Medicaid Waivers

Medicaid Waivers / Home and Community Based Services

Medicaid Waivers, sometimes called Home and Community Based Services, allow Medicaid to fund supports and services for children and adults with disabilities in their family homes or communities instead of institutions.  Medicaid Waivers allow an individual to use traditional Medicaid services and the additional services available through the Medicaid Waiver program.

What Medicaid Waivers are available in Indiana?

Indiana’s Medicaid Waiver program is designed for children and adults with medical needs requiring skilled nursing care (A&D Waiver), traumatic brain injuries (TBI Waiver) and developmental disabilities, including autism.

Medicaid Waivers for people with developmental disabilities, including autism, include:

• Family Supports (FS) Waiver
• Community Integration and Habilitation (CIH) Waiver

The FS Waiver can provide up to $17,300 annually in services and supports.

The CIH Waiver provides supports and services based on the individual’s level of need and living situation.

Individuals on the waiting list for the FS Waiver will be targeted to begin waiver services based on their date of application.

New applicants will be placed on the FS Waiver waiting list.

Individuals between the ages of 18 and 24 who have finished school can request priority status to begin receiving Family Support Waiver services.

There is no waiting list for the CIH Waiver. Consideration for CIH Waiver services is made on a case by case basis in situations that include:

• Loss or incapacitation of the primary caregiver with no other caregiver available
• Living with a primary caregiver age 80 or older with no other caregiver available
• Aging out of a residential placement for children through the Department of Children’s Services of Indiana State Department of Education
• Extraordinary Health and Safety Risk
• Moving from a nursing facility or group home
• Certain other emergency or crisis situations, including substantiated abuse, neglect or exploitation

How do you qualify?

• You must require the type of care that ordinarily would be provided in a Medicaid-funded facility, such as a nursing home, large residential facility or group home.
• If you are over 18, you must qualify for Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI). Individuals who qualify for SSI will automatically be found eligible for Medicaid.
• If you are under 18 and do not financially qualify for SSI, a separate eligibility determination for Medicaid Waiver services will be made once you are targeted for the waiver.
• If you are over 18, working, and can maintain your job, you may be able to enroll in MED Works, which does not require a social security disability determination.
• Your family income and assets are NOT counted to determine eligibility for children under 18; however, assets or income in the child’s name Are counted. For those older than 18, only the individual’s income and assets are counted.

Where do you apply?

Adults and children with developmental disabilities/autism: Apply through your local Bureau of Developmental Disability Services (BDDS) office. Obtain the number for your local BDDS office by calling 800-545-7763.  BDDS District Map

Adults and children with medical needs requiring skilled nursing care/TBI: Apply through your your local Area Agency on Aging (AAA).  Obtain the number of your local AAA office by calling 800-986-3505.

If you need assistance in completing the application, contact The Arc at 317-977-2375 or 800-382-9100 and ask to speak to a Family Advocate.

Family Supports & Community Integration and Habilitation Waiver

Eligibility: Must meet ICF/DD level of care. An ICF/DD is a facility specifically licensed to care for people with developmental disabilities. In Indiana, group homes for 6-8 people may be licensed as an ICF/DD. Large facilities for 15 or more people may also be licensed as an ICF/DD. The income and resources of an adult or child (under 18) receiving waiver services Are considered in determining financial eligibility. Parental income and resources for children under 18 is NOT considered. Medicaid financial eligibility for individuals receiving waiver services is based on 300% of the Supplemental Security Income (SSI) maximum.  As of January, 2018 the SSI maximum income is $750 per month, making Medicaid Waiver financial eligibility $2,250 per month.

Waiver Services (examples)

Aged and Disabled & TBI Waiver

Eligibility: Must meet nursing facility level of care. It is important to note that children are eligible for the A&D Waiver. Children under the age of 12 must have a skilled nursing need, such as an unstable g-tube, tracheotomy, or ventilator. The income and resources of an adult or child (under 18) receiving waiver services Are considered in determining financial eligibility. Parental income and resources for children under 18 is NOT considered. Medicaid financial eligibility for individuals receiving waiver services is based on 300% of the Supplemental Security Income (SSI) maximum for the A&D Waiver and 150% of the SSI maximum for the TBI Waiver.  As of January, 2018 the SSI maximum income is $750 per month, making Medicaid Waiver financial eligibility $2,250 per month for the A&D Waiver and $1,125 per month for the TBI Waiver.

How long will you have to wait for services?

There are waiting lists for Medicaid Waiver services. The length of time that you may have to wait is due in part to the availability of state and federal funds. However, it is important to apply even if you do not immediately need services. Applying is an important part of the process in planning for the future of your loved one.

How do I check my status on the waiting list and keep my information up-to-date?

The state has created a Waiting List Web Portal to check your status on the waiting list for the Family Supports Waiver and to keep your information updated.

To access the Waiting List Web Portal visit: www.in.gov/fssa/ddrs/4328.htm.

You should periodically check the portal to verify that your information is correct. If you do not have access to the Internet, contact your local BDDS office by calling 800-545-7763.

If an application date is not provided on your record, contact your local BDDS office by calling 800-545-7763.

Always keep paperwork in a safe place, including a copy of your original application and application date. If you have questions or need assistance, contact The Arc of Indiana at 317-977-2375 or 800-382-9100 and ask to speak to a Family Advocate.

Learn More

• State & Federal Programs
• Employment
• Natural Supports & Community Connections
• Introduction to Indiana’s Medicaid Waiver Program for Home and Community Based Services
• Natural Supports & Community Connections Guide
• Guide to Transitioning to a Home with Medicaid Waiver Supports in Your Community
• Moving from a Nursing Facility to a Home in Your Community – Video
• Family and Consumer Guide to Objective Based Allocations