#altcs #cmp #VA Aid and Attendance
www.CareFundingSolutions.com
Thanks for watching the video, How to stay in your home and have ALTCS pay for your needed care.
ALTCS and VA Pension will provide care or funding for personal care in the home. You don’t! Have to be in an assisted living community or group home to qualify.
Arizona is an approved Home and Community-Based Services State or HCBS waiver state, and under the HCBS program, benefits extend and include:
• Home daycare,
• Personal and respite care
• Medical transportation,
• Mental health services,
• Homemaker services,
And most importantly
• Attendant care and home health aides.
It’s important to understand that the ALTCS qualification requirements are precisely the same whether you stay in your home or a certified ALTCS community or group home.
The difference between being in a community or group home is the way care services are provided.
Here are the three qualifications you must meet to be eligible for ALTCS.
First, you must be;
A US citizen or have resident status and have a Social Security Number.
And ba an Arizona resident.
Need nursing home level or custodial level of care as determined by AHCCCS.
If you are a war-time veteran or surviving spouse of a qualified veteran, you must prove that you have applied for the Veteran’s Pension with Aid and Attendance benefit. I’m a VA Accredited Claims Agent, so if needed, I can Legally Prepare, Present, and Prosecute a claim for a veteran or surviving spouse.
Unless someone is accredited, it is illegal to do so.
So what are the Medical Requirements?
An ALTCS medical assessor who is a social worker or nurse uses a tool called the Pre-admission Screening (PAS). The PAS’s purpose is to determine if the applicant has an intermediate or custodial level of care need.
They review medical records and conduct a face-to-face or over the phone interview. The applicant must score 60 points or higher to qualify.
Since the assessment is somewhat subjective, it can be redone at any time if the applicant score is less than 60 points, and the decision can also be appealed.
The assessment takes about an hour and covers a full range of medical and cognitive questions.
PAS Assessments are good for six months but can be redone at any time if the applicant does not score the needed 60 points.
The assessor looks at the person’s need for assistance with activities of daily living or ADLs. These ADLs include:
• Bathing
• Dressing;
• Grooming and Personal Hygiene
• Eating and Drinking
• Toileting
• Mobility; and
• Transferring;
Someone that has been diagnosed by a Neurologist with dementia is worth 20 of the 60 points needed to be approved, so having dementia alone is not enough to qualify, but it does help a lot.
One of the most significant issues with the PAS assessment process is during the live assessment when questioned. The applicant has a natural tendency to hide their health issues.
Out of pride, hide their need for assistance. For instance, someone that is incontinent will not admit it to a stranger. But Incontienance scores high on the PAS, like dementia, will go a long way to reaching the 60 points needed.
To avoid being denied, consult a Certified Medicaid Planner for assistance with the PAS process. It also may be useful to have an RN or a Board Certified Patient Advocate review your records and be at the assessment to be sure that the assessor doesn’t miss score your level of care.
Next, what are the Financial Qualification Requirements?
Since the actual dollar limits change each year, please refer to our website CareFundingSolutions.com for current amounts. We will use approximant rounded amounts for this video.
The financial qualification requirements for ALTCS, on the one hand, are reasonably straight forward, yet on the other, they can get very complicated and confusing. Meaning, even if your income and assets are too high, several strategies can be considered, so you will qualify financially.
Seek the help of a Certified Medicaid Planner before you apply, or if you’ve been told your income are assets are too high to qualify.
Further, someone who is not familiar with the application process may find it difficult and ALTCS information request hard to satisfy. Being able to meet the ALTCS required deadlines; this again is why working with a competent and knowledgeable Certified Medicaid Planner is essential.
Now keep in mind regardless of Marital status, the most an applicant can have in countable assets is $2,000. Please note that the $2000 is a hard limit; any amount above the $2000 will cause a denial.
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