Frequently Asked Questions
What is CDPAP?
CDPAP stands for Consumer Directed Personal Assistance Program. This is a Medicaid program that offers older adults or people with disabilities another opportunity to receive home care services.
Under the CDPAP program, the consumer or their designated representative can select, hire and supervise their own personal assistants, who may be family members, friends or acquaintances. This gives consumers more control over their care, choosing people they trust and who understand their specific needs.
CDPAP is available in several US states and eligibility requirements may vary by state. Generally,to qualify for CDPAP a person must be Medicaid-eligible and require assistance with daily activities such as bathing, dressing, or preparing meals.
Am I eligible for CDPAP?
You may be eligible for CDPAP if you:
- Live in New York
- Has Medicaid, or Eligible for Medicaid.
- Senior or disable people who needs help of daily living activities such as walking, cleaning, bathing, preparing food, taking outside, visiting doctors, buying groceries, medication, and other daily activities.
Who can be my personal assistant?
CDPAP caregivers are a group of personal assistants hired and supervised by Medicaid recipients themselves, giving Medicaid-eligible individuals freedom of choice regarding their personal care. Whether it’s a family member, friend, or professional caregiver, the CDPAP program allows Medicaid recipients to choose a caregiver that meets their needs. CDPAP caregivers are tasked with a variety of services, including assisting with activities of daily living such as bathing, dressing, grooming, administering medication, preparing meals, cleaning, transportation and more. The services provided by the CDPAP caregiver are based on the individual needs of the Medicaid recipient and their care plan. What sets the CDPAP program apart is that the caregiver is not affiliated with an agency.Instead, they are considered employees of the Medicaid recipient, meaning they are responsible for payroll taxes and insurance. The Medicaid recipient assumes responsibility for scheduling the caregiver and handling other employment-related issues.
May my spouse serve as the personal assistant?
No.
Does personal assistant require any certification or license?
No.
What is the pay rate for personal assistant?
The pay rate for CDPAP personal assistants in New York can vary depending on several factors, such as the location of the Medicaid recipient, the level of experience and qualifications of the personal assistant, and the number of hours worked.
Our pay rates range between $18 to $22 an hour depending on the Medicaid recipient’s location and insurance.
How many weekly hours does a Medicaid recipient receive?
The number of home care hours a CDPAP beneficiary receives depends on their individual needs and the amount of care allowed by their Medicaid plan.
What does Medicaid Pending mean?
The concept of pending Medicaid homecare is confusing as it refers to people who have applied for Medicaid to cover their homecare benefits but are still awaiting approval. During this period of uncertainty, these individuals may receive home care services paid for from other sources or out of pocket.
Once your Medicaid application is approved, this can be a great relief as Medicaid can cover your home care services retroactively from the date of application. This can be an explosion of joy for the person as Medicaid can reimburse any expenses incurred during the limbo period.
It is important to note that not all states have an outstanding Medicaid program and eligibility criteria can be confusing and vary from state to state.It is highly recommended that you check with your state’s Medicaid program to fully understand the confusing Medicaid guidelines and requirements for upcoming Medicaid home health care.
How long does it take to approve my home care service?
It takes about 4 to 6 weeks depending on your current Medicaid status.
May I be eligible if I only have Medicare?
Medicare is not enough; you need to have Medicaid.
What is Fiscal Intermediary?
Fiscal Intermediaries (FIs) are organizations that provide administrative support to health care providers who participate in government health programs such as Medicaid. These organizations help healthcare professionals manage their finances and ensure they comply with program rules and regulations. Tax intermediaries typically handle tasks such as invoicing, payment processing, and record keeping. In Medicaid managed care plans, tax intermediaries play a particularly important role. These plans are designed to provide comprehensive health care services to people eligible for Medicaid.To participate in these plans, caregivers must contract with a managed care organization (MCO), which is responsible for coordinating care and managing costs. Tax intermediaries liaise between healthcare professionals and MCOs. They help suppliers navigate complex MCO administrative requirements and ensure they are paid quickly and accurately. Additionally, tax intermediaries can offer training and assistance to suppliers on topics such as compliance and invoicing. Now let’s see how tax intermediaries relate to New York’s Consumer Directed Personal Assistance Program (CDPAP).This program is designed to allow Medicaid recipients to self-manage their care by choosing their personal assistants and determining the types of services they receive. The program allows you to hire family and friends as personal assistants and offers more flexibility in terms of the types of services that can be provided. Tax intermediaries play a key role in the CDPAP program as they are responsible for managing the financial aspects of the program. They handle tasks such as payroll processing, withholding, and benefits administration. Additionally, tax intermediaries can provide support to personal assistants and help them navigate the administrative requirements of the program. Finally, fiscal intermediaries are an important part of the health ecosystem, providing administrative support to health professionals participating in public health programs. Under Medicaid managed care plans, tax intermediaries help providers manage the administrative requirements of MCOs. In the New York CDPAP program, tax intermediaries manage the financial aspects of the program and provide support for personal assistants. As healthcare continues to evolve, tax intermediaries will remain a major player in ensuring patients receive the care they need.
What is Medicaid spend-down?
Medicaid Spend Down is a process whereby individuals with income or resources that exceed Medicaid eligibility limits may still qualify for Medicaid insurance. The spend-down process allows people to “spend” their excess income or resources on medical expenses, after which Medicaid begins covering their healthcare costs.
Can I get Medicaid without paying a “spend-down”?
Yes, you can qualify for Medicaid in New York without paying a deductible. Here are some general guidelines for qualifying for Medicaid in New York with no deductible:
Income: You must have an income that is equal to or less than the Medicaid income limit for your household size. The income limit varies based on your family size and the type of Medicaid program you are applying for. The income limit for your situation can be found on the New York State Department of Health website.
Net Worth: You must have net worth equal to or less than the Medicaid net worth for your household size.The wealth limit includes cash, bank accounts, stocks, bonds, and other investments. It does not include your primary residence or certain other assets. Again, the wealth limit varies depending on the size of your family and the type of Medicaid program you’re applying for.
Eligibility Category: You must be in an eligibility category that does not require a deductible. Examples of categories that do not require a deductible are pregnant women, children and blind or disabled people.
If you meet these requirements, you can apply for Medicaid through the New York State Health Marketplace or by contacting your local Department of Human Services. It’s important to note that Medicaid eligibility can be complex and there may be other factors that affect your eligibility. It’s always a good idea to enlist the help of a qualified professional when applying for Medicaid.