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Job Aid Member Coverage Desciptions Version 1.0

6 © 2024 Gainwell Technologies. All rights reserved. Coverage Coverage Description Coverage Level 062 - HCBS Assisted Living Waiver Participants qualify based on income under 300% of the SSI limit (NF limit). Income/Resource criteria, including Spousal Impoverishment and Income Trust provisions, are the same as Nursing Home/Long term care rules. There is no cost of care paid by the waiver participant. SSI recipients do not have to file a separate application to participate. Area Agency on Aging is the start point. Aged (65 or over) and disabled (21-64). Participating COE-001. Full Medicaid benefits plus case management, personal care, homemaker services, chore services, attendant care, medication oversight and administration, transportation and certain other services available under the waiver program. Full Medicaid benefits plus case management, personal care, homemaker services, chore services, attendant care, medication oversight and administration, transportation and certain other services available under the waiver program 063 - HCBS Elderly and Disabled Waiver Participants qualify based on income under 300% of the SSI limit (NF limit) Income/Resource criteria, including Spousal Impoverishment and Income Trust provisions, are the same as Nursing Home/Long Term Care rules. There is no cost of care paid by the waiver participant. SSI recipients do not have to file a separate application to participate. Area Agency on Aging is the start point. Aged (65 or over) and disabled (21-64). Participating COE-001. Full Medicaid benefits plus case management, personal care, homemaker services, chore services, attendant care, medication oversight and administration, transportation and certain other services available under the waiver program. Full Medicaid benefits plus case management, personal care, homemaker services, chore services, attendant care, medication oversight and administration, transportation and certain other services available under the waiver program 064 - HCBS Intellectually Delayed (ID/DD) Waiver Participants qualify based on income under 300% of the SSI Limit (NF limit). Income/Resource criteria, including Spousal Impoverishment and Income Trust provisions, are the same as Nursing Home/Long Term Care rules. There is no cost of care paid by the waiver participant. Certain recipients do not have to file a separate application to participate. Dept. of Mental Health is the start point. Mentally disabled individuals of any age Participating COE's include: 001, 003, 007, 019, 025, 026, 071, 072, 073, 074, 075, 088, 094. Full Medicaid benefits plus support coordination, day support, home and community support, respite and other services specified in the waiver. Full Medicaid benefits plus support coordination, day supports, home and community supports, respite and other services specified in the waiver.