State waiver programs are designed to keep people out of nursing homes and allow them to stay in their communities. Most programs are for people with “nursing home level of need,” though some will provide services to people who are less severe but “at risk” for a nursing home.
While many seniors and children join these programs, people who became disabled or developed chronic illness as adults are usually never told that this kind of help is possible.
These programs are often called “Medicaid waivers” “long term care” or “home and community based care.” In California, the most popular program is called IHSS (though there are several other programs in California as well).
These programs are run by Medicaid, but you do not need to be on Medicaid right now to apply. In many states, you can qualify even if you have too much money for Medicaid.
Most waiver programs have a “self-directed” option or an “agency” option. They can send someone from an agency, or you can select your own aide. It is common for people to select a friend or family member (In many states, spouses are not allowed).
Learn more about how to apply: How To Apply for a Medicaid Waiver.
Find waiver programs in your state: How to Find Waiver Programs in Your State
If you are not on Medicaid, or have too much money for Medicaid, you may still be able to qualify for this program: When You Have Too Much Money
Success stories. Stories from people in waiver programs, how they applied and how they got approved: How I Got Approved for a Home Aide
Assessment interviews: To apply for a waiver you will need to do an assessment You do not need to leave your house, it will happen either over the phone, or they will send someone to your house to ask you questions). Here’s what they ask and what to expect: Assessment Interview for Home Care. They may also ask your doctor to sign a form about your personal care needs.
Criteria to qualify. The criteria varies from state to state. Here is a Sample Criteria for Applying for Medicaid Home Aides. In California, there is a program called IHSS for people with less severe needs.
Connect with others in waiver programs: Facebook Groups for Medicaid Home Care
Medicaid home aide programs offer many more hours and services than other programs. If you would like to look into other options: Other Programs that Provide Caregivers.
After approval, you will be given the choice to hire a home aide through an agency (they will send someone to your house) or hire the person of your choice (friend, neighbor, family member, etc). Both ways have advantages and disadvantages: How to Decide: Agency Care or Self-Directed Care
If someone tells you that you are not eligible for a waiver, this may not be correct. Many people are told by their local Medicaid or Social Services office when it is not true. Make sure you speak directly to a Social Worker who specializes in screening for Medicaid Waivers or Longterm Care (do not apply for regular Medicaid health insurance). If you are still told no, ask for the decision in writing and ask how you can appeal. Never let them turn you down over the phone. How to Respond When You Are Told You Can’t Get Medicaid