Treating your Family As Our Own
Who Pays for MIHC Services: Medicaid pays for the Monitored in Home Care (MIHC) services. Private Insurance or HMO’s do not cover or pay for MIHC services.Member’s Eligibility for MIHC: A Holistic Case Management Health RN and Care Manager meet with members interested in receiving services through the MIHC Program for a complete assessment of their needs. Member eligibility is determined for Level I or Level II service within the MIHC Program. If the Member is eligible a Comprehensive Care Plan is created.
Eligibility (Level I): Monitored in Home Care services are provided to (LEVEL I) medicaid members who meet the clinical criteria for MIHC. Medicaid pays for MIHC at Level I if a member requires:
- At least 16 years of age or older;
- A physician must write an order for MIHC;
- The member must have a medical or mental condition that requires daily physical assistance or cueing and supervision during the task in order for the member to successfully complete at least One ADL;
- A member must be clinically approved for AFC services by MassHealth to receive benefits.
- Physical assistance with THREE ADLs (bathing, dressing, toileting, transferring, ambulating and eating); or
- Physical assistance with TWO ADLs and management of behaviors that require caregiver intervention: i.e. wandering, verbally abusive behavioral symptoms, socially inappropriate or disruptive behavioral symptoms and resisting care.