What are Medicaid Waivers? Waivers are a part of the federally and state funded Medicaid program that provides for reasonable and necessary medical care for persons meeting eligibility requirements. Waivers provide funding for children and adults with disabilities to receive support and services in the home and community rather than in an institutional setting.

How is Eligibility Determined? To be eligible for the A&D or TBI Waiver an individual must need Nursing Facility level of care, meaning the person would be at risk of being placed in a nursing facility without the services provided by the waiver. The level of care need is determined by the Area Agency on Aging based upon a physical examination and physician’s recommendation of home and community-based services.

Important Consideration: Upon receipt of the waiver, a service plan aligning with the participant’s needs and level of care will be developed by care manager and participant. The participant has the right to choose all providers who render care, including the care management company.