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Effective: December 1, 2006 |
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03.40ar1 - Waiver Programs (Archive) |
Archived: July 1, 2008 |
Some people who are disabled, age 65 or older, or have other chronic medical needs may have certain Medical Assistance (MA) rules waived and receive services in addition to those already covered by MA. People who are eligible for either federally or state-funded MA (NMED ) may be eligible for the waiver programs.
l The rules that are waived include the deeming of spousal or parental income or assets.
l The additional home- and community-based services enable the person to receive care in the community rather than being admitted to a medical or nursing facility.
Example:
Ashley is an infant who lives with her mother and is eligible for MA as an auto newborn. She needs community-based services that are not covered by MA.
Action:
Consider MA eligibility for Ashley under one of the waiver programs.
The waiver programs include:
l Community Alternative Care (CAC).
l Community Alternatives for Disabled Individuals (CADI).
l Developmental Disabilities (DD).
l Traumatic Brain Injury Waiver (TBI).
A married person who is disabled may be eligible for MA under the CAC, CADI, DD, or TBI waivers, but not be eligible for the Medicare Savings Programs. This is because spousal income and assets are not counted for the waivers but are counted for the Medicare Savings Programs.
A person who is age 65 or older and eligible for the elderly waiver (EW) may still qualify for the Medicare Savings Programs. This is because spousal income and assets are not counted when determining EW eligibility for either spouse.
For specific eligibility guidelines for each waiver program, see the sections listed above.