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Posted by Positive Aging SourceBook on 05/26/2022

Medicaid Waivers

Medicaid Waivers

For millions of Americans living on limited incomes, Medicaid is an essential program. Many Americans are eligible for both Medicaid and Medicare. These dual enrollees may also be eligible for Medicaid Waivers that will cover home and community-based care in lieu of nursing home care. 

What is Medicaid?

Medicaid provides health coverage for low-income Americans. Although the Federal government establishes certain parameters for all states to follow, each state administers their Medicaid program differently.

How do Medicaid and Medicare work together?

According to the Centers for Medicare and Medicaid Services, Medicaid provides health coverage to 7.2 million low-income seniors and 4.8 million people with disabilities who are also enrolled in Medicare. These individuals are referred to as “dual enrolles” or “dually eligible.” 

What is a Medicaid Waiver?

Many older adults prefer to age in their homes and communities, rather than moving to a long-term care setting. Medicaid Waivers can help make this possible. 

Within broad Federal guidelines, States can develop home and community-based services waivers (HCBS Waivers) to meet the needs of income-eligible individuals who prefer to get long-term care services and supports in their home. State programs have their own names, eligibility requirements, and coverage limitations. 

Qualifying for Medicaid Waivers Is Easier Than Traditional Medicaid

Eligibility for Medicaid coverage is entirely based on income; however, individuals who DO NOT qualify for traditional Medicaid MAY QUALIFY for Medicaid waivers to receive home and community-based services. 

When applying for a Medicaid waiver, states first consider the applicant’s need. They determine if the individual needs assistance with the activities of daily living or has a medical nursing need. For individuals who have a confirmed need, states only consider the income of the individual covered by the waiver. Therefore, a lot of applicants who would not qualify for traditional Medicaid because of household income will qualify when only their personal income and assets are counted. 

Families should not assume they will not qualify!


Understand Virginia Medicaid and Waivers

a live and interactive discussion designed to help you better understand how Medicaid works in Virginia. Learn about the Commonwealth Coordinated Care Plus (CCC Plus) program and how...

Posted by Positive Aging SourceBook on 06/17/2021

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