The Story of How Texas Medicaid Helps Connect Texans with Long-Term Care at Home

Something was very wrong. Even though it wasn’t clear what was happening to Michael Lerma, it was obvious he needed to get to a hospital as quickly as possible. After arriving at the hospital, physicians diagnosed Michael with viral encephalopathy, and he’d fallen into a coma.

Thankfully, Michael recovered and was stable enough to leave the hospital. He was able to transfer to a nursing home in Round Rock for care, but Michael was experiencing impaired speech and a general lack of awareness. He was wheelchair-bound, requiring supervision and care for all his needs.

Michael’s mom, Janie, thought Michael would show greater improvement if he was able to receive care at home. Texas Medicaid and UnitedHealthcare were there to help.

After spending about a year in the nursing facility, UnitedHealthcare helped Janie transition Michael to her home in Thrall, Texas, where he could receive constant care and support from his family and Texas Medicaid team. UnitedHealthcare worked with Janie to modify her home and improve accessibility for Michael through changes including a shower conversion, bedroom ramp installation and lift modification to the family van. The team also connected Michael’s family with in-home skilled nursing, attendant care, therapy, respite services and even meal delivery to help him on the road to recovery.

Michael has improved significantly since he returned home and began working with UnitedHealthcare. He is alert and oriented with clear speech. His strength, dexterity and mobility have all improved so much that he requires little hands-on assistance.

“I’m very grateful for Texas Medicaid. Very, very grateful. Because we have always gotten everything we needed,” said Janie.

With the support of his family and assistance from his team at UnitedHealthcare, Michael works hard each and every day to be as independent as possible. Thanks to his Texas Medicaid service coordination, he is able to do so from the comfort of the home he’s chosen as he lives his life to the fullest.

“The STAR+PLUS waiver program allows Michael to remain in his own home, he remains independent, he’s allowed to participate in his own health care needs, and that’s why Texas Medicaid works for them. At the end of the day, it’s about his quality of life and his quality of care,” said UnitedHealthcare Health Service Manager Andrea Oates.

Watch now to see how Texas Medicaid helps Texans utilize long-term care in the environment of their choice.

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Texas Medicaid Works is an education and advocacy effort highlighting the impact of Medicaid in Texas. We highlight the need for continued innovation in Medicaid and to ensure that Medicaid’s best solutions reach as many families as possible.

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