When I started to work with Goally I had no idea what a autism waiver program or state medicaid waiver program was. My only experiences with waivers were the kind that make sure you can’t sue laser-tag birthday venues or zipline companies for breaking an arm. But hearing the concerns of Goally parents made one thing abundantly clear: no one, outside of healthcare professionals, really understands the intricacies of what waivers are, how they work, and how to apply to them.
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Taking a first glance at the Medicaid waiver process was daunting. Complicated and outdated government websites that never had enough information. There are also third party websites I wasn’t sure I could trust, and no guidance on where to start. The fact that state governments expect parents, who are already caring for children with special needs, to have the time to navigate this difficult system is frankly ridiculous.
We’re here to make things just a little bit easier
At Goally, we understand the challenges parents face when searching for Medicaid waivers that can provide vital support. That’s why we’ve taken the initiative to conduct thorough research on state Medicaid waivers, gathering valuable information to make your journey easier. Our team has compiled a comprehensive list of contact numbers, helpful organizations ready to assist you, and starting points for your search. To access these invaluable resources, simply visit our forum and explore the state guides we’ve meticulously put together. Not only will you find valuable information, but you’ll also have the opportunity to connect with fellow parents who are navigating the same path and share your experiences. Be sure to explore the useful links located at the bottom of this page for additional assistance.
So…. What is Autism waiver program then?
Medicaid waivers waive, or disregard, certain requirements that Medicaid has. The most frequent item to waive is income. Usually, in order to qualify for Medicaid the caregiver must have an income lower than 133% of the federal poverty level ($28,888 for a family of 3). What almost every Medicaid waiver does is make it so that this income requirement only applies to the child if they have a disability. This means that unless your child’s lemonade stand is wildly successful, they will almost always qualify for these programs.
Another important aspect of Medicaid waivers is comparability. Usually, Medicaid recipients can only receive services that are given to other Medicaid recipients. However, this doesn’t make sense for children with intellectual and developmental disabilities such as autism because their needs are diverse and unique. That’s why Medicaid waivers come into play, so that specialized treatments can be included as part of your child’s plan.
Let’s talk about an important aspect that sets state Medicaid waivers apart from traditional Medicaid coverage—the location of services. In the past, many children with disabilities were placed in institutions because their families didn’t have the necessary resources to provide care at home. However, with the introduction of Medicaid waivers, there’s been a significant shift. These waivers enable services that were once restricted to medical institutions to be delivered right in the comfort of your own home. Not only does this help control costs since institutional care can be incredibly expensive, but more importantly, it allows families to stay together, fostering a stronger sense of unity and support. It’s a game-changer that brings both practical and emotional benefits to families in need.
In essence, Medicaid waivers make it so that families, regardless of income, are able to receive goods and services such as assistive technologies like Goally, occupational therapy, respite, and much more. These waivers enable children to be able to stay with their families and in the community instead of needing to stay at an institution that provides them with the same services.
That sounds amazing! How do I get a Autism waiver Program?
Every state has unique Medicaid waivers, application processes, eligibility requirements, and available services. In order to get all of this specific information please check your state on our forum.
Here are some general tips that we have found after perusing so many Medicaid waiver systems.
- Try not to rely on government websites too much. It usually feels like you’re trying to glue a piece of shredded paper back together with how terrible they are. Instead, hop on the phone. Department phone numbers or regional office contacts that we provide are far more informative and you will typically have to end up calling them anyways to apply.
- Most waivers say that your child must require an intermediate care facility (ICF) level of care to qualify. Don’t be afraid by this because they are not trying to put your child in an institution. ICF level of care is a technical definition that typically just means that your child has limitations with 3 of the 6 following challenges: self-care, understanding, and use of language, learning, mobility, self-direction, and capacity for independent living.
- Many, many states have 1-10 year waitlists before you can get services. It’s unacceptable that these are so long, there is simply not enough funding available for everyone currently. You still get so many important services from them so we suggest you go through the eligibility process early so you can get on these lists. While you wait make sure to explore other state and county resources, many states have stipends available for families with disabilities.
- If you really don’t know where to start, its a good bet to call your state’s Department of Human and Health Services. However, if they can’t help you directly they should at the very least direct you in the right direction.
What happens when you get on the waiver?
Once you get on the waiver or county fund program you will typically start working with a case manager and developing an individual service plan (ISP). This ISP can include tons of different services tailored to your child and additional funds for items such as assistive technology like Goally. You can view our guide HERE.
Find your State’s Autism Waiver Program guide below
Alabama State Medicaid Waiver Program Application Guide
Alaska State Medicaid Waiver Program Application Guide
Arizona State Medicaid Waiver Program Application
Arkansas State Medicaid Waiver Program Application Guide
California State Medicaid Waiver Program Application Guide
Colorado State Medicaid Waiver Program Application Guide
Connecticut State Medicaid Waiver Program Application Guide
Delaware State Medicaid Waiver Program Application Guide
Florida State Medicaid Waiver Program Application Guide
Georgia State Medicaid Waiver Program Application Guide
Hawaii State Medicaid Waiver Program Application Guide
Idaho State Medicaid Waiver Program Application Guide
Illinois State Medicaid Waiver Program Application Guide
Indiana State Medicaid Waiver Program Application Guide
Iowa State Medicaid Waiver Program Application Guide
Kansas Medicaid Waiver Program Application Guide
Kentucky Medicaid Waiver Program Application Guide
Louisiana Medicaid Waiver Program Application Guide
Maine Medicaid Waiver Program Application Guide
Maryland Medicaid Waiver Program Application Guide
Massachusetts State Medicaid Waiver Program Application Guide
Michigan State Medicaid Waiver Program Application Guide
Minnesota State Medicaid Waiver Program Application Guide
Mississippi State Medicaid Waiver Program Application Guide
Missouri State Medicaid Waiver Program Application Guide
Montana Medicaid Waiver Program Application Guide
Nebraska Medicaid Waiver Program Application Guide
Nevada Medicaid Waiver Program Application Guide
New Hampshire Medicaid Waiver Program Application Guide
New Jersey Medicaid Waiver Program Application Guide
New Mexico Medicaid Waiver Program Application Guide
New York State Medicaid Waiver Program Application Guide
North Carolina State Medicaid Waiver Program Application Guide
North Dakota Medicaid Waiver Program Application Guide
Ohio Medicaid Medicaid Waiver Program Application Guide
Oklahoma Medicaid Waiver Program Application Guide
Oregon Medicaid Waiver Program Application Guide
Pennsylvania Medicaid Waiver Program Application Guide
Rhode Island Medicaid Waiver Program Application Guide
South Carolina Medicaid Waiver Program Application Guide
South Dakota Medicaid Waiver Program Application Guide
Tennessee Autism Waiver Program Application Guide
Texas Medicaid Waiver Program Application Guide
Utah State Medicaid Waiver Program Application Guide
Vermont Medicaid Waiver Program Application Guide
Virginia Medicaid Waiver Program Application Guide
Washington Medicaid Waiver Program Application Guide
West Virginia Medicaid Waiver Program Application Guide
Wisconsin Medicaid Waiver Program Application Guide
Wyoming Medicaid Waiver Program Application Guide
FAQs About State Medicaid Waiver
What is a state Medicaid waiver program? A state Medicaid waiver program is a program that allows states to create and fund services that are not traditionally covered by Medicaid. These programs are designed to help individuals with special needs or disabilities live more independently and receive the services and support they need. Who is eligible for state Medicaid waiver programs? Eligibility for state Medicaid waiver programs varies by state and program, but typically individuals with special needs or disabilities who require ongoing services and support are eligible. Some programs have specific eligibility criteria based on age, diagnosis, income, or other factors. What types of services are covered by state Medicaid waiver programs? The services covered by state Medicaid waiver programs vary depending on the specific program and state, but may include home and community-based services, respite care, personal care services, assistive technology, and behavioral support services. How do I apply for a state Medicaid waiver program? To apply for a state Medicaid waiver program, you will need to contact your state's Medicaid agency or a local agency that provides services to individuals with special needs or disabilities. The application process can be complex, and it's important to provide all the necessary documentation and information to ensure eligibility. How long does it take to get approved for a state Medicaid waiver program? The approval process for state Medicaid waiver programs can vary depending on the program and state, but it typically takes several months to receive approval. Some programs may have waiting lists due to high demand, so it's important to apply as early as possible. Can I choose my own service providers with a state Medicaid waiver program? In most state Medicaid waiver programs, individuals are given the option to self-direct their services, which means they can choose their own service providers and manage their own care. However, this can vary by program and state. How does a state Medicaid waiver program differ from traditional Medicaid? State Medicaid waiver programs differ from traditional Medicaid in that they allow states to create and fund services that are not typically covered by Medicaid.
This post was originally published on 12/28/2020. It was updated on 06/23/2023.
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