Medicaid Waivers for Families and Individuals with Developmental Disabilities

Being healthy is a gift. However, not everyone is blessed with good health. There are people who are in need of medical care, and it can be a predicament to avail of treatment or any medical assistance when you are on a tight, or out of, budget.

The U.S. government’s Medicaid program provides Medicaid Waivers that will shoulder the additional expenses that a person with developmental disability needs. The service itself can be given in the person’s home or community. The Medicaid Waiver service is open to both adults and children.

Medicaid is used to pay for medical fees such as doctor’s professional fees, hospital bills, therapy, and any adaptive equipment that a person may need. The Medicaid Waiver gives Medicaid the chance to provide payment for additional services that an eligible person may need. The state proposes a plan and spells out the type of service that will be provided under the Medicaid Waiver program. However, the federal government has to approve the Medicaid Waiver plan.

Medicaid Waivers are not automatically given to a person who is eligible for Medicaid; they are applied for. There is an evaluation team that screens each applicant and determines if they are qualified or not. Many states have more applicants than waiver places, so there is often a waiting list, and how it works differs by state.

In many states, a person enrolled in a waiver is assigned a support coordinator, sometimes called a case manager, who checks in regularly and may visit the home. When a place opens, your state’s agency will tell you, often by letter.

The evaluation team will be tasked to complete the paperwork for the waiver. They will take note of the eligible person’s social history, psychological update, and nursing needs; and complete all other Medicaid documents that are required. If you are a parent of a child diagnosed with autism spectrum disorder (ASD or autism) and the child is being evaluated, make sure that the papers they are filling out will describe the needs of your child.

Each state will have a different approach to how they check their specific Medicaid Waivers. There are general principles that will apply in the entire nation; however, each state’s waiver needs approval from the federal Centers for Medicare & Medicaid Services (CMS) before the state can offer it. It is important to check with your regional office to find out what services are covered by your state’s Medicaid Waivers.

If your organisation serves autistic people or people with disabilities, the Funding Finder lists United States government funding opportunities for those services.

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