Medicaid Waiver Myths vs Facts

Myths

• The parents make too much money.
• There is a “waiting list” for all waivers.
• Max hours of services allowed is 12 (20) (40).
• There’s an IQ requirement for Elderly and Disabled waiver.
• The patient must be on Social Security to get on a waiver.
• Waivers aren’t for kids already on Medicaid.
• Waivers aren’t for kids with private insurance.
• Waivers are the only way to get private duty nursing.
• Documenting Nursing Facility (NF) Level of Care (LOC) means the patient belongs in a nursing home.

FACTS

Natural supports (parent/guardian/grands):

• Are not required to provide Intermediate or Nursing Facility LOC.
• Are not required to provide ‘extraordinary care’.
• Are required to provide ‘age-appropriate parenting’.

Natural supports are unpaid supports that are provided VOLUNTARILY to the individual in lieu of waiver services and supports. 42 CFR 441.301(c)(2)(v)

Compulsion of natural supports is antithetical to the law!

In short, Medicaid waivers are programs designed to help people with disabilities get the care they need at home or in the community, instead of in institutions. States are required by law to offer these services to avoid discrimination and institutionalization.

For assistance on better understanding Medicaid Waivers in Alabama, please reach out to Disability Advocacy Solutions.