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Are You Eligible for a Medicaid Waiver?



You may qualify for home-based care paid for by Medicaid. Medicaid is a federal and state program that pays for healthcare for people with limited income or resources. “Medicaid Waivers” give states more flexibility when it comes to providing services to individuals or families who might not qualify for coverage under the traditional Medicaid rules. Through Medicaid Waiver programs, each state can accomplish goals that are important to its residents, such as expanding Medicaid coverage, reducing costs, or improving care to vulnerable groups like elderly people or pregnant women.

One interesting program is the Home and Community-Based Services Waiver Program (“HCBS program”). In many cases, people with disabilities are more comfortable receiving care in their own home instead of in a nursing home or group home. The HCBS program helps people with disabilities or chronic conditions receive long-term care services in their home so they don’t have to move. HCBS services can include home health aides, chore and homemaking services, counseling services, transportation to non medical appointments, and assistance with skill development.

Providing long term care for a person with a disability or a chronic condition can be expensive and time consuming for family members. The HCBS program helps family members because it can cover the kind of care family members would normally be expected to provide themselves. The HCBS program also covers “respite services” so family members can take a temporary break from care giving. Specific HCBS services will be different depending on your state, but every state has some version of the HCBS program. HCBS programs are not entitlement programs, so there may be a waiting list to be accepted into the program.

There are many benefits to the HCBS program. It keeps people in their own home, in their own community, and near family. This type of care can sometimes improve a person’s mental health and/or shorten recovery time after injury or surgery.

If you are interested in HCBS or other Medicaid Waiver programs, first apply for Medicaid to see if you qualify. Generally, a person must show that if they don’t receive the services they are asking for, they would have to move to a nursing home or other institution. Examples of people who may qualify include elderly people, people with developmental disabilities, and people who are medically fragile. More information about the HCBS program can be found at https://medicaid.ohio.gov/FOR-OHIOANS/ Programs/HCBS-Services.

This article was written by Davida Dodson and appeared in The Alert: Volume 35, Issue 3

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