Common Pitfalls

Waiver programs have eligibility rules that include an income limit and a resource limit. Your income must be less than $2,901 a month and you must have less than $2,000 in resources ($3,000 for a couple).

Make sure your income and resources don’t cause you to lose your eligibility for your waiver!

Note: If your disability began before you turned 26, you can open an ABLE account where you can save up to $19,000 in resources each year (plus more if you have earned income) and not have it counted by Medicaid. Learn more about ABLE accounts.

You may qualify for a Medicaid waiver program even if you don’t qualify for regular disability-based Medicaid, because the income limit for waiver programs is higher than the regular Medicaid income limit.

If you have limited income and resources and need a level of care that is equal to the level of care at a nursing home or a hospital, you should look into Medicaid waivers. You may qualify for a waiver’s benefits and services even if you don’t have Medicaid coverage. Contact your local Aging and Disability Resource Connection site to see if you might qualify for a waiver program.

The number of slots for each waiver program is different from year to year. In some cases, there may be a waiting list for the program you want to enroll in.

If you are on the waiting list for a Medicaid waiver program and your situation changes, like your condition or your finances, you should contact the agency through which you applied for the waiver. It may affect your placement on the waiting list and you may be able to get services sooner.

When you apply for Medicaid and Medicaid waivers, you need to explain your disability and your level of need. You should document your medical condition as much as possible. Keep track of your diagnosis, medical appointments, supplies, services, and general independence. Consider starting a journal or having a place where you can write down when something new happens related to your disability.

Fill out and return all forms and other paperwork related to your benefits on time. This includes annual eligibility paperwork for Medicaid, waivers, or other similar services. Talk to your case manager or the agency in charge of your waiver program if you have questions about paperwork or due dates.