Medicaid Wavier Programs Eligibility Requirements CBA

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Medicaid WavierPrograms

• Eligibility Requirements

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CBACommunity-Based Alternatives

• Have to be over 21 years old
• Must meet same eligibility as nursing home
• Cant make more than 300 of SSI or 1,809 per
  month
• Cant have more than 2,000 in resources
• Once you get into the waiver, then you also get
  Medicaid

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CLASSCommunity Living Assistance and Support
Services

• Can be a child or an adult (no age requirements)
• Must have a diagnosis of related condition that
  happened before the age of 22 years
• Have to live in a county that is served by CLASS
• Must have a need for habilitation and case
  management services
• Parental income is not considered for children
• Cant make more than 300 of SSI or 1,809 per
  month
• Cant have more than 2,000 in resources
• Once you get into the waiver, then you also get
  Medicaid

4
Deaf Blind with Multiple Disabilities

• Have to be over 18 years old
• Must be legally deaf legally blind and have
  another physical disability
• Cant make more than 300 of SSI or 1,809 per
  month
• Cant have more than 2,000 in resources
• Once you get into the waiver, then you also get
  Medicaid

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HCSHome and Community Based Services

• Can be a child or an adult (no age requirements)
• Must have either mental retardation with an IQ
  below 70 or a related condition with an IQ of 75
  or below
• Parental income is not considered
• Cant make more than 300 of SSI or 1,809 per
  month
• Cant have more than 2,000 in resources
• Once you get into the waiver, then you also get
  Medicaid

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MDCPMedical Dependent Children's Program

• Have to be under 21 years old
• Must meet same eligibility as nursing home
• Parental income is not considered
• Once you get into the waiver, then you also get
  Medicaid

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CWPConsolidated Waiver Program

• Have to meet the same eligibility requirements
  for either HCS, CLASS, MDCP, CBA and/or DB/MD
  waivers
• Parental income is not considered
• Cant make more than 300 of SSI or 1,809 per
  month
• Cant have more than 2,000 in resources
• Once you get into the waiver, then you also get
  Medicaid

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Texas Home Living

• Can be a child or an adult (no age requirements)
• Diagnosis of mental retardation with an IQ below
  70 or a related condition with an IQ below 75
• Must be eligible for Medicaid prior to enrollment

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Medicaid Entitlement

• Once you get into the waiver, then you are
  eligible for Medicaid. Under Medicaid, you are
  entitled to receive Medically Necessary services
  such as hospital care, doctors office visits,
  wheelchairs, skilled nursing, etc.
• The Medicaid waiver will pay for things that
  Medicaid will not cover, like habilitation,
  environmental control units, etc.

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How to speed up process

• Once you are offered the Medicaid waiver, there
  will be lots of forms to fill out. Make sure that
  you fill them out completely.
• Include copy of pertinent medical records
  documenting disability
• Be informed Medicaid process is changing and
  things often do not move quickly