PA Medicare Waiver
Medicare covers medical issues; however, the various Medicare waiver programs provide funding directly to Pennsylvania and specifically waive the requirement that funding be used for medical purposes. The objective of this funding is to allow Pennsylvania residents to remain in their own homes and to maintain the maximum amount of independence possible. These programs keep people out of costly institutional facilities and result in substantial Medicare savings.
Which government agency administers these programs?
These programs are part of Pennsylvania's Home and Community Based Services that are administered by the Office of Long Term Living (OLTL), which is part of Pennsylvania's Department of Public Welfare (PA DPW). These programs are under PA DPW because they are means tested. Your income and assets will be evaluated to determine if you qualify. You can reach the OLTL at 1-866-286-3636 to discuss your eligibility.
How do the programs work?
You must begin the Medicare Waiver process by calling the PA Independent Enrollment Broker (IEB) at 1-877-550-4227. The IEB is a private company that is contracted by OLTL for a five-year term. If you contact the IEB to request for services, the IEB will schedule an intake visit at your home within seven days. During the intake visit, the IEB representative will explain the program to you in greater detail, provide documentation about the process and your rights, and assist you in completing the paperwork. The IEB representative will also coordinate all other activities necessary to complete all of the steps needed and communicate the status of your request to you in writing during the process.
The evaluation process can take up to 90 days. If you are accepted into one of the PA Medicare Waiver programs, you will be asked to select a Service Coordinator (SC). The SC is a private company that will help you coordinate your personal care through a provider like Comforting Home Care by Phoebe. Additionally, if your circumstances change, your SC will be available to modify your care services. Your SC may also make recommendations to OLTL to reduce your hours of service if your need for care decreases.
Who's who in the process?
Independent Enrollment Broker (IEB) -> Application and approval
Service Coordinator (SC) -> Coordinates benefits
Provider (Comforting Home Care by Phoebe) -> Provides home care
What Waiver programs does Comforting Home Care by Phoebe serve?
Your other partner in PA Medicare Waiver program is the care provider. Comforting Home Care by Phoebe provides services to the Aging Waiver, Attendant Care / Act 150, COMMCARE, Independence Waiver, and OBRA waiver programs. We take great pride in ensuring that our Medicare waiver clients receive the identical level of care and services as insurance or private pay clients. We go above and beyond by providing every client with a free assessment with a registered nurse (RN), continued care supervised by an RN, 24-hour phone access, and all of our web-based access tools. Comforting Home Care by Phoebe serves a number of waiver clients and we strive to deliver outstanding care to everyone we serve.
Can I switch to Comforting Home Care by Phoebe?
You have the right to choose or change your care provider without impacting your eligibility. If you are currently in a waiver program, you can call us at directly at 610-625-5600. We can coordinate the details and change your care within a few days. Call us if you are not getting the care you deserve.
Tell me more about the Waiver programs
These are all of the Waiver programs that Comforting Home Care by Phoebe services. Click on the links below to go to the PA State website for each program. All of these programs are essentially alternatives to assisted living facilities or other health care institutions.
- Aging Waiver, aka Pennsylvania Department of Aging (PDA) Waiver - Home care is provided to Pennsylvania seniors over 60 years old that require skilled nursing care, but are living at home. The program is means tested.
- Attendant Care / Act 150 Waiver - This program serves physically disabled adults between the ages of 18 and 59 that require home care to maintain their independence living at home. Participants must be capable of independently managing their own care, financial, and legal concerns. The program is means tested and may require a financial contributions from participants.
- COMMCARE Waiver - A program that is available to adults over 21 who have suffered a traumatic brain injury (TMI) that requires home care in order to live at home.
- Independence Waiver - A waiver program for severely physically disabled adults between the ages of 18 and 60 that require nursing facility care but are able to live at home with proper care. This program is means tested.
- OBRA Waiver - This waiver program is open to adults between the ages of 18 and 59, with developmental physical disabilities, such as cerebral palsy, epilepsy, and similar conditions. The program is means tested.
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