budget to.
To find all of this information, refer to your Plan of Care (POC) documents. If you don’t have them or can’t find them, reach out to your support coordinator or call the number on the back of your card for assistance.
Prioritizing Essential Services
Which services do you need the most? Think about this for a minute. Which ones sustain life or ensure your safety? Most of the time, the following services take priority:
- Personal care services
- Medical therapies
- DME and other equipment
Designating your most important services can be immensely helpful, especially in cases where your budget is on the lower side. Doing so reduces your chances of having to forego essential services.
Working with Your Support Coordinator
A lot of the time, beneficiaries aren’t well-versed in budgeting. Luckily, you aren’t in this on your own. Your support coordinator is your guide and safety net. You can talk to them about how you’d like to prioritize your services. They can also help with:
- Clarifying your waiver’s spending limits.
- Getting your POC revised if your needs change.
- Coming up with ways to stretch your Medicaid budget.
Tracking and Managing Your Expenses
Tracking and managing your expenses is a critical part of managing your Medicaid waiver budget. It involves keeping a tight record of the services you receive and any Medicaid waiver payments. To ensure that everything is in order, look at your monthly Medicaid statements and check all totals against your records.
What to Do If Your Needs Exceed Your Budget
After looking at your services and budget, you might come to a sobering conclusion – your budget is too low to cover everything. In that case, you have a few options to consider:
- Request a POC revision through your support coordinator.
- Explore alternative resources to fill any budget gaps – nonprofit firms, community-based programs, etc.
- Appeal unfair denials through Medicaid’s appeals process.
Lean on Your Support Coordinator
Regardless of where you are with budgeting, your support coordinator could be a big help to you. They can give you tailored budgeting advice, loop in your medical provider for perspective, clarify different aspects of your budget, and more. They act as the bridge between you and your benefits, and their goal is to help you get the services you deserve.
