Oklahoma’s Medicaid program, known as SoonerCare, can help pay home health care costs for eligible seniors through its ADvantage Waiver Program. Medicare can also cover medical costs of care at home but not the nonmedical services available to Medicaid beneficiaries. The Program of All-Inclusive Care for the Elderly (PACE) is a third option (although not available statewide) that combines the medical and nonmedical benefits of Medicare and Medicaid to cover all care costs.

ADvantage Waiver Program, Medicare and PACE

The ADvantage Waiver Program (Medicaid) is the most popular method of paying for home health care services in Oklahoma. It can pay for medical care and nonmedical services, such as home-delivered meals and a caregiver to help with activities of daily living (E.g. bathing, dressing, etc.). To be eligible, the senior must be assessed by an approved professional as needing medical care that can be delivered at home and of having a modified adjusted income within the guidelines. Other qualifying criteria relate to U.S. and Oklahoma citizenship and being aged 65 or older.

Medicare can pay for some skilled nursing services at home, such as physical therapy, speech therapy, medical social services and durable medical equipment (E.g. wheelchairs, hospital beds, etc.). It can also pay for medical supplies but can’t pay for nonmedical services, such as bathing, dressing and home-delivered meals. PACE providers deliver medical and nonmedical care, including prescription drugs, to seniors who qualify for Medicaid and Medicare. The difference is that, unlike the other choices (where the senior has a degree of choice), the PACE provider controls all aspects of care (so, it will supply its own medical professionals and caregivers). 

Home Health Care Vs. Nursing Home Care

Home health care is often the preferred choice of seniors who require skilled nursing services, as it allows them to remain at home while still getting the care they need. Medical professionals visit as per the care plan prepared by the senior’s doctor to deliver home-appropriate care, such as injections and physical therapy. Finding a home health care agency with qualified medical professionals shouldn’t be difficult, as there are many in Oklahoma.

Not all seniors requiring skilled nursing can remain at home. Nursing home care is for patients who need round-the-clock support from medical professionals. This can be people recovering from illness or surgery or those needing care for longer periods. Residents receive meals three times daily and reside in private or shared rooms that are more homelike than hospital rooms, although not as homey as their own residences. There are few amenities, such as those found in assisted living facilities, but residents can socialize as much as their conditions allow.