Understanding your long-term care (LTC) coverage
If you have a Humana LTC Plan as part of your Florida Medicaid coverage a care manager will reach out to you soon to set up a welcome visit in your home. The care manager will introduce you to these services.
The goal of the Medicaid LTC program is to let you live where you want for as long as you choose. We provide long-term support and services to help you live in your home and your community. A care manager will make sure you get the services you need.
For a full list of services and to learn what’s covered, see your member handbook.
Medicaid covers these LTC services for you:
- Adult companion care and attendant nursing care
- Adult day healthcare
- Assistive care services, assisted living, nursing facility services, hospice services and respite care
- Behavioral management
- Caregiver training
- Care coordination / case management
- Homemaker services
- Intermittent and skilled nursing
Health and wellness services
- Nutritional assessment and risk reduction
- Personal care services
- Personal emergency response system (PERS)
- Physical therapy, respiratory therapy, occupational therapy and speech therapy
Supplies and other services
- Medical equipment and supplies
- Medication administration and management
- Home accessibility / adaptation services
- Home delivered meals
Plus more from Humana
Humana wants to help you get the most out of your LTC plan by providing extra services and support.
- Assisted living bed holds or reservations
- Cell phone service
- Discount at CVS stores
- Day trip meal reimbursement/allowance
- Vision services
- Hearing services
- Individual therapy sessions to caregivers
- Non-emergency transportation
- Outpatient hospital services
- Over-the-counter (OTC) drug allowance
- Support to transition out of a nursing facility
You may need to get approval before using these benefits. This is called prior authorization. You can always call Customer Care if you have questions about what needs prior authorization.
Care coordination and case management
We know keeping everything organized can be a challenge when it comes to your healthcare. Part of your LTC plan is having the help of a care manager. The care manager will help manage and organize your care.
Your care manager is your contact for getting services through Humana’s LTC program. The care manager will help coordinate your care and act as a case manager while helping you meet your LTC needs.
Electronic Visit Verification
Humana has partnered with HHAeXchange, a leading Electronic Visit Verification (EVV) vendor, to electronically confirm members are receiving the care they need, when they need it.
In 2016, the 21st Century CURES Act was passed. This Act requires the individual receiving services and the caregiver performing services to electronically verify the type of service, the date, the location where the service was performed, and the time the service starts and ends.
What is EVV?
EVV is a technology solution which electronically verifies your caregiver or home health aide was providing services in your home on the dates and times scheduled by the agency. This helps ensure your Medicaid dollars are being spent properly on services that were actually delivered to you.
How EVV Works
The process is simple! Your caregiver can electronically clock-in and clock-out at the start and end of each visit and enter the services they performed. This data is automatically sent to the caregiver’s agency for confirmation, and then transferred to Humana for processing.
What to Expect
Starting December 1, 2019, you may notice your caregiver utilizing HHAeXchange’s EVV methods to clock-in at the start of services and clock-out at the end of services. HHAeXchange offers two simple and easy-to-use methods:
- Member’s Landline: Using your landline phone, your caregiver can call a special HHAeXchange phone number to clock-in and out and record the services they provided during the visit. The EVV system recognizes the phone call is coming from your home phone, ensuring the caregiver was in the correct location at the time of service.
- Caregiver Smartphone: Your caregiver can download the HHAeXchange mobile app on their cell phone and clock-in and out while in your home using the mobile app. Their phone’s GPS will verify the location of the service.
If you have any questions or concerns, please contact your homecare agency to discuss which EVV method is best for you.
Participant Direction Option
There is another option for you as a part of your LTC plan—the Participant Direction Option (PDO). The PDO allows you to self-direct your services. This means you get to choose who provides your services and how and when your services are provided. You are responsible for hiring, training and supervising your direct service workers.
Find more information about PDO
Find a doctor
It’s important to know which doctors you can see on your plan.
LTC specialists and services covered by your plan include adult day care centers, homemaker and companion services, adult family-care homes, assisted living facilities, home health agencies, hospices and nursing homes.
Find a doctor with your care manager
Finding a doctor or specialist you trust is important. Your care manager will help you choose a doctor in our LTC network in your area. Talk to your care manager if you need help or have questions.
Find a doctor online
You can search for a doctor yourself, too. It’s easy to use Humana’s online Find a Doctor tool to search for a doctor or healthcare facility. You can compare doctors, filter by distance and even view ratings.
Caring for a loved one can be challenging. Humana offers support and resources to help you. Looking for the forms you need to grant a caregiver access? You can find those here, too.