What caregiver services do government programs (SSID) cover for spinal cord injury?

In general, Medicare does not cover unskilled services; they cover skilled care in the home for homebound care on a short-term basis. But unskilled care they do not cover. Medicaid programs vary from state-to-state.

Every state is different, every county is different, and every city is different. The resources available are as variable as the amount of as many cities and counties there are in the United States of America. I worked in a program that covered five states—Alaska, Washington, Oregon, Idaho, Montana, parts of Wyoming and Utah—that’s pretty big territory and each of the Medicaid programs were different. Some had nursing homes for people on ventilators, most of them didn’t, so if you were on a ventilator from that state you couldn’t live in that state. Some had an in-home program that said, “We’ll come by and spend an hour.” The other says, “We’ll cover 16 hours-a-day.” It’s hugely variable.

There is one waiver program in Arkansas—and I’m pretty sure the other states have that too—that provides monetary assistance to the family to be the caregiver. They also have a program where they have a home-health agency that provides the caregivers, and they just pay the healthcare agency to send the caregivers out. They also have another program—well in Arkansas it’s called Independent Choices—and they give the family the money, and they can utilize it for personal care services. Or if there’s medical supplies that their insurance company maybe doesn’t’ pay for, they can use part of that money on those things, so it doesn’t have to come out of their pocket.