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3300.00.00 OVERVIEW OF MEDICAID WAIVERS Indiana’s home and community based services waivers, approved under Section 1915(c) of the Social Security Act, are designed to provide home care for persons who otherwise would need institutional care.1 Sections 3305.00 through 3349.00 explain the eligibility requirements that apply to individuals who have been approved for HCBS.2 Certain provisions are special for HCBS and provide an additional eligibility methodology as an option to regular eligibility in the Aged, Blind, and Disabled categories. 3305.00.00 GENERAL INFORMATION ABOUT HCBS WAIVERS There are four home and community-based services (HCBS) waivers: • Community Integration and Habilitation • Family Supports • Health and Wellness (formally known as “Aged and Disabled”) • Traumatic Brain Injury • PathWays (formally known as “Aged and Disabled”) The Medicaid waivers each have a specific number of slots that can be filled in each time period. When all slots are filled, applicants are placed on waiting lists. The waivers provide special services, in addition to regular Medicaid services, that are designed to allow a person who otherwise would need institutional care, to remain in the community. An individual must meet the level of care and cost comparison criteria to receive waiver services. If an applicant/recipient is eligible for both a HCBS waiver and BPHC, then the waiver budgeting would apply.3 If the member fails the waiver budgeting, but qualifies for BPHC, and the member wishes to voluntarily withdraw from the waiver while pursuing the BPHC, then it is best practice to get the voluntary withdraw in writing. In this situation, members should be referred to their waiver care manager. The eligibility system will continue to build the waiver budget if the HCBS waiver is interfaced. To qualify for services under one of the approved waivers, an individual must meet the waiver criteria above and must meet Medicaid eligibility requirements. There may be two different ways in which a person can be eligible for Medicaid under a waiver: regular Medicaid eligibility rules and special waiver rules which are applied in the Aged, Blind, Disabled categories (MA A, MA B, and MA D). The following sections explain the policies and procedures that are used by the Division of Family Resources in determining Medicaid eligibility under each of the waivers.