Medicaid waivers could very well transform your life. These programs broaden access to essential services and support and are tailored to people with medical issues beyond what traditional Medicaid covers. The goal is to help you live and thrive at home or in a community-based setting.
But before pursuing a waiver, it’s important to become adequately informed, and that’s how we’ll help. In this article, we’ll focus on the financial aspects of Medicaid waivers. By the end, you’ll have some concrete information you can use along your waiver journey.
How Medicaid Waivers are Funded
Medicaid waivers are funded through two sources: the Centers for Medicare and Medicaid Services (CMS) and your local state government. The funds are primarily used to build out the waiver program and pay for the services and supports recipients need.
Waiver Recipient Costs
Medicaid waivers don’t typically cost you anything as the beneficiary. But remember that waivers vary widely by state, so it’s essential to check with your local Medicaid office for more information. You don’t want to be blindsided by surprise premiums or copays.
How to Manage and Plan for Waiver Costs
Managing and planning for waiver costs is something every potential waiver beneficiary should consider. Though waivers provide very broad coverage, there may be gaps that you need to fill to obtain comprehensive care for yourself or your loved one. Here are a few ways to keep your waiver costs in check:
- Keep an eye on state-specific resources that apply to services the waiver program doesn’t cover.
- Speak to your support coordinator about your financial situation and see if there are any mitigation options to explore through Medicaid.
- Participate actively in your care plan along with your support coordinator to ensure that it best covers all necessary bases. That way, you won’t find yourself trying to fill so many care or service gaps through other means.
Main Financial Benefits of Medicaid Waivers
Medicaid waivers are a financial lifeline for those with certain medical problems requiring ongoing care. Here are a couple of the main waiver benefits pertaining to finances:
- Money savings: Simply put, Medicaid waivers cover many essential services and support costs that would have been out-of-pocket. Depending on your needs and the waiver you qualify for, you could receive substantial financial assistance for home and community-based services like activities of daily living (ADLs), nursing care, respite care, adult day health care, and more.
- Provider Flexibility: With a Medicaid waiver, there’s greater flexibility concerning who provides your care and supports. This empowers you to shop around for more affordable services to stretch your healthcare budget. Traditional Medicaid healthcare options can be much more restrictive.
Misconceptions That Simply Don’t Apply
There are several misconceptions floating around when it comes to Medicaid waivers. Below, we’ll cover two of the biggest ones and debunk them:
- You won’t qualify for a waiver if you don’t meet Medicaid’s income guidelines. Many states have measures in place to help certain non-income-eligible people get the help they need via a Medicaid waiver. In Louisiana, there’s the Medicaid Spend Down program.
- Medicaid waiver benefits are minimal. Often, Medicaid waivers offer comprehensive benefits to support people holistically.
Reach Out to a Support Coordinator in Louisiana
LA Medicaid Support coordinators are an invaluable resource for people looking to get started with a Medicaid waiver. They’ll help you navigate the world of Medicaid, handle paperwork, answer questions, and more. They’ll do everything they can to match you with the best waiver for your situation.
