Medicaid waiver
Elderly and Disabled Waiver
Checked
- Who qualifies
-
People 21 or older who need nursing facility level of care, as found by a comprehensive long-term services and supports assessment, and who are either eligible for SSI or are aged, blind or disabled and meet all the factors of institutional eligibility. You must live in a private residence, not a nursing facility or a licensed or unlicensed personal care home.
If income is above the institutional limit, the person pays the Division of Medicaid the part of their income due under an Income Trust to qualify. The Division of Medicaid administers and operates the waiver.
- Can a family member be paid
-
Depends. Only a relative who is not legally responsible for you, and only when the rule's conditions are met. For personal care services and in-home respite, the Division of Medicaid may allow payment to a relative by blood or marriage who is not your legal guardian or legal representative, when the relative is qualified to provide the service, agrees in writing before starting to follow the service's scope and requirements, and you or your representative sign a verification that the services were given.
The Division of Medicaid can remove a selected relative from providing services, and you would then choose another qualified provider. For in-home respite, the rule also lists parents and stepparents among those who cannot qualify. A provider may not apply for a Division of Medicaid provider number for the purpose of providing care to friends or family members.
- Can a spouse be paid
-
No. No. Payment to a relative is allowed only for a relative who is not a legal guardian or legal representative, and the rule lists spouses among those who cannot qualify.
- Can a legal guardian be paid
-
No. No. Guardians, conservators, people who hold your power of attorney and your Social Security representative payee cannot qualify as a paid relative.