Resources

Frequently Asked
Questions

Getting Started With The CDPAP
Home Care Program – How To Enroll

For Patients

Our agency will assist you in several ways: helping you and your chosen caregiver enroll; managing employment details for your personal assistant; paying them weekly; and serving as a go-between you and MLTC medical long term care). Medicaid requires a Fiscal Intermediary (FI) like Horizon to process the funds used to pay your personal assistant.

How do I sign up?

1.
Call us at 518-203-3271 and speak with one of our knowledgeable, friendly reps. Please have your Medicaid number handy and we’ll work with your insurance plan to confirm your eligibility.
2.
Paperwork – we’ll share the necessary forms with you. You will need to have an assessment by a nurse who will work with a doctor to complete the medical forms.
3.
We come to you – one of our local Upstate New York team members will visit you and provide you and your caregiver details on how the program works and get the caregiver signed up to work and get paid.
4.
Systems and Payroll – once you and your caregiver are onboard, we work behind the scenes to ensure that everything is set up properly in our systems so that your caregiver is paid efficiently in a timely manner.

Yes. Call us at 518-203-3271

First you, the patient, must contact their insurance company to make the request to switch. Next, the caregiver must provide their medical form with their physical exam results. One of our local Upstate New York team members will come visit the two of you right in your home and complete the necessary paperwork so your caregiver can get paid from our agency.

The amount of time it will take to verify eligibility and onboard your caregiver can be as little as 1 week depending on the response times of your insurance company, your completion of the intake process and your caregiver providing their medical and work authorization forms.

No. In most cases, we can handle everything by phone and email. However, our local Upstate New York team members will also come to your home if you prefer.

While we have offices, our team can also come right to your home if you prefer. Coming into one of our offices is by appointment only. We have local offices in Monsey, Monroe, Canton, Syracuse, Rochester, Troy, and the Bronx.

Patient Qualification For The
Medicaid CDPAP Program

Yes. The CDPAP program is paid for and administered by Medicaid. If you do not yet have Medicaid but believe you might qualify, call 315-328-5229 To reach someone who can help determine if you qualify and, if so, get you enrolled.

Unfortunately, the CDPAP program is only available through Medicaid which is health care coverage provided by state and local government. Medicaid is only available based on income eligibility citizens. The federal government provides Medicare health coverage to individuals 65 years old and older or who have a severe disability. Medicare is available to people of all incomes.

First, you must be on Medicaid and live in the state of New York. Then, a medical practitioner, typically a nurse, will evaluate your need for assistance with activities of daily living (ADLs) such as meal prep, eating, bathing, grooming, cleaning, transportation and errands. Based on that assessment he or she will determine if you qualify and how many hours of care you may receive each week through the program.

You may qualify. Call us at and we can help determine your eligibility.

Your insurance company will approve you for a certain number of hours. Typically, they will ask you to select one program or another. If you choose to use a combination, the insurance company may limit the total number of hours for CDPAP.

We work with most health plans in New York state. Our team members coordinate with plan administrators to ensure you qualify, get you enrolled, and get your caregiver paid.

No. The CDPAP program pays individuals directly, not agencies. With the CDPAP program, the caregiver is typically a family member or friend.

Managed long-term care at home (MLTC )plans are available on a regional basis to those who have Medicare and Medicaid (dually eligible individuals) and require long-term care services and supports. MLTC plans are approved by the New York State Department of Health. In many cases, Horizon is able to work with MLTC plans to provide at home care to you in your home.

Choosing A Caregiver

You can choose an adult child, sibling, other relative, friend or neighbor to be your in home caregiver. They must be at least 18 years old, be eligible to work in the U.S. and complete and pass a physical exam with documented work clearance (called a Habituation Statement).

Legal spouses, designated representatives (authorized to make home care decisions for you) are not eligible. For persons with disabilities or special needs, parents are ineligible if the patient is under 21.

Patient Costs

Working through authorized agencies like Horizon Home Care Services, Medicaid pays all costs. The CDPAP program is absolutely free to you. There are no hidden costs. No cost to enroll. Still have questions? Call and speak with one of our knowledgeable team
members.

CDPAP Caregiver Requirements –
Qualification Process

No, however you will need to have a physical and submit a form completed by your doctor confirming your physical abilities.

No you will not need a background check. your patient may request that you do one, but we do not.

● 18 or older
● Can be an adult child, other relative, neighbor or friend (spouses not eligible)
● Pass a physical and submit the medical form signed by a doctor
● Authorized to work in the U.S – must submit an I-9

● A legal spouse
● Designated representative who makes home care and other decisions for the patient
● Parent, if patient is under 21

● Pass a physical and submit the medical form signed by a doctor
● Fill out an application – we will provide this to you
● Provide an I-9 form verifying your identification and authorization to work in the U.S.
● Complete an application including a W-4

No. We will work with you by phone for the initial steps and then will come meet with both you and the patient at their home.

Yes. As long as your neighbor/brother/sister, etc. live in New York state and have Medicaid, you can be compensated as their caregiver.

Yes. As long as you can prove you are authorized to work in the U.S. Contact us and we’ll help you get the right form (the I-9).

Medicaid Family Caregiver Compensation -
Getting Paid

Yes, as long as you can work your agreed up caregiving hours.

Rates vary by county and the member’s insurance. They change often. However, we offer competitive rates. Call us to at 315.238.5229 to learn more.

No, but you will only be paid for the number of hours you actually work.

No. but you will only be paid for the number of hours you work and some plans will not
allow overtime pay.

Once you complete the onboarding process and get the go ahead to start working for your member, you will start earning your wages. You can choose to get paid via direct deposit, pay card, or a paper check in the mail.

Our team members are standing by to help you. Just call 315.238.5229 and one them will help you. After hours you may leave a detailed message and we will research the issue and respond no later than the next business day.

Every caregiver earns up to 56 hours a year of sick pay. You accrue one hour of sick pay for every 30 hours worked. In addition, there are wage parity benefits for caregivers who work in NYC, Westchester, Nassau and Suffolk counties. These benefits include PTO, Flex benefits and Medical Benefits.

Only in wage parity counties which include NYC, Westchester, Nassau and Suffolk counties.

Every caregiver earns up to 56 hours a year of sick pay, accruing one hour of sick pay for every 30 hours worked. In addition, some areas such as NYC, Westchester, Nassau and Suffolk counties offer wage parity benefits for caregivers. These benefits include PTO, Flex benefits and Medical Benefits. Caregivers may use their PTO days for vacation.

Caregiver Duties And Responsibilities -
Daily Work And Special Cases

You will personalize the service you provide to the patients. Often, they need help with:
● Bathing
● Dressing
● Preparing meals
● Taking medication on time
● Doing errands
● Transportation to doctor’s appointments
● Light housekeeping
● Laundry

Contact your Client Care coordinator to let them know. Once the patient is admitted, you must not claim hours. Medicaid will not pay you during patient hospitalizations.

You need to communicate your schedule directly with your member. It is up to them to have a backup caregiver in case the need arises.

No, personal expense for you such as travel and meals are not reimbursable through the
CDPAP program.

Not necessarily. When you and your patient begin your arrangement, you should work together to determine your schedule. In most cases, you can build in the flexibility your need.

Pay And Benefits

Upon enrollment your coordinator will give you Electronic Visit Verification (EVV) information and explain the time tracking process. There are 3 methods you can use, including the patient’s Phone, our app on your phone, or a small FOB (fixed object device) in the patient’s home. You will need to log in at the beginning and end of each shift in order to get paid. If you have any technical issues or forget to clock in or out, please call your client care coordinator.

Caregivers earn up to 56 hours per year of sick pay, accruing one hour for every 30 hours worked. Also, in some areas such as NYC, Westchester, Nassau and Suffolk counties caregivers also are eligible for wage parity benefits. These benefits include Flex benefits, Medical Benefits, and PTO. They may use their PTO days for vacation.

Electronic Visit Verification (EVV) records go directly into our payroll platform. Once you successfully call in or you do not need to do anything else.

Our payroll system has an app where you to view your paystubs and year-end
documents. The Electronic Visit Verification (EVV) app also has all your clock in information.

Our team members can help you. Just call 315.238.5229 After hours, please leave a detailed message and we will
research the issue and respond no later than the next business day.

Patient Qualification Criteria
For Special Needs And Disability

Yes. As long as he or she has Medicaid and lives in New York State, they will likely qualify.