Admission and Eligibility
Each community-based service or program will have its own eligibility criteria and admission procedures. A basic understanding of the major program eligibility criteria may be helpful in determining which program(s) may help you or your loved one remain independent in the community. Where applicable, there is reference to admission procedures as well.
Below is a brief explanation of the eligibility criteria for a number of:
Persons of all ages are eligible for health and disease prevention screenings. There is usually not a financial criterion for screenings. If a third party is to be billed for the cost of screening there are criteria for reimbursement. Medicare Part B pays for a number of screenings (examples of these include mammograms, PAP smears and prostate and colorectal screenings).
An older person who has Medicare Part B can have an annual flu inoculation as well as pneumonia vaccine at no cost. Others can pay privately or check to determine if private insurance pays some or all of the cost.
There are no age or income eligibility requirements to join a health club or fitness center. The member must only be able to afford the monthly or annual cost. As to physical eligibility—it is strongly recommended that an individual consult with his or her physician to determine the extent of exercise he or she should pursue and then follow the physician's recommendations. If you or your loved one chooses to use the exercise programs and equipment available at senior centers, you must meet the general eligibility criteria for membership.
- Counseling and Support Services
To receive the community-based mental health services covered by Medicare, one must be enrolled in Medicare Part B and have the services provided by a Medicare-authorized health care professional. Medicare's pamphlet, Medicare and Your Mental Health Benefits (PDF), is helpful in fully explaining what mental health services are available for Medicare recipients.
- Nutrition Education
Any person eligible for membership at a senior center or nutrition site may attend nutrition education classes held there. Residents of senior citizen apartment buildings that offer meal service may attend nutrition education programs offered there, even if he or she does not participate in the congregate meal program.
- Adult Medical Day Centers
To be medically eligible for admission to an adult medical day center, one must be at least 16 years old and mentally and/or physically disabled, needing assistance and/or supervision during the day. Financial eligibility requirements for reimbursement under a long-term care insurance policy, the Medical Assistance Program or through a state or local program are discussed in detail in the Adult Medical Day Services section.
- Home Health Care
Medicare covers skilled care provided in the home. Private and long-term care insurance policies may cover skilled care for those not eligible for Medicare; check your policy to determine what kind of home health care may be covered. Personal (or non-skilled) care may be covered by long-term care insurance policies, but is usually available on a private pay basis only. To be eligible for payment under a long-term care insurance policy one must meet the medical eligibility criteria.
If an individual is looking for funding to pay for the services of a nursing assistant through the Senior Care Program, he or she will need to meet the age, income and asset eligibility requirements of that program. The eligibility requirements for the Senior Care program and a number of other programs are provided on the Baltimore County web site.
- Housekeeping/Chore Services
There are specific cases in which there may be Senior Care funding available for chore services. However, most chore services must be paid for privately. To be eligible for funding through the Senior Care Program, an applicant must meet the age, income and asset eligibility requirements of that program.
- Food Delivery
Meals on Wheels provides and delivers meals to individuals unable to shop and prepare food independently. There are no specific income requirements; however, the fee is based on the individual's ability to pay. There may be subsidies available for individuals meeting the age and income requirements of the subsidy programs. The Meals on Wheels staff will refer individuals who may be eligible for a subsidy to the appropriate agency. A case manager may visit the individual in his or her home to determine if the individual is eligible for the subsidy as well as for other benefit programs.
- Volunteer Programs
Each volunteer program has specific eligibility criteria. Most home-based volunteer programs will require that the individual be homebound or unable to leave his or her home without assistance. There are usually age requirements as well, which will vary for each program. The local Maryland Access Point (MAP) Office can provide specific eligibility criteria for any program offered in your area.
- Prescription Deliveries and Hair Care in the Home
There are no eligibility requirements for these services as they are a private arrangement with a provider and the individual pays for these services him or herself.
- Specialized Transportation Programs
The specialized transportation programs offered by local government agencies usually have age requirements. In addition, there may be a requirement that your physician provide proof of your disability. The local MAP Office can give you the specific eligibility criteria for the program serving your area.
- Medical Assistance Transportation Program
Only Medical Assistance recipients are eligible for the Medical Assistance (MA) Transportation Program. The transportation is only available for medical appointments that are covered by Medical Assistance and only if the recipient has no other means of transportation.
For more information about the MA Transportation Program in Baltimore County, the Health Department provides eligibility criteria and contact information on the Baltimore County website. The local MAP Office in other counties and Baltimore City can provide the contact information for the MA Transportation Program operating in the area.
If you or your loved one chooses to attend programs available at senior centers, you must meet the general eligibility criteria for membership. Recreation and Parks programs have no age or income requirements.
- Senior Apartments
Senior apartments are available for individuals 62 and older and younger people with disabilities. The rent is based on one's income—usually it is 30 percent of the adjusted gross income—but there is no income criteria for admission.
- HUD Section 8 Apartments
HUD Section 8 apartments are subsidized apartments for low-income individuals of all ages. There are specific apartment complexes that serve elderly people and individuals with disabilities who need Section 8 subsidies.
Several websites provide information that can provide helpful information for choosing a health care provider.
- The National Institute on Aging offers information about choosing a doctor.
- The Joint Commission that offers accreditation to hospitals has developed a checklist that helps the consumer choose the right hospital.
- Medicare has developed Home Health Compare, an on-line information source that provides a listing of agencies and helpful guidelines to finding a home health care agency.