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Aged and Disabled Waiver

Aged and Disabled Waiver

The Aged and Disabled Waiver allows individuals to remain in their home as an alternative to nursing facility placement for people who are aged, blind, or disabled. The HCBS waiver is designed to provide services to supplement informal supports for people who would require care in a nursing facility if HCBS or other supports were not available.

WHO IS ELIGIBLE?

You must meet HCBS waiver eligibility and Medicaid eligibility guidelines in order to be eligible for a Medicaid HCBS waiver.  To be eligible, you must be:

  • Aged, blind, or otherwise disabled
  • Eligible for services by meeting the nursing facility level of care
  • Reside in or transitioning into an HCBS-compliant setting (non-institutionalized)
  • Income must not exceed 300% of maximum Supplemental Security Income (SSI) amount (parental income for children under 18 years of age is disregarded)

For more information on eligibility, see the Eligibility Guide.

What is Nursing Facility Level of Care?

To be eligible for services, an individual must meet the required "nursing facility level of care."  Level of care is the minimum need an individual must have to be considered eligible for HCBS waiver services. Level of care is evaluated both when you apply and then at least once a year after that.  The initial level of care determination is made by the Area Agency on Aging.  For the purposes of nursing facility level of care, a person must have one of the following:

  • an unstable, complex medical condition, which requires direct assistance from others for the following conditions: decubitus ulcers, comatose condition, or management of severe pain
  • direct assistance from others for medical equipment, such as ventilator, suctioning, tube feeding, central intravenous access (I.V.)
  • direct assistance for special routines or prescribed treatments from others, such as tracheotomy, acute rehabilitation conditions, administration of continuous oxygen
  • medical observation and physician assessment due to a changing, unstable physical condition
  • other substantial medical conditions.

Level of Care is required in order for the person to be admitted into a nursing facility or initially start waiver services. The waiver case manager will complete an annual Level of Care evaluation for waiver services.

AVAILABLE A&D Waiver SERVICES

  • Adult Day Service
  • Adult Family Care
  • Assisted Living
  • Attendant Care
  • Self-Directed Attendant Care
  • Case Management
  • Community Transition
  • Environmental Modifications
  • Environmental Modification Assessments
  • Health Care Coordination
  • Homemaker
  • Home Delivered Meals
  • Nutritional Supplements
  • Personal Emergency Response System
  • Pest Control
  • Respite
  • Specialized Medical Equipment and Supplies
  • Structured Family Caregiving
  • Transportation
  • Vehicle Modifications

APPLYING FOR the A&D WAIVER

When should I apply?

It is helpful to apply as soon as you identify a need for waiver services.

Where Do I Apply?

First, go to your local Area Agency on Aging (AAA). There are 16 Area Agencies on Aging throughout the State.  You must also apply for Medicaid.  You can learn more about applying for Medicaid by going to the Apply for Medicaid webpage.

If you have been denied Medicaid eligibility before applying for HCBS services, you can re-apply after visiting a AAA office.

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