What Is A Medicaid Waiver?

A Medicaid Waiver is money that can pay for services for people with developmental disabilities. These services can take place in the person’s home or in the community. Both children and adults can be supported by Medicaid Waiver services.

Medicaid usually pays for doctor appointments, hospital expenses, medicine, therapy, and some adaptive equipment. The Medicaid Waiver allows for Medicaid to be used to pay for additional services. The state writes a plan that tells what kind of services will be provided under their Medicaid Waiver program. The federal government has to approve the Medicaid Waiver plan. The Medicaid Waiver dollars are part state and part federal money.

Services which may be available( it may differ from state to state) using Medicaid Waiver:

• Behavioral Support –If your family member has challenging behaviors, waiver dollars can help purchase the services of an expert to address the behaviors and support the person.

• Community Access –This service can be provided individually or with a group of people. It can take place during the day, in the evening, or even on weekends. Community activities that would be enjoyable to the person would be identified, and participation and support arranged.

• Community Guide –Waiver dollars can pay a person to link your family member to local community resources. The community guide can research what is available based on the person’s interests and needs.

• Community Living Support –This service helps the person live at home. The support can help with bathing, dressing, grooming, toileting, eating, shopping, banking, exercising, decision making, supervision of the person taking their medication, or other community living activities.

• Community Residential Alternative –This waiver service is for people who are living in a residential home operated by a provider agency(such as an assisted living facility). The person can receive support in daily living activities, community activities, and household chores. The agency staff provides the training and supervision in the home.

• Dental Services for Adults –Currently Medicaid only pays for adults to have teeth pulled. Dental services cover preventative dental care or

  dental treatment.

• Environmental Accessibility Adaptation - Medicaid Waiver funds can be used to modify a home to make it more accessible, like adding

  ramps or grab bars.

• Financial Support Services –This is a service that assists families in paying for the services when the family chooses to hire the people they want to work with their family member. The financial support service manages payroll, taxes, background checks, etc.

• Professional Therapeutic Services - The Medicaid Waiver can pay for physical therapy, occupational therapy, speech therapy, or nutritional therapy.

• Respite –The Medicaid Waiver will pay for respite care to give the family a break from their demanding schedules involved in caring for their family member who has developmental disabilities. This can be hourly or overnight.

• Specialized Medical Equipment and Supplies –The Waiver can pay for medical supplies or adaptive equipment that might be needed.

  This could include things like disposable diapers, chux pads, latex gloves, and wipes.

• Support Coordination –The support coordinator will be responsible for completing all the waiver paperwork and will monitor to make sure the services are being delivered. They also check on the individual’s health and safety.

• Transportation –Waiver dollars can be used to purchase transportation to get people where they need to go in the community.

• Vehicle Adaptation –If a vehicle needs to be adapted, waiver funds can be used to pay for such things as a van lift, a portable ramp, wheelchair tie downs or brackets, or a specialized seatbelt.