This form is a sample of an agreement between an elderly or disabled client and a Caregiver who operates as an independent contractor and provides personnel to assist Client to live at home and to have as much control over the home environment and life as possible under the circumstances. Caregiver's personnel also assist Client with the activities of daily living, scheduling medication, assistance with mobility, accompanying Client on errands and appointments, and such other services as agreed between Client and Caregiver.
In this agreement, Client waives damages for simple negligence of Caregiver, but not gross negligence or misconduct that is intentional or criminal in nature. Courts generally will not enforce waivers of this type of misconduct since such a waiver would be deemed to be against public policy because it would encourage dangerous and illegal behavior.
Illinois Caregiver Application For Medicaid In Allegheny
Category:
State:
Multi-State
County:
Allegheny
Control #:
US-00458BG
Format:
Word;
Rich Text
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FAQ
Apply for Medicaid Apply Online. Use our quick, easy, and secure COMPASS website. Apply by Telephone. Call the Consumer Service Center for Health Care Coverage at 1-866-550-4355. Apply In-Person. Your local county assistance office (CAO) have professionals that will help you apply. Apply by Mail.
Documents Needed for a Medicaid Application DRIVERS LICENSE, PHOTO ID CARD, OR PASSPORT. SOCIAL SECURITY CARD FOR APPLICANT (and spouse if living) RED, WHITE, AND BLUE MEDICARE CARD. HEALTH INSURANCE CARDS, PREMIUM AMOUNT STATEMENT.
In determining a reasonable and fair level of assistance, UPMC applies a sliding scale. If a patient's income is below 400 percent of the federal poverty guidelines, the patient may receive some form of Financial Assistance.
If you plan on applying for Medicaid, the best Medicaid plan in the state is the Keystone plan, from Independence Blue Cross. I have helped multiple people sign up for Medicaid, and trust me, you're going to want that Keystone plan.
Income & Asset Limits for Eligibility 2025 Pennsylvania Medicaid Long-Term Care Eligibility for Seniors Type of MedicaidSingle Income Limit Asset Limit Institutional / Nursing Home Medicaid $2,901 / month $2,000‡ Medicaid Waivers / Home and Community Based Services $2,901 / month†$2,000‡1 more row •
SOLQ clearance showing an Illinois address. AWVS clearance showing an Illinois address. Current vehicle registration. Current public or private school enrollment records (of applicant or family member who lives with them)
Illinois offers Medicaid coverage for people with disabilities with income up to 100% of the federal poverty level (monthly income of $1,012 for an individual) and non-exempt resources (assets) of no more than $2,000 (for one person).