For residents of Pennsylvania looking for home care, you may have heard of Community HealthChoices (CHC), the Medicaid-funded Pennsylvania State program that pays a loved one to provide in-home care for you. This can be a life-changing program for people who need extra help at home to live safely and comfortably due to age, illness, or another condition.
As with any application, there are bound to be questions or moments where extra clarity is needed. While Renaissance is happy to guide you through every step of the enrollment process for CHC in person or on the phone, it’s also useful to have a written guide that explains the general steps you can expect.
What is Community HealthChoices (CHC)?
CHC program is a Medicaid managed-care program for people who are 21 years of age or older and are eligible for both Medicaid (known as Medicaid Assistance in Pennsylvania) and Medicare (the Federal Health Insurance program). Complete qualifications include:
- Age: You must be 21 years of age or older.
- Residency: You must be a resident of Pennsylvania.
- Citizenship/ Immigration Status: You must be a U.S. citizen or qualified immigrant.
- Medical Necessity: You must require care and assistance with daily tasks due to physical disabilities or long-term health conditions.
- Medicaid and Medicare: You must either be dually enrolled in both Medicaid and Medicare or be receiving long-term support through Medicaid.
- Functional Eligibility: Your functional ability will be assessed to determine the scope of your needs
- Financial Eligibility: There are income and asset limits that you must meet to qualify for the program. These limits typically vary based on your household size.
- Level of Care Determination: You must undergo a care assessment to determine the appropriate services and supports to meet your specific care requirements.
Eligible individuals must require help managing one or more of the Activities of Daily Living (ADLs) such as:
- Bathing
- Dressing
- Feeding
- Toileting
- Mobility assistance
Getting Paid to Care for a Friend or Family Member:
Under the CHC Waiver Program, there is a self-directed option called Services My Way (SMW). SMW pays your family member or loved one for the in-home care they may already be providing.
Who Can Qualify to be a Caregiver ?
- A sibling, child, grandchild, unmarried domestic partner, close family members or friend
- Not a spouse, legal guardian, or power of attorney
- Parents of adult children can qualify, as long as they are eligible for the program
- Must be legally allowed to work in the USA
How do I enroll?
Enrolling in CHC can be somewhat confusing. That’s why we created a simple way to access our home care services. To enroll with CHC under Renaissance Home Care, follow these simple steps:
- Check if you qualify for Medical Assistance (Pennsylvania Medicaid). Use the COMPASS website to check your eligibility.
- If you are eligible for Medical Assistance, register for the state of Pennsylvania’s Health and Human Services programs on the COMPASS website.
- Within 60 days, a case worker from your local County Assistance Office (CAO) will be assigned to review your information.
- Once you are approved, you will be responsible for selecting one of the four managed care plans: Amerihealth Caritas, UPMC, UPMC Community HealthChoices or PA Health and Wellness.
- If you qualify for Pennsylvania’s Medicaid waiver program, you will be notified which services you qualify for upon your CHC program approval.
- You should qualify if you are:
- Receiving both Medicare and Medicaid
- Receiving long-term services and supports in the Attendant Care, Independence, COMMCARE, or Aging waivers
- Receiving services in the OBRA waiver AND determined nursing facility clinically eligible
- Receiving care in a nursing home paid for by Medicaid
- An Act 150 participant who is dually eligible for Medicare and Medicaid
- Receiving care in a nursing home paid for by Medicaid
- Receiving services in the OBRA waiver AND determined nursing facility clinically eligible
- Receiving long-term services and supports in the Attendant Care, Independence, COMMCARE, or Aging waivers
- Receiving both Medicare and Medicaid
- You should qualify if you are:
- Choose Renaissance Home Care as your appointed home care agency and let us know who your chosen caregiver will be. Once your care plan is in place, you’re ready to begin receiving home care from the caregiver of your choice under CHC with Renaissance!
Summing it Up:
Renaissance Home Care is a dual-licensed home care and home health agency registered to participate in the CHC program to pay and support caregivers. At Renaissance, we prioritize your autonomy and comfort by giving you the option to choose your own caregiver. For more information on CHC and the application process visit our website or contact Renaissance Home Care today!
DISCLAIMER: THIS BLOG DOES NOT PROVIDE MEDICAL ADVICE
The information in this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen.