Medicaid Waiver Program

 

Medicaid Waiver is a program designed to allow elderly or disabled individuals who are at risk of nursing home placement to remain in their home as long as possible.

Medicaid Waiver is a program of the Alabama Department of Senior Services (ADSS) and the Alabama Medicaid Agency and administered by the Regional Planning Commission of Greater Birmingham.

To be eligible, a client’s income cannot exceed $2742 per month and the client cannot have resources in excess of $2,000. Clients must exhibit same disabilities and frailty for admission to a nursing home in Alabama as determined by their physician.

Admission to the Program

There is not an age requirement for this program, however a recipient must be financially eligible for Medicaid and meet the program’s level-of-care criteria. Once accepted, a case manager will work with the client to develop a care plan based on the client’s needs and choices. Services available through the Medicaid Waiver program, include: case management, personal care, homemaker, companion services, respite care, adult day health or nutrition/frozen meals.

Financial Eligibility for program: (must meet at least one of the requirements below)

  • Individuals receiving Supplemental Security Income (SSI)

  • SSI related protected groups deemed to be eligible for SSI/Medicaid

  • Individuals whose income is less than 300% of the SSI Federal Benefit Rate (FBR) and cannot have resources in excess of $2,000 (FBR is the max amount payable to an individual with no income and is based on living arrangements)

  • Federal or State Adoption Subsidy Individuals

Frequently Asked Questions

How do I qualify?
The Medicaid Waiver program requires proof of Medicaid. The extent of disability must meet nursing home criteria. Your doctor makes this decision. There is a waiting list for those who are not financially qualified.

How much does it cost?
There is no cost for these services nor do they affect your eligibility to receive other benefits.

How long does it take to get approved?
The approval process can take several weeks. To get started, contact the Medicaid Waiver office or fill out the online referral form.

Please note, clicking the button above will download the form via your browser. It should appear on the bottom left of your screen.

What affects the services I can receive?
The following criteria affect the extent of services that you receive: your capabilities and activity level, your current level of care/family support and the cost of care required to meet your needs.

Does this program provide 24-hour care?
This program is not designed to provide 24-hour care.

You’re responsible for:

  • All required cleaning and personal supplies needed for the worker to do their job.

  • Reporting changes in medical condition or living arrangements to your case manager as soon as possible.

  • Calling your case manager anytime there is a problem with a worker.