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.
Caregiver Form Application With Medicaid In Virginia
Instant download
Description
Free preview
Form popularity
FAQ
Virginia Medicaid currently has five MCOs: Aetna Better Health, Anthem HealthKeepers Plus, Molina Healthcare, Sentara Community Plan, and UnitedHealthCare Community Plan.
Applying for Medicaid Apply online at commonhelp.virginia. Call the Cover Virginia Call Center Monday through Friday, 8 a.m. to 7 p.m. and Saturday 9 a.m. to 12 p.m. at 833-5CALLVA (TDD: 1-888-221-1590). Apply online at the Virginia's Insurance Marketplace at marketplace.virginia.
Income & Asset Limits for Eligibility 2025 Virginia 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†$2,0001 more row •
Apply in one of these ways: Apply online at commonhelp.virginia. Call the Cover Virginia Call Center Monday through Friday, 8 a.m. to 7 p.m. and Saturday 9 a.m. to 12 p.m. at 833-5CALLVA (TDD: 1-888-221-1590). Apply online at the Virginia's Insurance Marketplace at marketplace.virginia.
It may take up to 45 days to get a decision on your application. To check your status, you can log in to your account at commonhelp.virginia by clicking the Check My Benefits button or call Cover Virginia at 1-855-242-8282 (TDD: 1-888-221-1590). Is there only one type of Medicaid coverage?
Income & Asset Limits for Eligibility 2025 Virginia Medicaid Long-Term Care Eligibility for Seniors Type of MedicaidSingleMarried (both spouses applying) Medicaid Waivers / Home and Community Based Services $2,901 / month†$4,000 Regular Medicaid / Aged Blind and Disabled $1,043 / month $3,0002 more rows •
Your state Medicaid agency may ask for: Your name and date of birth. Your Social Security number. Your monthly payment amounts for rent, mortgage, or utilities. Proof of citizenship or immigration status. Proof of income, like paystubs or W-2s. A verification of what other government benefits you receive.
The Medicaid agency usually has 45 days to process your application. If the application requires a disability determination, the agency can take 90 days. But, it may take longer for the state to determine your eligibility if you do not provide the required documents on time.
The law requires the State to process medical applications as follows: • 60 days - Medical assistance for persons requiring a disability determination. 45 days - Medical assistance for all others.