Medicaid Waiver: What You Need To Know

Medicaid provides a provision under Medicaid law that is a Medicaid waiver. The federal government waives certain rules under specific circumstances that usually apply to the Medicaid program through a Medicaid waiver. The Medicaid waiver intends to allow states to accomplish particular goals like expanding coverage, reducing costs, or improving care for target groups like the elderly. With the help of Medicaid waivers, states can provide residents with services otherwise uncovered by Medicaid, such as in-home care for people.


Home And Community-Based Services (HCBS) Section 1915c Waivers

While several different types of Medicaid waivers exist, the Home and Community-Based Services (HCBS) waivers offer people an alternative to long-term care. The HCBS waivers are designed to allow individual states the ability to provide home and community-based services to people who need long-term care and otherwise would be in a facility. This waiver is critical as it means people can remain in their own home, a relative’s home, or a community setting like a supported living community instead of a nursing home facility. The HCBS waiver helps people access quality care and services while remaining at home. 


What Services HCBS Waiver Covers

Beneficiaries of HCBS waivers may live in a home setting or community care environment and receive a range of medical and non-medical in-home care services. Depending on the state guidelines and an individual’s needs, these services may include: 

* A home health aide

* Personal care supervision and services at home

* Nursing

* Medical equipment and supplies

* Hot meal delivery 

* Homemaking services and personal care/ errands

* Respite care for the primary caregiver

* mental health services

* Home improvement/safety modifications

* Case management support

* Access to senior and adult group daycare

* Non-emergency medical appointment transportation

* Personal emergency response systems

* Nursing home transition services


When considering Medicaid waivers, it is essential to note that services covered will vary on a case-by-case basis and are affected by the state in which the beneficiary lives. 


Benefits Of A Medicaid Waiver

Studies show that seniors who can remain in their own homes or the home of a loved one or community setting respond better to care. According to the American Association of Retired Persons (AARP), close to 90% of people over 65 report they rather stay in their homes for as long as possible as they age. The Medicaid waiver provides pathways that allow beneficiaries to remain safely at home and receive the care needed to thrive.