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VA Medicaid Waivers

Virginia provides services under community-based care waivers to specifically targeted individuals. These services are not available to all Medicaid recipients in the state. The waivers and the services offered include the following:

·   AIDS Waiver

·   Elderly and Disabled Waiver

·   Consumer-Directed Personal Attendant Services (CD-PAS) Waiver

·   Mental Retardation Waiver

·   Technology Assisted Waiver

·   Individual and Family Developmental Disabilities (DD) Support Waiver

·   Community Based Care (CBC) Waiver

For individuals receiving Medicaid Waiver services, the resource limit is $5,000. Note, however, that none of the real property exclusions in sections M1130.100, M1130.140, S1130.150, or M1130.160 of the DSS Medicaid Manual apply to the property. (See VA Medicaid Resources Defined and Medicaid Resource Exclusions.)

To be income eligible for Medicaid Waiver services, the individual's Gross Income must not exceed 300% of the SSI Individual Payment Limit (the Federal Benefit Rate).

AIDS Waiver

Provides services to qualifying individuals who have a Diagnosis of AIDS or AIDS Related Conditions (ARC) and documentation that the individual is experiencing medical and functional symptoms associated with AIDS or ARC which would require nursing facility or hospital care.

The following services are offered under the AIDS Waiver:

·             Case management

·             Nutritional supplements

·             Private duty nursing

·             Personal care

·             Respite care

Elderly and Disabled Waiver

Provides services to qualifying individuals 65 years of age or older or who are disabled and who meet screening criteria and are at imminent risk of nursing facility placement.

The following services are offered under the Elderly and Disabled Waiver:

·             Adult day health

·             Respite care

·             Personal care

Consumer-Directed Personal Attendant Services (CD-PAS) Waiver

Provides services to qualifying individuals 65 years of age or older or who are disabled, who meet screening criteria and are at imminent risk of nursing facility placement, and who have no cognitive impairments. The individual must be able to hire, train and fire, if necessary, his or her own attendant.

The following service is offered under the CD-PAS Waiver:

·             Personal attendant services

Mental Retardation Waiver

Provides services to qualifying individuals with a diagnosis of mental retardation and individuals under the age of 6 at developmental risk who have been determined to require the level of care provided in an Intermediate Care Facility for the Mentally Retarded (ICF/MR). The following services are offered under the Mental Retardation Waiver:

·             Day support

·             Supported employment

·             Residential supports

·             Therapeutic consultation

·             Personal assistance services

·             Respite care

·             Skilled nursing services

·             Crisis Stabilization

·             Environmental Modifications

·             Assistive Technology

Technology Assisted Waiver

Provides services to qualifying individuals who need both a medical device to compensate for the loss of a vital body function and substantial and ongoing skilled nursing care.

The following services are offered under the Technology Assisted Waiver:

·             Private duty nursing

·             Respite care

·             Assistive Technology

·             Personal care

·             Environmental modifications

Individual and Family Developmental Disabilities (DD) Support Waiver

Provides services to qualifying individuals 6 years of age and older who have a condition related to mental retardation -- but who do not have a diagnosis of mental retardation -- if they have been determined to require the level of care provided in an Intermediate Care Facility for the Mentally Retarded (ICF/MR).

The following services are offered under the DD Waiver:

·             Day support

·             Adult Companion Care

·             Supported employment

·             In-home residential support

·             Therapeutic consultation

·             Personal care services

·             Respite care

·             Skilled nursing services

·             Attendant care

·             Family and caregiver training

·             Crisis stabilization

·             Environmental modifications

·             Assistive technology

·             Personal emergency response systems

Community Based Care (CBC) Waiver

Provides long-term support in a community-based setting for eligible individual. See Medicaid Long-Term Care for more information.

See Also:

VA Medicaid Income Limits

VA Medicaid Resource Limits

Back to:

VA Medicaid Eligibility

VA Medicaid Covered Groups

VA Medicaid Overview

VA Benefit Information System Welcome and Introduction

Source:

Information for this topic was drawn from the Department of Medical Assistance Services (DMAS) Medicaid Handbook.

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