Qualifying for Home Aid

Home aid can be a lifesaver for individuals with physical and mental health limitations. However, this type of additional medical assistance can be expensive and exceed the budget of most individuals on disability benefits. The good news is that you could qualify for home aid if you meet certain requirements.

Types of Home Aid

Home health care is exploding in popularity, availability and affordability, especially these days during the pandemic. In-home care has a variety of applications and purposes in both a medical and non-medical capacity. From a medical perspective, home aids can assist with medical care in the home, so that someone with a disability does not have to visit a doctor’s office. This might include physical therapy, medicine administration, taking vitals, wound treatments and more. The non-medical related assistance can range from bathroom and meal assistance to walking and dressing.

This industry and the types of services offered are growing each year. Today, some people can even receive lab work at home, pharmacies can deliver equipment and medications and dietitians can come to your home to help create and implement appropriate meal plans. And some insurance covers the cost of a companion.

Eligibility for Home Aid

However, it is important to understand that a universal home healthcare policy does not exist as part of your SSDI benefits. Each case is unique, and the type of assistance one qualifies for is specifically dependent upon the disability and the level of severity of the disability. Someone who is approved for Medicare or Medicaid could potentially qualify for in-home care. However, the benefits an applicant receives must meet the requirements.

According to Medicare.gov, to qualify for Home Aid, the requirements include: Being under the care of a doctor, and you must be getting services under a regularly reviewed plan of care with a doctor, you are homebound, and the doctor must certify that you need one or more of the following:

• A certified need for intermittent skilled nursing care (other than drawing blood)
• Physical therapy, speech-language pathology, or continued occupational therapy services

Individuals who are considered to be homebound by the definition of Medicare or Medicaid will typically be approved for home aid assistance. These individuals will have to verify (and have certified by their doctor) that to leave their home, they require assistance with walking, use a wheelchair or have had a doctor state that it is dangerous for the individual to leave their home. Eligibility can also be approved if you require skilled care on an intermittent basis, such as speech therapy, occupational therapy or physical therapy. At the end of the day, you will require a note from your doctor stating that homecare is essential.

Learn the Process for Getting Home Aid

Medicare and Medicaid have strict policies regarding the type of home care deemed necessary, and the type and extent of care will vary based on each individual. It is important to understand the process before you hire someone. In most states, the approved care is free. Keep in mind that only the care you have been approved for will qualify and be covered. Therefore, it is essential that you know the types of services for which you qualify, such as personal care or medical care.

In most cases, it is possible to select the home care provider you prefer. It is often possible to choose between an agency or a qualified individual to perform your assisted tasks. It is important to note that these individuals or companies must be considered acceptable by your insurance provider. It is important to verify your selection with Medicare or Medicaid before you begin any services or to avoid the risk of having to pay out-of-pocket expenses. And in some cases, insurance will pay for a loved one to perform the necessary care at home.

State Programs and Policies

Each state has different programs and policies regarding home aids and their acceptable roles and responsibilities. They might also have different program names, such as IHSS (In-Home Supportive Services), Home and Community Based Services or Medicaid Waiver. To maximize your benefits potential, reach out to your state programs to learn more.

You might also qualify for additional state programs or nonprofit organization programs not directly associated with Medicare or Medicaid. A number of disability programs exist for free or for a minor fee that assists individuals with various disabilities. Each state might also offer volunteer programs that send members of the community to homes to assist with personal needs. In any of these instances, you will have to schedule a home visit and complete an assessment process to determine your eligibility for each program.

There is also a pre-screening process to determine your possible needs and your eligibility. This pre-screening process will also assess your financial situation to determine whether or not you qualify and to evaluate your situation and condition. Most people already on Medicaid will automatically qualify. If, for some reason, you do not get approved, you can try again. And remember that many programs will require that you have already been declared to have a disability by medical professionals.

Be Prepared

To prepare for the screening process, make sure you have all of the right information and documentation ready to present. For individuals receiving disability benefits, have your documents ready. If you have not yet been declared to be disabled, it is a good idea to start this process with your doctor first. Be sure to have your financials ready too. Create a list of your limitations and medical conditions as well as to have statements and forms from your doctor or doctors. Some states will require specific forms to be completed by your doctor for approval. It is important to be prepared to share your situation.

You can receive home aid for free or for an affordable rate if you qualify. To increase your chances for approval, be sure to learn the processes, programs and policies. Make sure your doctor is on board and have your verifiable information ready before you make the initial phone call to make the process as easy and seamless as possible.

This article is presented for general information purposes only. Nothing in this article should be taken as medical advice. Medical decisions (including whether to start, stop, or modify any treatment plan) are extremely important and should always be made with the advice and counsel of a qualified medical professional.

About Citizens Disability, LLC:

Since 2010, Citizens Disability has been America’s premier Social Security Disability institution. Our services include helping people in applying for SSDI benefits, managing the process through Reconsideration, and representing people in person at their Hearing, and if necessary, bringing their case to the Appeals Council. Our mission is to give a voice to the millions of Americans who are disabled and unable to work, helping them receive the Social Security Disability benefits to which they may be entitled. Learn more about us and disability benefits like SSDI & SSI or give us a call at (800) 492-3260.

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