By Federico Salas, J.D.
On May 13, 2019, Governor Larry Hogan signed into law Senate Bill 699, helping hundreds of Marylanders who receive services at home through Community First Choice (CFC) to avoid losing access to those services once they get Medicare. Beginning July 1, 2019, affected Marylanders will be allowed to apply to the Medicaid Home & Community Based Options Waiver without having to go on its eight-year waiting list or having to go through unnecessary and extremely costly nursing home admission.
Under federal law, Medicaid Expansion coverage ends at age 65, or when the individual gets Medicare (i.e., either enrolls due to disability or turns age 65). In Maryland, if the individual qualified for CFC services through their Medicaid Expansion coverage, this also means that they will lose their CFC services when they get Medicare.
For most, or about 75% of those affected with too much income or assets, the only viable option to resume receiving CFC services is to access the Medicaid Home & Community Based Options Waiver. However, the Waiver currently has a 22,000-person, eight-year waiting list. In addition, prior to Senate Bill 699, the only way to bypass the waiting list was to transition back into the community after a qualifying 30 day nursing home stay while on Medicaid. Thus, for many Marylanders who lost their CFC services after getting Medicare, accessing the Waiver typically meant that they had to first go through unnecessary and extremely costly nursing home admission.
How Do I Know If I Am Affected?
Generally, those that may be affected are Marylanders who both: (1) have or had Medicaid Expansion coverage; and (2) receive or received Community First Choice services at home. In addition, those at risk of losing access to services tend to have monthly incomes of $771 – $1,396 (in 2019)*, or, assets greater than $2,000 (not including the home and one car).
To find out if you or a loved one can benefit from Senate Bill 699, contact your local Maryland Access Point office or the lawyers at Frank, Frank & Scherr, LLC.
*These figures are subject to change annually. Refer to the current income limits for SSI and Medicaid Expansion, respectively.