How Do You Apply for an Assisted Living Waiver Program?

To apply for an assisted living waiver program, begin by researching eligibility and state requirements. Each state has its own Medicaid waiver programs, so the criteria for applying and the extent of the financial support will vary. Contact your local Medicaid office or the agency that oversees long-term care services in your state for information regarding these specifics and to obtain an application.

Assisted living waiver programs provide financial assistance to seniors who need support with activities of daily living but prefer a residential care setting over a nursing home. While waiver programs do not cover all the costs associated with assisted living, they subsidize expenses such as personal care, transportation, emergency response systems and meals. They also cover medication management, on-site therapy services and skilled nursing care that isn’t covered by Medicare.

As each state has its own Medicaid waiver programs, it’s important to look into what expenses your local program will cover. Medicaid doesn’t cover the price of room and board in any state, so seniors and families may consider additional options to help cover the cost of assisted living.

Before getting started on an application, gather information about the eligibility requirements to make sure you qualify. Eligibility requirements vary by state and by program, though they usually focus on income, age and medical need. Most assisted living waiver programs require that seniors are:

• Aged 65 and up or have a disability
• In need of a nursing home level of care
• Eligible for Supplemental Security Income (SSI)

Use this helpful tool to find Medicaid enrollment information and requirements for your state.

Medicaid waiver programs typically require documentation to confirm eligibility. This may include financial statements, medical records and proof of age. Thoroughly review the checklist provided by the waiver program to ensure you have all the necessary documentation in order.

Once you’ve completed these steps, you’re ready to apply. Some states may have online application portals, while others may require you to mail the application. Before submitting, ensure that you’ve included all the necessary documentation and have filled out your application fully and accurately. Incomplete submissions may result in delays in the application processing or denials.

Some organizations guide you through the application process and provide valuable information about long-term care. Aging and Disability Resource Centers (ADRCs), for example, are invaluable for older adults who need assistance accessing long-term services and supports (LTSS). These agencies have dedicated staff who provide a detailed breakdown of the eligibility requirements, help applicants obtain the necessary documents and assist with applying.