Page Reviewed / Updated - Mar. 2017
Choices is a consumer directed Medicaid waiver that provides home and community-based services and supports to older Ohio residents. Consumer direction is based on the federal Cash and Counseling program which allows the individual receiving care services to self-direct their own care. This means they are given the flexibility to select from whom they receive care services and from whom they purchase medical equipment and supplies. Waiver participants are assessed for their care requirements and allocated a budget for goods and services. A third party fiscal agent is empowered to make payments on the waiver participant's behalf.
This type of care delivery model is becoming increasingly popular with families because it allows a loved one to remain living at home instead of in a nursing home and because certain family members and friends are eligible to be hired as personal care providers. While spouses and legal guardians are not eligible, adult children can become paid caregivers for their parents.
The State of Ohio has restrictions for the age, physical residence, functional ability and financial resources of applicants.
Age and Residence Requirements
Applicants must be at least 60 years of age. They must be Ohio residents and live in the south, central or northwest areas of the state. They also must be living at home; they cannot reside in skilled nursing homes or assisted living residences.
Functional Ability Requirements
Applicants must require assistance with the activities of daily living such as mobility, transferring, bathing, personal hygiene and eating. This waiver is offered in conjunction with Ohio's PASSPORT waiver, therefore the individual must be eligible for that waiver as well.
Applicants must be financially qualified for Ohio Medicaid which considers both their income and assets. The 2014 income limit is $2,163 / month for an individual applicant. If they are married and their spouse is not seeking Medicaid, then some of their joint income can be shifted towards the spouse to help the applicant meet the limit.
The 2014 asset limit is $1,500 for an individual. However, if married and the spouse is not applying, the spouse is allowed up to $117,240 in countable assets. One's home and primary vehicle are considered non-countable assets in most circumstances.
When Resources Exceed the Limits
Ohio does not offer a Medically Needy Medicaid program. Therefore individuals whose assets and incomes exceed these limits cannot qualify. However it is possible to re-structure one's income and assets into trusts, annuities and other forms of non-countable assets so that one does meet the limits and can qualify for Medicaid. It is worth noting that to achieve this goal is complicated and usually requires the assistance of Medicaid planning professionals.
At the time of enrollment in the Choices Waiver, participants are assessed by a team of medical professionals to determine the care and medical services they require. An individual plan of care is developed which may include any of the following. Once developed, the participant elect from whom to purchase goods and services.
As of March 2014, the Choices Waiver was scheduled to cease operations at the end of June 2014.
As of March 2013, the Choices Waiver was only available in certain areas of Ohio. These are the geographic areas served by the Area Agencies on Aging based in Columbus, Toledo, Marietta and Rio Grande. This program is not an entitlement program and there are a limited number of slots available. This means that while an individual may meet all the eligibility criteria, they may still be put on a waitlist for services.
To learn more or apply, contact your local Ohio Area Agency on Aging.