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What are Medicaid Waivers? Waivers are a part of the federally and state funded Medicaid program that provides for reasonable and necessary medical care for persons meeting eligibility requirements. Waivers provide funding for children and adults with disabilities to receive support and services in the home and community rather than in an institutional setting. Indiana has two different types of home and community-based waiver programs, medical and developmental. The type for children and adults whose needs are primarily medical in nature is called the Nursing Facility (NF) Level of Care or Medical Model Waivers There are two Indiana Medicaid Waivers requiring NF Level of Care the Aged and Disabled (A&D) Waiver and the Traumatic Brain Injury (TBI) Waiver. How is eligibility determined? To be eligible for the A&D or TBI Waiver an individual must need Nursing Facility level of care, meaning the person would be at risk of being placed in a nursing facility without the services provided by the waiver. The level of care need is determined by the Area Agency on Aging based upon a physical examination and physicians recommendation of home and community based services on a 450B form that the case manager has. To be eligible for the TBI Waiver, a person must also have a diagnosis of traumatic brain injury. Age is not an eligibility determinant for either of these waivers. Family income and assets are NOT considered when determining Medicaid eligibility for a child under the age of eighteen who is also applying for a waiver. How do I apply for a Waiver? If you think your family member may be eligible for a Nursing Facility Level of Care Waiver you can apply by calling the local Area Agency on Aging (AAA) for an application. See the state map (on the back) or call 1-800-986-3505 to identify your local office. Applicants will be assigned a case manager who will assist you in completing an Application for Long-Term Care Services. You may apply for one or both of the waivers, as appropriate. If there are no slots available on the waiver, the applicant will be placed on a waiting list. How long is the waiting list? There may be a waiting list for the A&D and TBI Waivers. Waiting lists change often. To help you track your wait you may periodically ask your local AAA office what date of application is currently being served. What do I need to do to stay on the waiting list? You will need to update your local AAA whenever your contact information, including phone or address, changes. If you move to a different area of the state, ask that they assist you in transferring your application to your new local office. As long as you remain in Indiana you will not have to reapply. It is advisable to contact the AAA office once a year to update and confirm your contact information. Keep a copy of your dated waiver application and any other correspondence with your AAA office for your own records.
Apply for a Waiver At your Local Area Agency on Aging (AAA) Office. To find your local office, call 1-800-986-3505
Medicaid Waivers About Indianas Aged and Disabled and Traumatic Brain Injury Waivers
What other community-based services are available? Indiana's Area Agencies on Aging (AAA) provide case management, information, and referrals to various services for persons who are aging or developmentally disabled. There are other programs and services for which you might be eligible. Additionally, you may be eligible for more than one type of waiver. Apply for all waivers for which you may be eligible. To learn about the other types of home and community-based waivers in Indiana, please refer to our fact sheet on Developmental Disability, Autism and Support Services Waivers.
Apply for a Waiver At your Local Area Agency on Aging (AAA) Office. To find your local office, call 1-800-986-3505
Where to get more Information: Your local AAA office is the point of entry for Nursing Facility Level of Care waivers and can answer your questions about those waivers. To contact the AAA nearest you (see interactive map available at http://www.in.gov/fssa/da/3478.htm) or call toll free 1-800-986-3505. The Division of Aging (DA) is a part of the Family & Social Services Administration. DA implements the Nursing Facility Level of Care Waivers and other communitybased services for people who are elderly and/or have disabilities. DA Website: http://www.in.gov/fssa/2329.htm The Consumer Guide to Indiana Medicaid Waiver Home and Community Based Waiver Services Programs is available online at www.in.gov/gpcpd. Contact the Governors Council for People with Disabilities for a print copy at: 317-232-7770 or http://www.in.gov/gpcpd/2359.htm. Please note that the Council periodically publishes the Wavier Update Sheet of News to reflect changes. It may be helpful to consult these in addition to the Consumer Guide. Additional Community resources: The Arc of Indiana, www.arcind.org, provides information on legislative and administrative efforts related to the waivers. ASK, www.aboutspecialkids.org/ or 1-800-964-4746. Is a place for families and professionals in Indiana to go to ASK questions about children with special needs and to access information and resources about a variety of topics such as health insurance, special education, community resources and medical homes.
Programs and systems change often. It is important to ensure that you are using the most current information. This Fact Sheet was updated on April 18, 2011. Please check with http://www.earlychildhoodmeetingplace.org for the most recent edition. Supported in part by project
Page 2 of 3 Revised 4-18-11
H25 MC 00263 from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, Department of Health and Human Services
CASS
1531 13th Street, Suite G-900 Columbus, IN 47201-1302 (812) 372-6918 or (866) 644-6407 FAX (812) 372-7846 Web Site: www.agingandcommunityservices.org E-Mail: dcantrell@areaxi.org Diane Cantrell, Executive Director
GRANT
BLACKFORD
JAY
MADISON
DELAWARE RANDOLPH
1151 S. Michigan St., P.O. Box 1835 South Bend, IN 46634-1835 (574) 233-8205 or (800) 552-2916 FAX (574) 284-2642 Web Site: www.realservicesinc.com Becky Zaseck, President, C.E.O .
V E R M I L L I O N
FOUNTAIN
MONTGOMERY
BOONE
PARKE
HENDRICKS PUTNAM
MARION
HANCOCK RUSH
VIGO
CLAY OWEN
MORGAN
JOHNSON
SHELBY
FAYETTE
UNION
DECATUR MONROE
BARTHOLOMEW
FRANKLIN
13091 Benedict Drive Dillsboro, IN 47018 (812) 432-5215 or (800) 742-5001 FAX (812) 432-3822 Web Site: www.lifetime-resources.org E-Mail: contactltr@lifetime-resources.org Sally Beckley, Executive Director
SULLIVAN
GREENE LAWRENCE
RIPLEY
DEARBORN
KNOX
DAVIESS
MARTIN
WASHINGTON ORANGE
GIBSON
PIKE
VANDERBURGH
POSEY
WARRICK SPENCER
PERRY
426 Bank Street, Suite 100, P.O. Box 995 New Albany, IN 47151-0995 (812) 948-8330 or (888)948-8330 FAX: (812) 948-0147 E-Mail: kstormes@lsr14.org Web Site: www.lifespanresources.org Keith Stormes, Executive Director
1801 Smith Street, Suite 300 Logansport, IN 46947-1577 (574) 722-4451 or (800) 654-9421 FAX (574) 722-3447 E-Mail: areave@areave.com Web Site: www.areave.com Michael Meagher, Executive Director
521 West Main Street Mitchell, IN 47446 (812) 849-4457 or (800) 333-2451 TDD (800) 743-3333; FAX (812) 849-4467 E-Mail: area15@hoosieruplands.org Web Site: www.hoosieruplands.org David L. Miller, CEO Barbara Tarr, Director of Aging and Disability Services
1701 Pilgrim Blvd., P.O. Box 308 Yorktown, IN 47396-0308 (765) 759-1121 or (800) 589-1121 TDD (800) 589-1121; FAX (765) 759-0060 E-Mail: mail@lifestreaminc.org Web Site: www.lifestreaminc.org Kenneth D. Adkins, President/CEO
AREA 7 Area 7 Agency on Aging and Disabled West Central Indiana Economic Development District, Inc.
1718 Wabash Ave., P.O. Box 359 Terre Haute, IN 47808-0359 (812) 238-1561 or (800) 489-1561 TDD (800)489-1561; FAX (812) 238-1564 E-Mail: Area7AAD@netscape.net Mervin Nolot, Executive Director
630 W. Edgewood Drive Ellettsville, IN 47429 (812) 876-3383 or (800) 844-1010 FAX (812) 876-9922 E-Mail: area10@area10.bloomington.in.us Web Site: www.area10.bloomington.in.us Jewel Echelbarger, Executive Director
16 W. Virginia St., P.O. Box 3938 Evansville, IN 47737-3938 (812) 464-7800 or (800) 253-2188 FAX (812) 464-7843 or (812) 464-7811 E-Mail: swirca@swirca.org Web Site: www.swirca.org Robert J. Steve Patrow, Executive Director
1-800-986-3505