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Waiver Programs = Access to Free Services!
Do you have a child with disabilities or special health care needs?
Joseph Rosenblatt
September 18, 2024
In partnership with
Welcome to The Benefits Guide! We are on a Mission to support families and loved ones gain access to information about Medicaid and other government assistance programs. Each week, this newsletter will provide readers with the latest information about what subsidized or no-cost services are available from federal and state programs.
Stay tuned each week to learn about the latest trends across different states and what you may qualify for based on individual needs and circumstances.
If you have a specific question we can address in the future, please email us directly and we will do our best to support: [email protected]
Highlights in this week’s newsletter:
Get Familiar with Your State's Medicaid Website
Free or Low-Cost Health Insurance
Waiver Programs = Access to Free Services!
Navigating the 2024 Medicaid Disenrollments: What’s Behind the Shift?
👩⚕️ Healthcare Basics
Get Familiar with Your State's Medicaid Website
Are you new to the Medicaid Application Process? Or do you need to Renew or Re-Enroll? Medicaid eligibility varies by state and is determined based on several factors including income, household size, age, disability status, and other specific qualifications.
Income limits vary by each state but are typically expressed as a percentage of the Federal Poverty Level (FPL). As of 2023, the FPL for a family of four in the U.S is approximately $30,000. However, there are some states that expanded Medicaid and allow income levels to be higher - up to 138% of the FPL (about $41,400 for a family of four).
ELIGIBILITY: Find your State's Website by clicking HERE. (How to navigate: Select your State from the drop-down list and click "View").
APPLY: Apply directly through your state Medicaid Agency. Click HERE. (How to navigate: Scroll down to "2." and Select your State from the drop-down List and click "Go".
What is this program❓
Free or Low-Cost Health Insurance
Are you currently uninsured due to the high cost of health insurance - or do you have health insurance benefits, but coverage is very limited and you are left with large out of pocket expenses? This is a very common scenario for many individuals across the U.S. due to the often-complex Medicaid eligibility requirements. To support individuals in selecting the right health insurance solution, many states have developed a centralized health insurance marketplace, established under the Affordable Care Act (ACA).
For example - the State of California has developed an easy-to-navigate online resource to search for and purchase health insurance. Visit Covered California (https://www.coveredca.com/), enter the household income, zip code, household size and number and age of individuals needing care. The system provides a quick quote of cost per month. https://www.coveredca.com/
Many states offer an easy to navigate online search tool such as Covered California. You can find the marketplace in your state by visiting healthcare.gov (https://www.healthcare.gov/marketplace-in-your-state/).
✅ Do I qualify for this?
Waiver Programs = Access to Free Services!
Do you have a child with disabilities or special health care needs? Some states offer waiver programs that may cover services including respite care, attendant care, nursing care, therapies, education, home modifications, assistive technology and MORE!
In Texas, there are 7 Medicaid Waiver programs available, covering different populations and providing a broad level of services. For example, one of the waiver programs offers services for children and adults who are deaf-blind, another waiver program provides services to children and adults who are 20 years and younger who are medically fragile as an alternative to receiving services in a nursing facility. There is also a waiver program Texas Home Living (TxHmL) which provides services to children and adults with an intellectual disability (ID) or a related condition who live in their own home or their family's home. https://www.navigatelifetexas.org/en/insurance-financial-help/texas-medicaid-waiver-programs-for-children-with-disabilities
State waiver programs often time have "waiting" lists due to the high demand and beneficial nature of these services. Be sure to visit your state’s Medicaid website or call your state's Medicaid Office ASAP to inquire about these services.
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📰 Top Programs News:
Navigating the 2024 Medicaid Disenrollments: What’s Behind the Shift?
In 2024, millions of individuals and families across the United States faced disenrollment from Medicaid, raising concerns about access to vital healthcare services. This significant change resulted from various factors that have altered the landscape of Medicaid eligibility. In addition to the end of the PHE protections, rising costs of living and inflation have left some families in precarious financial situations. As household incomes change, many find themselves above the income threshold for Medicaid, pushing them into the private insurance market, which can be less affordable and accessible. Efforts are now underway to ensure that those affected by disenrollments can transition smoothly to alternative coverage options, including the Health Insurance Marketplace. Advocates emphasize the importance of raising awareness about available resources and assistance programs, urging those who may have lost their Medicaid coverage to explore other avenues for health insurance. As this situation unfolds, state agencies and healthcare organizations are working together to provide guidance and support to those impacted. Keeping informed and proactive is crucial during this time of transition—particularly for the millions now navigating the complexities of health insurance options in the wake of this significant policy shift. Stay tuned for more updates regarding Medicaid changes and available support as we continue to monitor this evolving landscape. Together, we can ensure that everyone has access to the healthcare they need.
For data on monthly Medicaid disenrollments, renewals, visit: https://www.kff.org/report-section/medicaid-enrollment-and-unwinding-tracker-overview/ |
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