Health care coverage
Home and community based services waiver programs
Medical Assistance covers home and community-based services through waiver programs for people who need extra help to stay at home instead of moving to a nursing home or other medical facility.
Home and community-based services waiver programs help people pay for things like additional medical supplies and equipment, help with daily living activities, case management, counseling and other services not covered through regular Medical Assistance.
Learn how to applyBrain Injury Waiver
Brain Injury Waiver (BI) is for people with acquired or traumatic brain injuries who need the level of care provided in a nursing facility that provides specialized – cognitive and behavioral supports – services for people with brain injury or neurobehavioral hospital level of care.
Learn more about BI WaiversCommunity Alternative Care Waiver
Community Alternative Care Waiver (CAC) is for chronically ill and medically fragile people who need the level of care provided in a hospital.
Learn more about CAC WaiversCommunity Access for Disability Inclusion Waiver
Community Access for Disability Inclusion Waiver (CADI) is for people with disabilities who require the level of care provided in a nursing facility.
Learn more about CADI WaiversConsumer Directed Community Supports Waiver
Consumer Directed Community Supports Waiver (CDCS) is for people enrolled in the Alternative Care or Elderly Waiver programs.
Learn more about CDCS WaiversDevelopmental Disabilities Waiver
Developmental Disabilities Waiver (DD) is for people with developmental disabilities or related conditions who need the level of care provided in an Intermediate Care Facility for Persons with Developmental Disabilities.
Learn more about DD WaiversElderly Waiver
Elderly Waiver (EW) is for people age 65 or older who require the level of care provided in a nursing facility.
Learn more about Elderly WaiversHow much does coverage cost?
Effective July 1, 2023, parents are no longer assessed a parental fee for children receiving home and community-based services waivers. Parents are still responsible for parental fees assessed for children receiving home and community-based services waivers before June 30, 2023.
Parental fees may still be assessed for children who have a developmental disability, or a physical disability or emotional disturbance in 24-hour care outside the home. This includes a:
- medical facility such as a nursing home or an intermediate care facility for a person with a developmental disability,
- state-operated psychiatric hospital for children, or
- psychiatric residential treatment facility
When can my coverage start?
After you are approved, coverage may start:
- The date you start receiving home and community-based services or are eligible for Medical Assistance payment of your home and community-based services, whichever is later.
- The day after your transfer penalty ends, if you have one, as long as you still meet all of the eligibility rules.
How do I know if I qualify for these services?
People who are assessed to need certain levels of care may get services through a home and community-based services waiver program if:
- You qualify for Medical Assistance
- You have had a Long-Term Care Consultation that shows you have a need for the services
Contact your county or Tribal office to find out how to get an assessment to find out if you are eligible.
Medical AssistanceFind your local county or Tribal officeWhat is the income limit?
The income limit depends on which home and community-based services waiver program you qualify for. Only your income is counted even if you live with a spouse or a parent.
Income limitsCan I get coverage if I have a house or car?
Yes, your home and one vehicle usually do not count toward the asset limit for MA. Children do not have an asset limit.
Asset limitsCan I get coverage if I have savings, a retirement account or other assets?
Yes, but adults may have an asset limit for MA. Children do not have an asset limit.
Asset limitsWill my spouse have to use part of their income to pay for my care?
No, your spouse will not have to use their income for your home and community-based services.
Adults may also have copays for some services. Children do not have copays.
About copaysWhat other rules should I know about home and community-based services?
There are three other rules that apply for anyone who needs Medical Assistance to help pay for home and community-based services through a waiver program.
- In the 60 months prior to your request for Medical Assistance help with your home and community-based services, you must not have given away income, or given away assets without getting paid the amount the assets were worth.
- If you have done this, you may have a transfer penalty which prevents Medical Assistance from paying for services. There are some exceptions to this rule.
- Your equity in your home has to be under the home equity limit.
- The home equity limit increases annually. Ask your worker what the limit is.
- Some annuities that you or your spouse own have to name the Department of Human Services as the preferred remainder beneficiary.
What if I have Medicare, other health insurance or long-term care insurance?
You may still get coverage. You must tell us if you:
- Have Medicare or other health insurance, including long-term care insurance
- Could be covered under someone else's insurance
- Could get coverage through an employer or military service
Sometimes we can help pay the cost of your Medicare or other insurance so you can keep that coverage.
Learn how other insurance could impact eligibility[Learn about help to pay for your other insurance]