Molly B. has struggled with chronic obstructive pulmonary disease (COPD) for years. Elijah J. has suffered from liver disease for years and now needs a transplant. And after her recent diagnosis, Hannah W. has questions about sickle cell disease. These people have something in common – they might benefit from Medicaid’s Health Home Program.
As a joint federal-state government program, Medicaid offers health benefits to qualifying individuals. Many people think of Medicaid when they face the need for nursing home care. Medicaid is much more than that, though. For example, the Health Home program.
The Details
Medicaid’s Health Home Program connects patients with the right services and resources. It also teaches patients about self-management and provides necessary transitional care. For some patients, Medicaid Health Home provides services to bridge medical and behavioral health services. This is by no means a comprehensive list.
The extra services provided by Health Home are offered, but not mandatory. Patients have the option of not accepting those services.
Eligibility
To receive benefits, the patient’s Primary Medical Provider (PMP) has to be contracted with the regional Health Home group. The patient also has to be enrolled in the Patient 1st Program.
Health Home services provides services in addition to support already received by the patient’s Primary Medical Providers. Patients who suffer from, or are at risk of contracting, the following chronic conditions often need an extra level of coordination between medical providers:
- asthma
- diabetes
- cancer
- COPD,
- HIV,
- mental health conditions,
- substance abuse,
- transplants,
- sickle cell disease,
- BMI over 25
- heart disease,
- Hepatitis C.
Hannah W. worried about how the combination of her sickle cell disease with diabetes would affect her care. Her doctor joined the Health Home program and directed her toward self-management resources and other programs that might help her.
How it Works
The Health Home group in the patient’s region will contact you to discuss their medical needs. They will let the patient know what services are available. The patient then has the right to refuse those services or accept. For example, Molly B. did not feel she needed any additional services and refused those offered by Health Home.
The patient will have to choose a doctor who is signed up with the Patient 1st program. After having been with the same doctor for years, Elijah J. was dismayed to learned that his doctor did not participate in the Patient 1st program. He had to decide whether to stay with him or move to another doctor.
This additional care is not permanent. The patient can cancel at any time.
The Catch? You Have to Be Receiving Medicaid.
The application process for Medicaid is a difficult path for most people to navigate. The attorneys at Miller Estate and Elder Law help many of their clients every step of the way.
For a free consultation with an experienced Alabama attorney, contact us at 256-251-2137 or use our convenient Contact Form. We have offices in Anniston and Birmingham and serve clients in Gadsden, Hoover, Talladega, Vestavia Hills, and surrounding areas.