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This Oklahoma Medicaid waiver is designed to help frail elders remain living in their homes, or the home of a family member, instead of in a nursing home environment. Seniors participating in the ADvantage Program can access a variety of long term care services, such as personal care and assistance, home modifications for increased safety and access, and adult day care.
Participants in the program have the option to let the state manage the care services they receive or self-directing their own care. Self-direction—also referred to as participant direction or Cash and Counseling—is through the associated program, Consumer-Directed Personal Assistance Services & Supports (CD-PASS).
Under the CD-PASS program, participants are free to choose their own personal care providers. Family members, with some exceptions, are eligible to be hired and paid to provide personal care services to the participant. Originally not available statewide, the program became available in all Oklahoma counties as of November, 2015.
Another option available under ADvantage, is assisted living. Formally called the Assisted Living Service Option (ALSO). ALSO is available to all program participants.
To be eligible for this waiver, an applicant must be a resident of Oklahoma. Age, functional ability, income, and assets are also all qualifying criteria for the ADvantage Program. Age and functional ability are related. Persons 21 and over are eligible if the Social Security Administration designates them as disabled. Persons 65 and over do not require full disability; instead they must have a need for the level of care provided in nursing homes.
Financially, the ADvantage Waiver requires that applicants qualify for Oklahoma's Institutional Medicaid. Medicaid in Oklahoma is also referred to as SoonerCare. The SoonerCare income limit for long term care services for a single applicant is $2,205 per month. The countable resources limit is $2,000. However, certain assets are considered exempt. For instance, an applicant’s primary home, given he or she lives in it, and it is valued under $560,000, is exempt.
If the individual is married and their spouse is not applying for Medicaid, their spouse is entitled to up $3,022.50 per month of their joint income and one half of the joint savings and retirement accounts, up to $120,900 in 2017.
Couples interested in preserving as much of their retirement savings as possible should consult a Medicaid planning adviser. These experts can usually help to restructure assets and income so that couples can maximize the spousal allowances and ensure eligibility. Read more.
The ADvantage Waiver is intended to help the elderly remain living at home. Therefore, the available benefits are selected with that goal in mind. Waiver participants can be approved to receive any of the following services. Certain unskilled services, most relevantly personal care, are available for self-direction.
The ADvantage Waiver is a SoonerCare program managed by the Aging Services Division of the Oklahoma Department of Human Services. It has replaced two older state waivers, My Life; My Choice and Sooner Seniors.
While available throughout Oklahoma, waiting lists may exist. The waiver's CD-PASS option, where family members are eligible to be hired and paid as caregivers for their elderly relatives, is currently available throughout the state.