Funding Sources
With so many options available for funding sources, we know it can be overwhelming to discover the best source for your specific needs. We have created a list of the current funding sources available in Indiana with detailed explanations on what each option entails and how you can determine your eligibility for each service.
Private Pay
Private pay is whenever you are paying someone out of your own funding sources, such as a checking account or 401k. This also includes things like reverse mortgages. Anytime you are taking money out of your own bank account to pay an agency that is considered private pay. This payment process is the largest portion of what we do.
Medicare
Another option for payment is Medicare advantage plans. Medicare has two types of plans available. They have their standard plan and their advantage plan. Advantage plans are administered through a third party such as Humana, United Health, or Anthem. These third parties manage the entirety of your plan, but you no longer have a Medicare card.
Larger healthcare companies decided it would be beneficial to offer some direct care to the people who participate in their advantage plans. As of now, this new approach to advantage plans is still in the beginning stages, so it is not widely available and there may not be a provider of these services in your area yet.
Medicaid
The next option for funding sources would be Medicaid. Every state has a Medicaid waiver program and each state administers these waivers differently. In Indiana, we have a very healthy waiver program. It provides attendant care and homemaking services for people within the community who are in need and meet a certain financial requirement. Medicaid waivers and traditional Medicaid are driven by your financial standing, whereas Medicare is age-related.
Medicaid is administered through your AAA Agency. In the Evansville area, we have Southwestern Indiana Regional Council on Aging (SWIRCA). If you find that you need services, you can make a call to your local agency. They will determine your eligibility and help you apply. If approved, the state will allocate hours and then you can pick an agency that will come out and provide the same services you would receive with private pay, but it will be funded by the state.
In Indiana, Medicaid also has additional programs available called CHOICE and Title III. These are state funded programs for care that have a different financial consideration than the waiver does. To learn more about these sources, you can contact SWIRCA.
Veteran Affairs
Next on our list of funding sources is the VA. The VA has multiple services available. They have their home-based services, which are administered through the clinic. For these services, there is usually a community nurse who makes the evaluation and determines the number of hours the client needs before contacting an agency.
We have endeavored to take care of as many vets as we can. We go in and give baths, help with activities of daily living (ADL’s), and do some light housekeeping. Sometimes it doesn’t take very many hours to secure your independence within your home; there may be just a couple of areas that you are lacking in where we can provide assistance. If we can help during the morning time and evening time frames when more activities take place, we can really help keep someone independent.
The VA also has a program called Aid and Attendance Care. To qualify for this benefit, you have to have been active duty during a certain time for a certain period of time and you have to have a certain asset portfolio in comparison to your medical expenditure. Forms for this opportunity are available online, or you can give us a call for more information if you think you might qualify.
Another resource the VA offers is the Spina Bifida Health Care Benefits Program (SBHCBP). This program is specifically for adults who were children of Vietnam vets who were exposed to Agent Orange. This exposure comprises your genetics, which led to some of the children being born with spina bifida. This program can be very extensive, with 24-hour care and a home care agency provider. It can be more difficult to find someone to help you with enrollment for this program, so if you ever need assistance, just give us a call.
Long-term Care Insurance
Another option for a funding source is Long-Term Care Insurance. This form of insurance is not health insurance, it is an insurance product that is intended to provide funds and protect investments when you reach a certain age or when something happens and you need long-term provision of care. There are different long-term insurance policies that vary depending on the writer and when written.
Occasionally, there will be an allocation for in home care if you are deficient in at least two activities of daily living. What usually occurs is that you’ve had a hospital or rehab stay and you looking to see if you can make a claim for long-term care. If something happens or you are starting to decline at home, you can also make a claim and a nurse will come out and make an evaluation.
Once the claim is made, depending on how the insurance policy is written, there may or may not be a waiting period. The writing of the policy will also determine whether you will receive daily stipends, monthly stipends, lifetime benefits, and whether or not your benefits will have a cap.
Sometimes people have signed up for long-term care insurance during the tenure of their work life and don’t realize it. They just keep paying the premium and come to find out that they’ve got a great source of funds built up for in home care. When you sign up for long-term care insurance, you will continue to pay that premium until you access the insurance. You can tell if a loved one is receiving long-term care insurance benefits if you are noticing substantial premium payments going out that resembles insurance.
Workman’s Compensation
Workman’s comp can be another good funding source. Sometimes your employer’s workman’s comp insurance has an allocation for direct care. For example, if you are injured and are going to be off of work for an extensive amount of time, there may be an allocation for a certain amount of hours for in home care within the policy.
As you can see, there are a wide variety of options available for funding sources in Indiana. If you or your loved ones are in need of assistance with navigating these different opportunities or you have questions about eligibility, please feel free to give us a call and we will be happy to help!