The MI Choice Waiver: An Option for Elderly Patients under Medicaid

For the nearly 2.3 million low-income children, pregnant women, adults, seniors and people with disabilities who benefit from Medicaid coverage across the state of Michigan, access to this affordable and long-term healthcare is not just a “good thing to have”—it is almost a necessity at this point.

For individuals who cannot afford or are otherwise ineligible for the similar Medicare program, Medicaid offers a way for any low-income individual or family to receive the financial assistance necessary to receive medical and long-term care from healthcare providers. Because each state has different eligibility requirements, different coverage options exist for the residents in each state, and in Michigan, most Medicaid recipients are usually only required to pay a small co-pay charge for necessary treatment.

Why Would a Medicaid Waiver be Necessary?

Even with Medicaid’s reduced-cost coverage, however, long-term coverage can still become extremely expensive; if, for example, a patient requires a nursing home or a round-the-clock caretaker, then that person’s treatment costs may exceed the normal allowances under a typical Medicaid plan and not be covered. In Michigan alone, the monthly costs of nursing home care can reach upwards of $10,000 per month.

This could potentially result in devastating financial hardship, or the impossible choice of abstaining from treatment in order to not saddle loads of medical debt onto one’s self or their families. Fortunately, in Michigan, options exist for those who require long-term care and healthcare services, such as nursing home patients or individuals with development/intellectual disabilities.

One such service meant to further alleviate medical costs for low-income individuals and their families comes in the form of its several waiver programs, such as the MI Choice Waiver, designed specifically for those who qualify to receive long-term care without fear of expending their Medicaid coverage.

These waiver programs allow patients the “choice” to have their long-term medical costs (such as living in a nursing home, or living at home with a caretaker representative) to be covered under their Medicaid plan.  This, in turns, allows qualifying patients (usually, seniors or individuals with developmental disability) to enjoy a quality of life and care that they might otherwise be financially barred from.

What does the MI Choice Waiver Cover?

Under the MI Choice Waiver, your Medicaid coverage would extend to long-term treatments that can be performed either in your own home, or within a nursing home/assisted living facility. These include:

  • Community transition services
  • Community living supports
  • Nursing services (preventative nursing)
  • Respite services
  • Adult day health (adult day care)
  • Environmental modifications
  • Non-medical transportation
  • Medical supplies and equipment not covered under the Medicaid State Plan
  • Chore services
  • Personal emergency response systems
  • Private duty nursing
  • Counseling
  • Home delivered meals
  • Training in a variety of independent living skills
  • Supports coordination
  • Fiscal intermediary
  • Goods and services

How can I Qualify for the MI Choice Medicaid Waiver?

In order to see if you or a loved one is eligible for Medicaid coverage related to long-term healthcare costs, contacting your Local Area Agency on Aging (AAA) is usually the first step in determining how your Medicaid plan can be expanded to include these services.

While a Local AAA can explain the strict eligibility requirements for extended Medicaid coverage, they unfortunately cannot offer assistance in helping families comply with or meet these requirements. Fortunately, the attorneys of SSR Law Office are confidently versed in Medicaid Planning, and can help you best determine what type of coverage is right for you and your family.

If you require any assistance or have any questions about applying, receiving or qualifying for a Medicaid Waiver in Michigan, our team is happy to help. Contact us today for a free consultation, and let us help you receive the Medicaid coverage you and your family deserve.