What does the waiver program cover?

What does the waiver program cover?

A waiver program allows the state to waive some requirements to meet the needs of individuals. For example, a waiver may help a person with an increased likelihood of requiring long-term care, such as those with behavioral issues or technologically dependent children.

What are the three eligibility requirements for waivers?

Eligible individuals determined to no longer need/receive active treatment in group home. Eligible individuals transitioning from 100% state funded services. Eligible individuals with loss or incapacitation of the primary caregiver.

What is Medi-Cal waiver?

​​​​​​​​Medi-Cal Waivers​ Medi-Cal waivers are programs that provide additional services to specific groups of individuals, limit services to specific geographic areas of the state, and provide medical coverage to individuals who may not otherwise be eligible under traditional Medicaid rules.

What is the DD waiver in California?

The Home and Community-Based Services for the Developmentally Disabled (HCBS-DD) Waiver is administered by the California Department of Developmental Services (DDS) who will authorize home and community-based services for developmentally disabled persons who are Regional Center consumers.

Who qualifies for a Medicaid waiver?

Generally, states offer HCBS waivers to elderly people (aged 65 or over), physically disabled people, adults and children with developmental disabilities, and medically fragile people (who require life support or other extensive medical equipment).

What is the primary goal of the waiver program?

The Nursing Home Transition and Diversion (NHTD) waiver uses Medicaid funding to provide supports and services to assist individuals with disabilities and seniors toward successful inclusion in the community. The individual is the primary decision-maker and works in cooperation with providers to develop a Service Plan.

Can Medicare pay for waiver services?

When you qualify for a Medicaid HCBS waiver program, Medicare still covers medical services you may need beyond your home health care. Even if you meet the eligibility guidelines for a Medicaid HCBS waiver program, there are generally limits on the number of people who can receive these benefits in your state.

Does California have a Medicaid waiver?

Home and Community-Based Services (HCBS) Waivers allow states that participate in Medicaid, known as Medi-Cal in California, to develop creative alternatives for individuals who would otherwise require care in a nursing facility or hospital. Recipients of HCBS Waivers must have full-scope Medi-Cal eligibility.

What is Home and Community-Based waiver Program?

A Home and Community-based Services (HCBS) Waiver is a Medicaid program that in general provides assistance with skill development, respite, transportation, and other services to help support the individual and their caregiver. Nearly all States and DC offer services through HCBS Waivers.

What services does the DD Waiver provide?

Services Provided

  • Homemaker.
  • Home Health Aide Services.
  • Respite Care.
  • Habilitation:
  • Environmental Accessibility Adaptations.
  • Skilled Nursing.
  • Transportation.
  • Specialized Medical Equipment / Supplies.

Whats the difference between Medicaid and Medicaid waiver?

Nursing Home Care vs. Medicaid, in all states, pays for care for individuals that reside in nursing homes; this is often referred to as Long Term Care Medicaid, LTC Medicaid, or Institutional Medicaid. Waivers are state specific Medicaid programs that allow for services to be provided outside of nursing homes.

What is the purpose of Medicaid waivers?

A Medicaid waiver allows a state to test and develop approaches to Medicaid that differ from the standard federal program. These programs may have unique eligibility requirements, or the programs may operate like managed care organizations.

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