Unraveling the Mysteries of Medicaid Long-Term Care

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The workings of the Medicaid system became clearer to me after talking to an extremely helpful nurse, Alex, from VNSNY Choice.  Here’s what I got from that conversation.

Medicaid is the government umbrella, a source of funding for long term health care services.  Under the umbrella are plans, such as VNSNY Choice Managed Long-Term Care, who oversee the agencies supplying health care workers’ services.  There are several agencies who are contracted to provide the nursing services.  Freedom Care is the one we chose.

I’m still slightly bewildered by all the organizations involved in providing these health care services.  However, there was some good news.  Now that my husband qualified and is enrolled in the Medicaid long-term care system, any equipment related to his health condition will be paid for, such as a shower chair, walker, and even hearing aids (or at least one hearing aid.  Alex wasn’t sure about that). The doctor must submit a prescription to the plan coordinator, and the item will be purchased, possibly even delivered.

My chosen caregiver has to have a physical and receives an orientation from the agency. 

Recently, I’ve heard news stories about the low wages home health aides are paid.  I’m wondering how much the caregivers are paid through the Medicaid program. 

Again, if you have any useful information about Medicaid and long-term care, drop me a comment.  Thanks


For a guide to Managed Long-Term Care in the Hudson Valley, go to


New York Medicaid Choice: 1-888-401-6782


Seeking Respite

A couple of weeks ago, I got this flyer in my mailbox. 

Although I had put out feelers to find someone to keep my husband company while I took a much-needed break, I was intrigued by the possibility that Medicaid would cover the cost of a caregiver.  I let the thought simmer for a while, and then I called Freedom Care.

After gathering information from a friendly person at VNS (Visiting Nurse Services?), we scheduled a phone evaluation to see if my husband qualified. 

The next week, the nurse called and asked us questions for an hour or more.  This kind of situation is difficult for me because my husband denies his condition.  If asked about it, he’ll say, “Oh, I have a little memory loss.”  I suppose denial is a happier state for him than admitting the reality of dementia. 

When the nurse asked, “Mr. D., do you dress yourself?” He answered, “Yes, of course.”  Then I had to amend his response because I lay out his clothes every morning.  If I didn’t, he’d be wearing the same underwear and clothes every day.  He also can’t make judgements about the right clothes for the weather.  Sometimes he forgets where things are in the house.

“Do you make your meals?” 

“Sure,” he said, “I do sometimes.” 

“I do the cooking,” I interjected.  “He washes the dishes.”

All the facts of our living arrangements were laid out in front of him.  He doesn’t drive.  I’m in charge of finances.  He can’t control the TV.  It breaks my heart to drown him in the reality of his losses.

After the interview, the nurse called back to say that P. qualified for the long term care assistance program.  At this point, the workings of this system got really murky for me.  I think I spoke to three different organizations or maybe it was two people from the same agency.  This is what I learned, although I suspect it’s not complete:

First I was directed to call Maximus (somehow related to NY MedicaidChoice) to find out which plans were available in our area.  This contact person told me that it’s the CBPAP (I don’t recall the actual name) program that pays family members for caregiving.  There were two types of plans:

MLTC—Managed Long Term Care provides home care, and allows participants to keep their doctors

Medicaid Advantage Plus covers all Medicare and all other services.  It provides a care manager and includes doctors, possibly not the same ones the participants have been using.  It offers hospital care and doctor visits.

The Maximus person gave me the names of six agencies that offer these plans, four for MLTC, and two for Medicaid Advantage Plus.  I thought it would be a good idea to research these different agencies but…she said that the 20th of the month is the cut-off date for an evaluation for May.  With that pressure, I essentially closed my eyes and picked—VNSNY Choice Managed Long Term Care.

We now wait for another evaluation by another nurse to determine the number of hours we’ll be offered.

I’m still a bit bewildered by all these agencies involved, but if this pays for a few hours’ respite for me, I’m for it.

If you have any more information on this process, drop me a comment. Thanks.