Can I Pick My Caregiver If I Am Covered by Medicaid?

Advances in medicine and technology coupled with an above average standard of living make it very likely that the average American will spend several decades as a retiree. Nevertheless, the natural aging process catches up eventually and typically causes physical and/or mental decline. At some point, this deterioration may result in the need for a caregiver. The Grand Forks Medicaid planning attorneys at German Law Group explain how you may be able to pick your caregiver if you are covered by Medicaid in North Dakota.

What Is a Medicaid Waiver?

“Medicaid Waivers,” which are also called Home and Community Based Services (HCBS) Waivers or Waiver Funded Services are programs that provide additional services to specific groups of individuals, limit services to specific geographic areas of the state, and provide medical coverage to individuals who may not otherwise be eligible under traditional Medicaid rules. Unlike the traditional Medicaid program, services or benefits provided through a waiver are only good for a designated period. They are often renewed, but there is no guarantee that a waiver will be renewed. These waiver programs allow people who would otherwise receive care in a long-term care (LTC) facility to receive that care in the community through an assisted living facility, a community-based care program, or even by family caregivers.

North Dakota Caregiver Options

As a North Dakota resident you may be able to choose your own caregiver using the Medicaid Waiver for Home and Community Based Services. This waiver program is designed specifically to help elderly and disabled North Dakota residents remain living in their homes, or in the community, or to return to living in these locations after placement in a nursing home. In addition to personal care at home, in adult day care, in adult foster care, or in memory care facilities (for those with Alzheimer’s Disease and other dementias), this program will cover minor home modifications for senior safety and improved access, as well as Personal Emergency Response Services to help monitor participants when no family members can be present.

The best thing about this waiver program is that it allows for consumer direction. This means participants are given the flexibility to choose their own care providers. Adult children can be hired as caregivers, and North Dakota is one of just a few states that allow spouses to be paid as caregivers. However, program participants are not given budgetary control. They cannot choose how much to pay their caregivers, only from whom they receive care. Typically, caregivers are paid between 50 percent and 75 percent of the going rate for home care in the state. As of 2020, it is estimated that personal caregivers receive an hourly rate of $13.50 to $20.25.

Formally, the waiver is called the Medicaid Waiver for Home and Community Based Services; however, it is commonly referred to as the “Aged and Disabled Waiver” and is administered by the Aging Services Division within the North Dakota Department of Human Services.

Am I Eligible for the North Dakota Waiver Program?

The North Dakota Aged and Disabled Waiver considers both the applicant’s age and level of impairment as related conditions for enrollment. Applicants under 65 years of age must be designated as disabled by Social Security. However, those 65 and older must require nursing home level care but need not be fully disabled. The Aged and Disabled Waiver is a Medicaid program and therefore applicants must be financially eligible to receive Medicaid. North Dakota factors in the applicant’s income and assets. The income limit is subject to change each year and will depend on your marital status at the time you apply. As of 2021, a single applicant is permitted up to $3,000 in countable financial assets. Married applicants, with both spouses applying, can retain up to $6,000 in resources. Certain assets, including equity in your home (up to a limit), are excluded when determining whether you meet the asset limit.

Contact a Grand Forks Medicaid Planning Attorney

Please join us for an upcoming FREE seminar. If you have additional questions or concerns about how to pick your caregiver if you are covered by Medicaid, contacta Grand Forks Medicaid planning attorney at German Law Group by calling 701-738-0060 to schedule an appointment.