Accessing care through Medicaid for those under age 65

Medicaid Care Programs Are Not Just For The Elderly

Many people believe that attorneys that practice elder law only help the elderly population. We could not disagree more! We are ready, willing and able to assist people who need care of all ages. There are Medicaid programs for disabled individuals under the age of 65 who may need care either at home or in an institutional setting. With this in mind, let’s learn more about some of these programs and how they work.

There is a Medicaid waiver program specifically for younger people with severe disabilities.

The Independent Care Waiver Program (ICWP) provides home care to individuals who are Severely Physically Disabled (SPD) or who have Traumatic Brain Injuries (TBI). This program is designed for people who need a higher level of care than other home and community-based programs can provide. ICWP applicants must be between the ages of 21 through 64 years of age. Services may even continue once they attain the age of 65 if they were approved prior to their 65thbirthday.

ICWP Medicaid recipients receive a variety of services.

These services include the following:

  • case management
  • companion services
  • counseling
  • emergency response system (ERS)
  • environmental modification
  • homemaker services
  • occupational therapy
  • personal care services
  • skilled nursing
  • specialized medical equipment and supplies

ICWP recipients also receive the underlying benefits of Aged, Blind, Disabled (ABD) Medicaid.

There are specific home and community-based Medicaid programs designed for individuals who have been disabled since birth.

New Options Waiver (NOW)/Comprehensive Supports Waiver Program (COMP) are classes of assistance that provide in-home and community-based services to Medicaid eligible intellectually disabled/developmentally disabled individuals (ID/DD) who do not receive Medicaid benefits under any other cash assistance programs. The goal of the NOW program is to help increase independence and quality of life for those with ID/DD. Participants can elect and direct their services as they choose. The COMP program is designed for those with a higher level of need. It primarily provides residential care for individuals with ID/DD. One of the goals of this program is to help participants either avoid the need for institutional placement or transition from institutional to community living. Both programs strive to ensure the health, safety and welfare of its participants.

Individuals under the age of 65 may qualify for programs that are traditionally for the aged.

Unfortunately, we see many younger clients who require the services provided by Nursing Home Medicaid, Community Care Services Program (CCSP) or Institutional Hospice. Individuals under the age of 65 can still qualify for these programs. First, the applicant must prove that they are disabled. If the applicant has been received a disability determination from the Social Security Administration, this may serve as sufficient evidence of disability. If the applicant does not meet the financial requirements of Supplemental Security Income (SSI), which will automatically qualify the recipient for Medicaid, there may be alternatives. One option is to obtain a disability decision through the State Medicaid Eligibility Unit (SMEU). Be aware that disability determinations do take some time to process. Don’t delay seeking out the help you need.

Expertise matters!

The attorneys at Hurley Elder Care Law can review your situation and explain in detail how the qualifications for these programs work. If you feel that these programs may benefit you but worry that you have too many assets or income to qualify, call our office at 404-843-0121. Our attorneys can illustrate ways that you may be able to protect your assets, qualify for these programs and receive the care that you need sooner rather than later.

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