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Understanding Medicaid waivers

As elderly people become unable to care for themselves, they often look for financial assistance from various government programs to help them find and pay for necessary care. One of the most useful program is Medicaid, the federal assistance program intended for persons with limited financial resources. Most people would prefer to remain in their homes or in an assisted living facility as they age. The state of Georgia and Medicaid have a program that is designed for such persons: the Community Care Services Program.

The CCSP is intended to help frail older adults continue to live in their homes instead of moving to a nursing care. In order to obtain Medicaid assistance, the patient must be able to convince Medicaid that he or she can remain at home at a lower cost than in a Medicaid approved nursing home or similar facility. In order to accomplish this goal, Medicaid must issue a waiver of its regulations for nursing homes and assisted living, hence the term "Medicaid waiver." The Georgia CCSP is intended to allow participants to direct a significant portion of their medical care to providers that they like.

To qualify for CCSP assistance, a person must be a resident of Georgia and able to pass certain functional and financial eligibility requirements. Applicants must have the same level of limited functionality that would qualify them for Medicaid in a nursing home. A physician's written opinion is usually required to meet the limited functionality test. The value of an applicant's resources must be less than $2,000; for couples, the limit is $3,000. Certain assets, such as the applicant's primary vehicle, are excluded from the calculation of the asset limitation. The use of a special needs trust or other legal device may help a person meet the financial limits for a Medicaid waiver.

The CCSP provides a variety of services, including adult day care, alternative living services, errand assistance, home-delivered meals, and home health care. The application process can be complex, especially meeting the financial limitations. The services of a knowledgeable elder care attorney can be essential to a successful application.

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