What Can I purchase with my monthly budget?
• Employment of individuals, including family members, to provide personal assistance; • Cleaning services from private companies to clean personal areas including bedroom, bathroom, kitchen, etc.; • Errand service to assist with banking, shopping and other types of routine tasks; • Laundry service from a laundromat or other provider; and, • Supplies and equipment that promote or enhance independence that are not covered by Medicaid.
How is the monthly budget determined?
Your MCO (Aetna, Amerigroup, Horizon NJ Health, UnitedHealthcare Community Plan or WellCare) is responsible for authorizing the number of Medicaid PCA hours you are eligible to receive, to provide you with options counseling and to enroll you into the PPP. The MCO uses the hours of service authorized from your initial PCA clinical assessment (or most recent reassessment) as the basis for determining your monthly budget. The number of authorized hours is converted into a dollar amount using the current reimbursement rate. A standard administrative deduction is then calculated to cover the costs of counseling and bookkeeping services. The remaining amount is available to you for purchasing services. The financial consultant will assist you in developing a cash management plan to help determine how best to spend your monthly budget to purchase services that you need.
What should I do if I’m not taking advantage of the PPP/PCA program through my MCO?
CONTACT YOUR SUPPORT COORDINATOR AT SPECTRUM CARE MANAGEMENT AND COUNSELING AND WE WILL GUIDE YOU!