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MISSISSIPPI DIVISION OF MEDICAID Eligibility Policy and Procedures Manual CHAPTER 101 – Coverage Groups and Processing Applications and Reviews P a g e | 17 Effective Month: September 2023
Optional 1915 Waiver Coverage under Home & Community Based Services (HCBS) The following is a list of waiver coverage offered by the Division of Medicaid. Eligibility for waiver participation is determined in full or in part by the Division of Medicaid, as noted. Waiver participants receive full Medicaid coverage plus additional waiver services that allow the individual to remain in a private living arrangement rather than a medical institution. 1. Elderly and Disabled (E&D) Waiver – is operated by the Division of Medicaid. This HCBS waiver includes aged or disabled individuals age 21 or older whose level of care has been certified using a preadmission screening tool. The aged or disabled individual must be eligible as SSI or qualify under an income level that is equal to the Medicaid institutional limit. Institutional income and resource limits and rules apply, including the use of an Income Trust to qualify for coverage. A waiver participant may not reside in a nursing facility or personal care home. The Division of Medicaid certifies eligibility for individuals who do not receive SSI.
2. Independent Living (IL) Waiver – is operated jointly by the Division of Medicaid and the MS Department of Rehabilitation Services. Eligibility is limited to individuals age 16 or older who exhibit severe orthopedic and/or neurological impairments. Clinical eligibility for waiver services is determined through a preadmission screening tool. An individual can participate in the IL waiver and be eligible as SSI, a Katie Beckett recipient, a Disabled Adult Child, a Working Disabled recipient or be eligible in a MAGI-related category or adoption assistance or foster child category of eligibility provided clinical waiver criteria is met. If an individual is not eligible in an allowed category, the individual may be determined eligible using institutional income and resource eligibility rules and limits, including the use of an Income Trust to qualify for coverage. The Division of Medicaid certifies eligibility for individuals who do not receive SSI or foster care/adoption assistance Medicaid through Child Protection Services.