If you have been told your mother is on CCC Plus, and someone else says Cardinal Care, and a third person says Medallion, you are not confused. The names changed and not everyone updated their script.
Here is the plain version.
Cardinal Care is the whole program
Virginia renamed its Medicaid program Cardinal Care. It covers everyone: children, pregnant women, adults, older adults, people with disabilities. If you have Virginia Medicaid, you are in Cardinal Care. The older names Medallion 4.0 and CCC Plus described two separate managed care programs that have since been brought together under the one Cardinal Care name.
CCC Plus is the waiver, and the waiver is what pays for care at home
This is the part that matters to your family.
Regular Medicaid pays for doctors, hospitals, medicine. It does not pay someone to come to the house and help your father bathe. A waiver does. The CCC Plus Waiver is the one that covers personal care, respite and related services at home for people who would otherwise need nursing facility care.
So when a care coordinator says “she is on Cardinal Care” they are telling you which program she is in. When they say “she has the CCC Plus Waiver” they are telling you that home care is covered. Those are different sentences and only the second one answers your question.
Your health plan is a third name
Inside Cardinal Care your family also has a managed care plan. In Northern Virginia that is Anthem HealthKeepers, Sentara, Humana or Aetna Better Health. The plan is who authorizes hours and who the agency bills. It is not the same thing as the waiver.
Three names, three different jobs:
- Cardinal Care is the program. It says you have Virginia Medicaid.
- CCC Plus Waiver is the benefit. It says care at home is covered.
- Your plan is the administrator. It says who approves the hours.
What to ask, and who to ask
Call the number on the back of the Medicaid card and ask two questions.
- Does she have the CCC Plus Waiver, or is a screening still needed?
- Who is her care coordinator, and what is their direct number?
The care coordinator is the person who arranges the assessment that sets the number of hours. If the answer to question one is that a screening is still needed, ask how to request one. Nothing else moves until that is done.
Where we fit
Millennium Home Health Care is enrolled with Virginia Medicaid and contracts with all four Cardinal Care plans in Northern Virginia. We are licensed by the Virginia Department of Health, license HCO-14982.
We can tell you quickly whether your situation looks like it fits, and we will tell you just as quickly if it does not. We cannot approve anyone. DMAS and the health plan decide who qualifies and for how many hours.
If a family member is already doing the caring, ask us about consumer-directed care. Virginia allows a spouse, adult child, sibling, niece, nephew or grandchild to be the paid caregiver, and the hours can be split so that person still gets a break.
Call (703) 941-8412 or ask for a free in-home assessment. A real person answers, in English or Amharic.
If a family member is already doing the caring
Virginia’s consumer-directed programme can pay a relative to be the attendant, and the week can be split so that person still gets time off. Two pages worth reading next:
- Get paid to care for a family member covers who qualifies and how the screening works.
- Paid family caregiver, with real time off covers what happens when one person is carrying the whole week, and how to divide it.