How to get help paying for Nursing home services in Lamesa
Finding affordable Nursing home services in Lamesa can be difficult if you just have Medicare health coverage.
Having Original Medicare alone will not cover long-term caregiver services, such as those provided in a nursing home or by a home caregiver. To get the necessary Nursing home services you will need supplemental coverage like Medicaid, long-term care insurance, or even VA benefits.
My name is Nick Bryant, a Medicare broker in Texas who has 13+ years of connecting clients to community resources and I am also the author of the book Understanding Healthcare Is Half The Battle. I have lots of experience helping clients understand their healthcare options and that’s what I want to do today.
This article will guide you through the available state programs, nonprofit organizations, and insurance options to ensure you understand whether or not you can get free Nursing home services in Lamesa, Texas. Keep reading to learn about your Lamesa long-term care options.
What Are Long-Term Caregiver Services?
Long-term caregiver services are services that provide assistance to you if you have difficulties performing daily living activities (ADLs) as a result of aging, a disability, or chronic illness. These services can include:
- Nursing Home Care:
- Provides residential care for individuals who need constant medical supervision and assistance with daily activities.
- Home Caregiver Services:
- Personal Care: Assistance with activities of daily living (ADLs) such as bathing, dressing, grooming, eating, and mobility.
- Homemaker Services: Help with household tasks like cleaning, laundry, meal preparation, and grocery shopping.
- Medical Care: Administration of medications, wound care, and other medical needs managed by healthcare professionals.
- Assisted Living Facilities:
- Residential care that offers personal care support, meals, housekeeping, and social activities while promoting independence.
- Adult Day Care Services:
- Provides daytime care, supervision, social activities, and medical services for elderly or disabled individuals.
- Respite Care:
- Temporary care services to relieve primary caregivers, providing a short-term break from caregiving duties.
- Hospice Care:
- Comprehensive care focused on providing comfort and support to individuals with terminal illnesses and their families.
- Rehabilitation Services:
- Physical Therapy: Helps patients recover and improve physical function.
- Occupational Therapy: Assists individuals in performing daily activities and improving their quality of life.
- Speech Therapy: Helps patients with speech, language, and swallowing difficulties.
These services can be provided in various settings, including the individual’s home, community centers, or nursing facilities.
Lamesa Programs That Pay For Nursing Home and Home Care Giver Services
| Program | Pays for Nursing Home Services | Pays for Home Caregiver Services | Details | Eligibility Criteria | How to Get the Benefit |
|---|---|---|---|---|---|
| Medicaid – STAR+PLUS | Yes | Yes | Provides long-term services and supports in home or community-based settings for elderly or disabled individuals. | Elderly or disabled individuals who meet income and asset limits set by Medicaid. | Apply through Your Texas Benefits or call them at 877.541.7905 |
| Medicaid – Community Care for the Aged and Disabled (CCAD) | No | Yes | Offers home assistance and support services to elderly and disabled individuals who need help with daily activities. | Elderly or disabled individuals who need assistance with daily activities and meet income criteria. | Apply through Your Texas Benefits or call them at 877.541.7905 |
| Medicaid – Primary Home Care (PHC) | No | Yes | Provides non-technical, medically related personal care services to eligible clients with functional limitations. | Individuals with functional limitations who meet Medicaid financial criteria. | Apply through Your Texas Benefits or call them at 877.541.7905 |
| PACE (Program of All-Inclusive Care for the Elderly) | Yes, but primarily aims to keep individuals out of nursing homes | Yes | Provides comprehensive medical and social services to elderly individuals to help them remain in the community. | Individuals aged 55 or older who need a nursing home level of care but can live safely in the community with support. | Apply through Your Texas Benefits or call them at 877.541.7905. You can also get more information at the National PACE Association website. |
| Medicare | Yes, but limited to short-term rehabilitation after a hospital stay | Limited, primarily post-hospitalization home health care | Covers short-term rehabilitation in a nursing home and limited home health care post-hospitalization. | Individuals aged 65 or older, or younger individuals with certain disabilities. | Enroll through Social Security Administration or Medicare.gov |
| Medicare Advantage | Yes, but varies by plan | Yes, but varies by plan | Varies by plan, often includes additional benefits not covered by Original Medicare, including some long-term care services however services are very limited. | Varies by plan, generally requires Medicare eligibility. | Enroll through private insurance companies offering Medicare Advantage plans. |
| Long-Term Care Insurance | Yes, depends on the policy | Yes, depends on the policy | Policies vary, but typically cover a range of long-term care services, including home care and nursing home care. | Depends on the policy; typically purchased by individuals who want to cover future long-term care needs. | Purchase a policy from a private insurance company, ideally before health issues arise. |
| Nonprofit Organizations | Yes, depends on the organization | Yes, depends on the organization | Varies widely, often includes organizations like Area Agencies on Aging, which provide support services for the elderly. | Varies by organization; often based on need and income criteria. | Contact local Area Agencies on Aging or call United Way at 211 and they can let you know about local nonprofits in Lamesa to help with Nursing home |
Veterans Have Access To Nursing home Services
Veteran benefits through the Department of Veterans Affairs (VA) provide comprehensive care options for eligible veterans. These benefits include coverage for both nursing home care and home caregiver services.
The VA offers a range of programs designed to support veterans with long-term care needs, including the VA Community Living Centers, VA-contracted nursing homes, and the Aid and Attendance and Housebound benefits, which provide additional monetary assistance to veterans and their survivors.
Eligibility for veteran benefits varies based on factors such as service-connected disabilities, income levels, and specific service requirements. Veterans must generally be enrolled in the VA health care system to access these benefits.
Veterans can apply for these benefits through the Department of Veterans Affairs by contacting their local VA office in Lamesa, visiting the VA website, or calling the VA Health Benefits Service Center at 877-222-8387.
Medicare Will Not Cover Long-Term Care Services
If you rely solely on Medicare, it is important to plan ahead because Medicare does not cover long-term caregiver services.
Medicare may cover short-term rehabilitation and limited home health care post-hospitalization, but for ongoing care, you will need additional coverage. Medicaid is often the best option for individuals who need help paying for long-term care services.
Medicaid Will Help You Pay For Nursing home Services in Lamesa
Medicaid will be your best option for getting long-term care services like nursing homes and home caregiver services paid for. Otherwise, if you only have Medicare this will not cover those services.
The reason why is Medicaid is a state and federally-funded program that provides healthcare coverage for low-income individuals, including long-term care services.
In Texas, Medicaid offers several programs to support elderly and disabled individuals who require long-term care:
- STAR+PLUS: This program provides long-term services and supports in home or community-based settings. It covers personal care, home modifications, medical equipment, and more.
- Community Care for the Aged and Disabled (CCAD): CCAD offers home assistance and support services to elderly and disabled individuals who need help with daily activities.
- Primary Home Care (PHC): PHC provides non-technical, medically related personal care services to eligible clients with functional limitations.
To apply for coverage you can visit the Lamesa Medicaid office nearest you or call 877.541.7905.
PACE: Comprehensive Care for the Elderly – Best For Those who want to live in their home
The Program of All-Inclusive Care for the Elderly (PACE) is another valuable option for seniors in Lamesa, Texas needing affordable Nursing home.
PACE provides comprehensive medical and social services to elderly individuals to help them remain in the community rather than moving to a nursing home.
Services include medical care, home care, rehabilitation, and transportation. You can find a local PACE program through the National PACE Association. In addition, you can learn more about PACE services via the Texas Health and Human Services PACE webpage.
Veteran Benefits for Lamesa Home Care Giver Services
If you are a veteran, you may be eligible for additional support for home caregiver services through the Department of Veterans Affairs (VA). The VA offers various programs to assist veterans with long-term care needs, including:
- Veterans Directed Care: Allows veterans to receive home and community-based services to help them remain in their homes.
- Aid and Attendance Benefit: Provides financial assistance to veterans and their spouses who require the aid of another per son for daily activities.
Contact the VA for more information at 800.698.2411 on how to apply for these benefits.
Qiana James owns Friendly Faces Senior Care in Houston and can also help you with caregiver services or guidance related to VA benefits and caregiver services.
Other Options For Long-Term Care Giver Services in Lamesa
- Medicare Advantage: These plans are offered by private insurance companies and often include additional benefits not covered by Original Medicare, such as long-term care services. Keep in mind that any home care giver services offered via Medicare Advantage will be minimal. At most 40 hours per year!
- Long-Term Care Insurance: Purchasing a long-term care insurance policy from a private insurance company can help cover a range of long-term care services, including home care and nursing home care. It is best to purchase this insurance before health issues arise.
Medicaid Estate Attorneys in Lamesa
Finding a Medicaid estate attorney can be a crucial step if your monthly income or assets disqualify you from Medicaid.
These specialized attorneys can help you navigate the complex Medicaid eligibility requirements and implement strategies to “spend down” your income and assets. By properly managing your finances, an attorney can assist you in qualifying for Medicaid, ensuring that you can access the long-term care services you need. This process might involve restructuring your assets, creating trusts, or making allowable expenditures that align with Medicaid rules, ultimately protecting your financial interests while securing necessary healthcare coverage.
To find Lamesa estate planning lawyers to help you qualify for Medicaid, visit the Justia website.
Nonprofit Organizations
Nonprofit organizations can also provide assistance with long-term care services in Lamesa, Texas.
Organizations like Area Agencies on Aging offer support services for the elderly, including caregiver support, respite care, and transportation.
Find your local Area Agency on Aging in Lamesa by calling Eldercare Locator at 800.677.1116 or by visiting their senior citizen services website and entering your zip code.
Conclusion
Having Medicare is not enough to get assistance with Nursing home services in Lamesa. You will also need a supplemental coverage like Medicaid, PACE, VA benefits, or long-term care insurance to get help paying for long-term care services.
If you need additional help or have questions, call me at 281.870.3599. My name is Nick Bryant and I’m a Texas Medicare agent who can help you to find the long-term care services in Lamesa that you need. Feel free to book a free consultation if you need assistance, I’m happy to help you.