Medicaid is the federal and state government-funded program that provides basic health care services to low-income people across the country. In Pennsylvania, the Medicaid plan called Medical Assistance provides coverage for about one-fifth of the state’s population.
Those who qualify are covered for doctor and specialist visits, inpatient and outpatient hospital care, prescriptions, X-rays and diagnostic tests as well as in-home, community-based and nursing home care.
Blair County residents who need long-term care services can qualify for MA if they’re aged 65 and older, or disabled, and a U.S. citizen or lawfully admitted alien. Applicants also must have a medical need for long-term care and meet these financial requirements:
- An income of no more than 300% of the current federal benefit rate, which equals $2,313 for single people and $4,626 for married couples applying together
- Maximum countable resources of $8,000 for single applicants and $16,000 for couples who apply jointly, which includes a $6,000 automatic resource disregard per person
All sources of income and most resources count for eligibility purposes, but certain assets are exempt, including an occupied primary home worth up to $585,000, household and personal effects, one automobile and burial plots and reserves.
Those with an income exceeding 300% of the federal benefit rate may qualify through the Medically Needy Only MA program. This lets an applicant spend down their excess income on eligible medical expenses to qualify for six months of MA coverage.
There are special rules for couples if only one spouse applies for MA long-term care coverage, which may let an applicant qualify who’d otherwise be over the income and resource limits. According to the rules established to prevent
spousal impoverishment, up to $3,160.50 of an applicant’s monthly income may go to their spouse as a living allowance. The spouse may also keep up to $126,420 of the couple’s joint assets as a resource allowance. The exact allowance amounts are determined during a review at the time of application.
Seniors can
apply for MA coverage online or in person at the
Blair County Department of Human Services Assistance office located at 1100 Green Avenue in Altoona.
Community HealthChoices Program Seniors and disabled adults who qualify for MA coverage and need long-term care are enrolled in the
Community HealthChoices program. This mandatory managed care plan is overseen by the state DHS
Office of Long-Term Living and provides comprehensive medical and long-term care support services. The program doesn’t cover the cost of assisted living room and board, but it can help eligible seniors lower their care expenses by paying for services such as:
- Primary, acute and emergency medical services
- Care coordination
- Durable medical equipment
- Medical supplies
- Home health aide and nursing care
- Assistance with activities of daily living
- Adult day health services
- Nursing home care
- Prescription drugs
- Occupational and physical therapies
- Nonmedical transportation
To qualify as a CHC program participant, applicants must be eligible for both Medicare and MA or require a nursing facility level of care as determined by a comprehensive assessment.
Seniors can start the
application process online or contact the CHC
independent enrollment broker at (877) 550-4227.