Caregiver Form Application With Medicaid In Washington

State:
Multi-State
Control #:
US-00458BG
Format:
Word; 
Rich Text
Instant download

Description

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.
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  • Preview Personal Care Service Agreement - Caregiver for Elderly or Disabled - Consent
  • Preview Personal Care Service Agreement - Caregiver for Elderly or Disabled - Consent

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FAQ

Online: Go to Washington Healthplanfinder - select the "Apply Now" button. Mobile app: Download the WAPlanfinder app​ – select “sign in” or “create an account”. Phone: Call the Washington Healthplanfinder Customer Support Center at 1-855-923-4633. Paper: Submit an Application for health care coverage (18-001P).

Definitions. Parents of Dependent Children: Income limits for 2024 are reported as a percentage of the federal poverty level (FPL). The 2024 FPL for a family of three is $25,820. Other Adults: Eligibility limits for other adults are presented as a percentage of the 2024 FPL for an individual is $15,060.

Home Care Aide (HCA) Training HCAs (Agency and Facility) and Individual Providers may begin providing direct care after completing the 5-hour Orientation and Safety trainings. Get more information on the Home Care Aide Certification and 75-hour training page.

Duals have both Medicare and Medicaid. the payer of last resort if there's another insurance (i.e. an employer or retiree health plan). Once on Medicare, claims are processed FIRST by Medicare A or B or their MA plan (Part C).

In Washington, the median household income is $82,400 and the per capita income is $43,817, ing to the 2021 U.S. Census. This means that an annual household income of under $65,920 or an annual per capita income of $35,053 for a single-person household would classify a senior as low income.

If you are eligible, Medicaid pays for services in your own home, a community residential care facility (adult family home or assisted living facility) or nursing facility. If you are 18 or older, you can apply for Medicaid through your local Home and Community Services (HCS) office or online.

Income & Asset Limits for Eligibility 2025 Washington Medicaid Long-Term Care Eligibility for Seniors Type of MedicaidSingleMarried (both spouses applying) Income Limit Asset Limit Institutional / Nursing Home Medicaid $2,901 / month $3,000 Medicaid Waivers / Home and Community Based Services $2,901 / month† $3,0001 more row •

Income & Asset Limits for Eligibility 2025 Washington Medicaid Long-Term Care Eligibility for Seniors Type of MedicaidSingleMarried (both spouses applying) Income Limit Asset Limit Institutional / Nursing Home Medicaid $2,901 / month $3,000 Medicaid Waivers / Home and Community Based Services $2,901 / month† $3,0001 more row •

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Caregiver Form Application With Medicaid In Washington