Elements of a Functional Assessment for Medicaid Personal Care Services
This policy brief identifies the elements states use for an assessment of a person’s physical and cognitive limitations and need, and compares these elements to the requirements of the CLASS Plan.Date Updated: 04/06/2011
State Medicaid programs provide long-term services and supports for eligible individuals who have been assessed and determined to be in need of these services. Medicaid beneficiaries must meet financial as well as medical/functional eligibility criteria. Included in the array of long-term services and supports are personal care services, which provide assistance to individuals with their activities of daily living (ADLs), such as bathing, eating, and dressing, as well as assistance with their instrumental activities of daily living (IADLs) such as shopping, preparing meals, and housecleaning…
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This policy brief provides background on the historical development of benefit eligibility triggers in the private long-term care insurance market. Understanding how these triggers came into being can provide important information to those charged with implementing the CLASS Plan.
This policy brief provides information about how long-term care insurers implement benefit eligibility triggers in the private insurance market. The way in which companies have operationalized benefit eligibility triggers can inform the development of regulations for the CLASS Plan.
This policy brief provides information on the benefit eligibility assessment process in the private long-term care insurance industry. It focuses on how long-term care insurers use the information in the adjudication process, who is involved in the process, and how activities of daily living and cognition are assessed.