Home and Community Based Waivers
The State of Utah, Department of Human Services, Division of Aging and Adult Services, Health Insurance Information Program, is committed to making available as much information as possible to ensure beneficiaries make informed choices about their health insurance.
The Health Insurance Information Program does not determine eligibility for, or administer any of the services mentioned in this web site. Please contact the appropriate agencies directly for your individual determination of eligibility and services.
There are four groups of people who qualify for Home and Community-based care. These groups have special income and asset requirements that are more liberal than ones used for regular Medicaid coverage.
General Information Included on this Web Page
- Technology Dependent Children, (Travis C. Waiver)
- Aging Waiver
- Developmentally Disabled Waiver
- Brain Injury Waiver
This waiver provides Home and community Based services for medically fragile children under age 21 who are residing at home. Space is limited in this program. To receive this coverage, the child must meet the medical criteria as determined by Family Health Services which includes being dependent on medical technology for survival.
The advantage of this program is that the parents' assets and income are not used to determine eligibility. Only the eligible child's income and assets are counted. Also, the Family Health Services case manager develops an intensive service plan for providing necessary services in the home rather than having the child institutionalized to receive such services.
The aging waiver is available statewide.It is designed to help frail, elderly people receive the services they need to remain in their own homes instead of entering a nursing facility.
The Area Agency on Aging provides case management services for people on the aging Waiver. The Area Agency on Aging case manager does a medical evaluation of the individual and writes an individualized care plan. In addition to the income deductions described, recipients receive a special shelter deduction.Eligibility
Aging waiver eligibility is determined on a case by case basis. To determine if the Home and Community Based Aging Waiver applies to your individual situation you must contact the Area Agency on Aging that serves the area in which you live.
Eligibility requirements for all waivers include, but are not limited to:
- Individual must meet the medical criteria.
- Individual must meet the requirements of a Medicaid program.
Income deductions include, but are not limited to:
- A personal needs deduction of 100 percent of the federal poverty level for one person.
- A deduction of health insurance premiums and medical bills, (client's bills only).
- A spousal allowance if living with a spouse who is not on a Home and Community Based Waiver.
To determine the enrollment requirements for the Home and Community Based Aging Waiver that apply to your individual situation you must contact the Area Agency on Aging that serves the area in which you live.
The services provided under the Home and Community Based Aging Waiver are designed to help families maintain the client in the community longer than might be possible without such help.
Some of the specialized services which may be provided under the aging waivers include:
- Adult Day Care
- Respite Services
- Homemaker Services, (general housecleaning services)
- In-home Physical, speech, and occupational therapy
- Behavior Management
- In-home Respiratory Therapy
- Personal Alert Systems
- Physical Modifications to the Home
The Developmentally Disabled Waiver is designed to serve people of all ages who are developmentally disabled and who need help with activities of daily living. Case management is provided by the Division of Services for People with Disabilities.
Services available include:
- Habitation Services include a number of residential, day treatment, supported employment, and prevocational services.
- Respite Care provides trained people who will take care of the disabled person allowing the family a chance to rest and recuperate from the stress of the daily care of their family member.
This new Medicaid waiver has been approved to provide home and community based services to adults who have sustained brain damage resulting in substantial impairment of the individual's ability to provide self-care and engage in regular activities of daily living.
Case Managers with the Division of Services for People with Disabilities will identify clients who meet the medical criteria for the Brain Injury Waiver. They will complete the medical eligibility evaluation. hen either the Case Manager, or a family member will complete the Medicaid application form and send it to the Office of Family Support/Bureau of Eligibility Services. This person will also be responsible for securing the needed verifications to determine the applicant's Medicaid eligibility.
Applicants for this waiver must be at least 18 years old. In addition to the income deductions described above, recipients receive a special shelter deduction.