The Process to Get PCA Services Set Up in Minnesota
Do you have coverage for PCA Services?
Do you know the process to get PCA services set up in Minnesota? First, you must determine if you have insurance coverage. In this state, most Personal Care Assistant (PCA) services are covered by Medical Assistance (Medicaid). However, if you're not eligible for one of these programs, Minnesota Quality Care can help you find out if you have coverage through other insurance you may have. If you don't have insurance coverage, we have reasonable prices for our PCA services.
Are you eligible?
To start, a public health nurse will conduct a PCA Assessment to review if you're eligible to receive PCA services. The nurse determines if you meet program requirements and, if so, how many hours of service you may receive. In addition, you'll need a prior authorization from your health plan, and after that a plan of care. Last, but not least, we find and train PCAs to care for you. Sometimes a friend or relative may even qualify to be your PCA!
We can help you through the process.
Does this all seem complicated? It is! Minnesota Quality Care was established in 2000 and has the experience to guide you through this process, beginning to end. We have shepherded thousands of satisfied clients through every step of setting up PCA services, all while following the eligibility rules in Minnesota.
In conclusion, PCA services can allow you to stay at home, so it is well worth investigating. And don't worry! We do this every day, so we make the process as smooth and seamless as possible. After all, that's our job.
Want to see the PCA process, step-by-step? We've outlined it for you below.
How to set up PCA Services in Minnesota
This "how to" describes the process to get PCA services in Minnesota.
- Obtain Coverage for Minnesota Medical Assistance (Medicaid)
- Firstly, if you don't already have coverage for Medical Assistance (MA), apply for coverage at your local county offices. Similarly, you can also apply online through MNSure.
- If you need PCA services and help with its expenses, then it is important to determine your eligibility. Most clients on MA and MinnesotaCare will have a health plan and, perhaps, a Care Coordinator to help them.
- Not everyone is eligible for MA. Even if you qualify for coverage, you may not be entitled to receive PCA services. Eligibility for MA is based on your income and, in some cases, on your assets (like your home and savings accounts).
- Request a PCA Assessment
- Once you have coverage, the next step is to obtain a PCA assessment. Minnesota Quality Care will help arrange an assessment with your health plan or county public health office.
- Subsequently, a specially trained Public Health Nurse will come to your home to evaluate your need for PCA services. The assessment is very thorough, and it will determine how many hours of PCA services you will have each week.
- You can read more about the PCA Assessment at the Department of Human Services website. Above all, it's very important to be completely honest with the nurse and explain everything you need help with.
- Obtain a Prior Authorization from your Health Plan
- Once you have your assessment, you'll need a prior authorization from your health plan.
- Your health plan will want to review your PCA assessment. Based on that assessment, they will first determine the number of PCA hours you're qualified to receive and then issue a prior authorization.
- Minnesota Quality Care will request the prior authorization for you. See our Resources page for contacts at all of the health plans.
- Develop a Plan of Care for your PCA Services
- So you have your prior authorization - what's next? After that, one of our nurses will come to your home to help you develop a plan of care.
- In the plan of care, the nurse writes up a very specific plan for the assistance your PCA will provide to you on a scheduled basis.
- Find and Train your PCA(s)
- Lastly, Minnesota Quality Care will find and train your PCAs.
- Most importantly, you will work with us to decide which PCAs will come into your home to provide personal care for you.
- In many cases, you may have a friend or a relative who qualifies to be your PCA. If so, we will provide training and supervision for your friend or relative.
- Ongoing Supervision of your PCA Services
- After your PCA services are set up, Minnesota Quality Care will walk alongside you every step of the way.
- Our nurses monitor your care and the PCA services you receive to make sure you are safe in your home.
- In short, if you have problems with your PCA services, we are only a phone call away.