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Texas Medicaid's Primary Home Care Program
Overview of Texas Medicaid's Primary Home Care Program
The Primary Home Care (PHC) Program is a Medicaid entitlement program designed to provide home care services to Texas residents that require assistance performing the basic activities of daily living such as bathing, eating and toileting. A Medicaid entitlement program means that anyone who is eligible for the program is guaranteed to receive services under the program. This differs from some other Medicaid programs in which eligible individuals may be put on a wait list for services.
Services provided in Primary Home Care Program can be managed by the state or participants can choose to manage their care providers themselves. These two types of service delivery models are referred to as Service Responsibility Option (SRO) or Consumer Directed Services (CDS), respectively. The Consumer Direct model is becoming increasingly popular with participants because they are given the flexibility to hire and manage their care providers and certain family members can be hired to provide attendant care services. Typically spouses and legal guardians are excluded from being hired but the adult children of aging parents and ex-spouses can be paid caregivers. This type of program is also referred to as Cash and Counseling or Participant Direction.
It is worth noting that this is a Medicaid program, meaning participants must be eligible for Medicaid and that Texas also has a very similar program for non-Medicaid eligible residents called the Community Attendant Services (CAS) Program.
It is worth noting that this is a Medicaid program, meaning participants must be eligible for Medicaid and that Texas also has a very similar program for non-Medicaid eligible residents called the Community Attendant Services (CAS) Program.
Qualifications for the Primary Home Care Program
To be eligible for the PHC Program, Texas residents must be 21+ years old and require assistance to perform at least one of the activities of daily living such as bathing, grooming, eating or toileting. Their functional limitation must result from a medical condition and must be documented by a medical professional.
In addition to having a functional need, the individual must be financially eligible for Medicaid. Qualifying is a complicated process involving a review of a family’s income, assets and asset transfers as far back as 5 years. Rules change frequently and there are many exemptions, but typically monthly income cannot exceed $2,000 and “countable asset” limits, excluding the car and home, range from $2,000 to $8,000.
Not qualifying for Medicaid can be devastating to the comfort of an individual, their family’s finances and even their health. For these reasons, Medicaid planners exist to ensure families have the best chance of acceptance into the program. With care costing $1000’s / month, there is a strong incentive to use a Medicaid Planner. Find assistance qualifying for Medicaid.
In addition to having a functional need, the individual must be financially eligible for Medicaid. Qualifying is a complicated process involving a review of a family’s income, assets and asset transfers as far back as 5 years. Rules change frequently and there are many exemptions, but typically monthly income cannot exceed $2,000 and “countable asset” limits, excluding the car and home, range from $2,000 to $8,000.
Not qualifying for Medicaid can be devastating to the comfort of an individual, their family’s finances and even their health. For these reasons, Medicaid planners exist to ensure families have the best chance of acceptance into the program. With care costing $1000’s / month, there is a strong incentive to use a Medicaid Planner. Find assistance qualifying for Medicaid.
Benefits / Services of the Primary Home Care Program
Participants in the PHC Program can be approved for up to 50 hours / week of assistance however the average individual receives approximately 16 hours / week. Services can include assistance with any of the following:
-Personal care assistance with bathing, grooming, dressing, eating, medication administration and transferring
-Assistance with the instrumental activities of daily living such as shopping, housekeeping, laundry and meal preparation
-Assistance with transportation for medical appointments
-Personal care assistance with bathing, grooming, dressing, eating, medication administration and transferring
-Assistance with the instrumental activities of daily living such as shopping, housekeeping, laundry and meal preparation
-Assistance with transportation for medical appointments
How to Apply for the Primary Home Care Program
This program is administered by the Texas Department of Aging and Disability Services. Visit their website to learn more or find your local DADS contact to apply for the PHC Program.
Use our Eldercare Financial Resource Locator Tool to find other public and private programs that can help pay for or reduce the costs of long term care for the elderly.
Use our Eldercare Financial Resource Locator Tool to find other public and private programs that can help pay for or reduce the costs of long term care for the elderly.
