Medicaid Waiver — 1915(c) waiver
A Medicaid waiver lets a state pay for home and community services for people who would otherwise need a nursing home or institution.
Official source: medicaid.gov
A Medicaid waiver helps people get the care they need to stay in their homes and communities. This means they can get services like help with daily tasks or therapy outside of a nursing home. Medicaid usually pays for care in institutions. But a waiver lets it pay for care at home instead. This allows people to live more independently. It also helps them stay connected to their families and friends.These waivers are for people who need a high level of care. Without a waiver, these people would have to go to a nursing home or other institution to get their care covered by Medicaid. This includes seniors, people with disabilities, and those with long-term illnesses. Each state has different waivers. They also have different rules about who can get help and what services they cover.Medicaid waivers are important because they give people choices. They can choose to get care in a place that feels more like home. This can improve their quality of life. It also helps manage healthcare costs. Getting care at home can be less expensive than staying in a nursing home. This helps both individuals and the state.If you think you or a family member might need help with care at home, contact your state's Medicaid office. They can tell you about the waivers available in your state. They can also help you understand how to apply for them. See also: <a href="/glossary/hcbs">HCBS</a>.
In real life
- An adult with developmental disabilities used a Medicaid waiver to get home aide hours.
- Maria's grandmother needed help with daily tasks after a stroke, so a Medicaid waiver paid for home care instead of a nursing home stay.
- John, who has a severe physical disability, uses a Medicaid waiver to get assistance with personal care and live in his own apartment.
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Frequently asked questions about Medicaid Waiver
What is Medicaid Waiver?+
A Medicaid waiver lets a state pay for home and community services for people who would otherwise need a nursing home or institution.
Who qualifies for Medicaid Waiver?+
Income-eligible adults, children, pregnant people, seniors, and people with disabilities. Income limits and rules vary by state.
How do I apply for Medicaid Waiver?+
Apply through your state Medicaid agency (find yours at medicaid.gov) or through healthcare.gov. Official forms and instructions: https://www.medicaid.gov/medicaid/home-community-based-services/index.html.
Where can I get help?+
Apply through your state Medicaid agency (links at medicaid.gov) or use BenefitKarma's Find Benefits tool to see if you qualify in your state.
Source: medicaid.gov