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The HCBS Waiver currently has 28 services [1] and there is a spending cap based on the individuals needs. However, services must be "medically necessary". Individuals that meet the following criteria are eligible to receive services under the Home and Community Based Services Waiver: Be under 65 years of age; Be a Florida resident
As of 2014, 26 states have contracts with MCOs to deliver long-term care for the elderly and individuals with disabilities. [2] There are two main forms of Medicaid managed care, "risk-based MCOs" and "primary care case management (PCCM)." [3] Managed care delivery systems grew rapidly in the Medicaid program during the 1990s.
Operating ICFs/IID certified companies and organizations must recognize the developmental, cognitive, social, physical, and behavioral needs of individuals with intellectual disabilities who live in their setting or environment by requiring that each individual receives active treatment in regards to appropriate habilitation of their functions to be eligible for Medicaid funding. [6]
Under an HCBS waiver, states can use Medicaid funds to provide a broad array of non-medical services (excluding room and board) not otherwise covered by Medicaid, if those services allow recipients to receive care in community and residential settings as an alternative to institutionalization.
Of the 1.9 million people in Florida who lost Medicaid coverage, according to KFF, patient advocates estimate that thousands of disabled people like Eakin have been affected.
2.6 million were in the "coverage gap" due to the 19 states that chose not to expand the Medicaid program under the ACA/Obamacare, meaning their income was above the Medicaid eligibility limit but below the threshold for subsidies on the ACA exchanges (~44% to 100% of the federal poverty level or FPL); 5.4 million were undocumented immigrants;
Florida's Medicaid call center is experiencing long wait times and high rates of disconnection that could be preventing families from renewing or accessing healthcare coverage, according to a ...
Individuals in Florida who are looking for more information about Medicare can contact Serving Health Insurance Needs of Elders (SHINE) at 800-963-5337. SHINE provides free and unbiased counseling ...
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