What I'm looking for specifically is the Medicaid Tech Waiver program guidelines. I have the links to the VA Medicaid office and the nursing and insurance books, but I can't find anything that specifically spells out how they determine your hours of nursing. I have been told by two hospital social workers that with at least 53 points you qualify for 16 hours a day until 1 month after the trach comes out. We have over 160 points because we both work, have 2 other kids, and Michael's condition, of course. I could hire a lawyer if they cut me, but it would be so much cheaper and easier if I could show the case worker what Medicaid offers before hand. If anyone knows where this is on-line, or has a Medicaid worker who could get this (it's public information), please let me know. Our Medicaid lady is...let's say, very tight with information. If this doesn't work, I'll try the insurance ombudsman that was recommended to me before. Thanks, guys! Sue Links are below if anyone needs them.
http://www.dmas.state.va.us/ this is the VA Medicaid site
http://www.state.va.us/scc/division/boi/ VA insurance site