Medicaid Waivers (HCBS): Services, Eligibility, and Application Steps
Medicaid Home and Community-Based Services (HCBS) waivers help people receive supports at home or in the community instead of institutions. This guide explains what waivers can cover, how states run them, and how to start an application.
Key Points
- Waivers are state-run and differ by program and population.
- Services may include personal care, respite, and job coaching.
- Many waivers have waitlists—apply early.
What Waivers Can Cover
- Personal attendant care, homemaker services, respite.
- Supported employment, day programs, transportation.
- Environmental mods, assistive technology, care coordination.
Who Qualifies
- Functional eligibility and medical necessity.
- Financial eligibility varies by state.
- Target groups: developmental, physical, or age-related disabilities.
How States Run Waivers
- Section 1915(c) waivers and similar authorities.
- Each state defines its own programs and oversight.
How to Apply
- Identify your state Medicaid agency.
- Ask about eligibility, documents, and waitlists.
- Submit your application; keep copies.
- Complete assessments and follow-ups.
- Stay in touch about waitlist updates.
Staying Eligible
- Report household and income changes.
- Participate in reassessments.
- Keep records of services.
FAQs
Do waivers replace Medicaid?
No; waivers add services for specific groups.
What if the waitlist is long?
Apply anyway; ask about priorities and interim supports.
Can I use self-direction?
Some waivers allow managing your own staff.
Do waivers cover housing?
They fund supports, not rent.