Colorado - Going on a Treasure
Hunt (to find information on Colorado's Medicaid
& Waiver Programs)!
by Trish Hughes Kreis
A fellow caregiver reached out
to me for help: “I live in Colorado and my wish is to
find a place for my brother and I to live and I take care of
for any state and “brother” for any relative or
friend and you have a dilemma faced by millions of caregivers
in the United States.
The living arrangement decisions in caregiving range from whether
to bring the loved one into the caregiver’s home, finding
a place to live together or a care facility for the loved one.
This dilemma can be summed
up in one short question:
How can I best help the person
I am caring for?
Whether help comes in the form
of moving the person receiving care into the caregiver’s
home or in finding the best assisted living facility, the underlying
wish of all caregivers is to give their care recipient the best
According to the US Census bureau,
of Colorado residents are 65 years of age or more. This,
although lower than the US average of 13.3%, is significant,
and this percentage has grown in the past several years.
There are currently 500+ assisted
living facilities in Colorado, and this number will grow
as well in the years to come, since Colorado's abundant sunshine,
as well it's reputation for being one of our 'healthiest states'
- not to mention the state's excellent choices for medical care
and senior housing - are attracting seniors from all over the
***The Median Monthly Cost for Assisted Living in Ohio (Private, One-Bedroom) is: $3,600
Caregivers do appreciate choices
but the decision to place a loved one in a facility is one of
the most gut-wrenching decisions to make. If it becomes apparent
it is time for an assisted living setting, then sorting out
how the facility will be paid for (using private pay, private
insurance, Medicare or Medicaid) can help narrow the choices
during this difficult time.
Understanding the Medicaid programs
can be an arduous task, made even more complicated because of
the differences from one state to another. Nationwide, over
50% of residents use some form of Medicaid to pay for nursing
home or assisted living care so it is worth knowing what is
Programs exist to be used but
knowing what programs are available and then sorting through
the requirements to qualify for the programs can feel like a
treasure hunt with a lot of obstacles.
Each state has its own “map”
to negotiate to find the information needed but it will be well
worth navigating to find assistance. Many states have their
own specific waiver programs to help defray the costs of long-term
care. Some states do not have separate waiver programs but have
other programs to help cover the costs of skilled or assisted
living facilities through their Medicaid program.
start our hunt!
The treasure hunt in Colorado for Long Term Care Medicaid services
begins with the County Departments of Social/Human Services.
Apply for Medicaid through the applicable county department
of social services. You can also use the Colorado Peak System
to check to see if you might be eligible for Medicaid benefits
Once Medicaid eligibility has
been determined and if you meet the program criteria, the Case
Management Agencies will set up services for those in need
of long-term care.
Please be aware that you must
already have applied for Social Security benefits before applying
for Medicaid. Contact the local Social Security office either
in person or visit their website at www.ssa.gov to apply for
Social Security benefits. The eligible adult may also qualify
for Supplemental Security Income (SSI) or Social Security Disability
Insurance (SSDI) but it is necessary to start with the Social
Regardless which state you live in, a Durable Power of Attorney
is not recognized by Social Security which can be a frustrating
realization for a caregiver. However, if assistance is needed
with financial matters at Social Security, it is possible to
appoint a Representative Payee (http://www.ssa.gov/payee/faqrep.htm).
Contact the local Social Security office in order to apply to
become appointed for your care recipient.
In addition, if the Medicaid
applicant needs assistance with financial matters, the local
Medicaid system will have their own form to complete in order
to appoint a representative (the Social Security Representative
Payee will not work with the county Medicaid offices).
So far, and depending on eligibility,
this treasure hunt has provided Social Security benefits as
well as Medicaid benefits. Take a breather (you deserve it!)
and then forge ahead for more programs.
Home and Community-Based Services
(HCBS) Waivers available in Colorado may provide additional
benefits depending upon eligibility. Visit the State Medicaid
Agency, the Colorado Department of Health Care Policy and Financing,
for more information about the various waiver programs which
range from Adult Day Services to Alternative Care Facilities.
HCBS Waiver Eligibility.
The basic income requirements
for HCBS Waiver eligibility are outlined as “must be less
than $2,094.00 per month” as well as “countable
resources less than $2,000 for a single person or $3,000 for
a couple.” (http://www.colorado.gov/cs/Satellite?c=Page&cid=1213781362679&pagename=HCPF%2FHCPFLayout#Adult_Waivers)
What Happens if I am Denied?
Continue the treasure hunt –
do not be deterred. Talk to the County Department of Social/Human
Services to exercise your right to appeal (this will most likely
be the same County Department of Social/Human Services where
you originally applied). Keep in mind, many of these programs
have limited funding and, unfortunately, not everyone who applies
and meets eligibility requirements will be accepted into a program.
It’s critical to know that
there are always a specific set of rules and timelines for the
appeals process which can bring a reversal of the denial. It
is important to know the appeal process and to follow the instructions
and timeline carefully.
In caregiving, the treasure hunt never ends but with the right
resources, the treasure hunt for the best care will be a little
easier to navigate.
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- Article by Trish
Hughes Kreis exclusively for Assisted Living Directory