If you have a disability or are elderly, you may qualify
for a 1915(c) Home- and Community-Based Services (HCBS) Medicaid waiver. These waivers provide the support you need to live as independently as possible.
The Department for Medicaid Services (DMS) offers six waiver programs:
You may qualify for a 1915(c) HCBS waiver if:
- You wish to live in the community as independently as you can.
- You would be admitted to a nursing facility or intermediate care facility if you did not have 1915(c) HCBS waiver services.
- You meet the nursing facility level of care defined in Kentucky Administrative Regulation 907 KAR 1:022, Section 4.
- You meet the financial conditions for Medicaid. There are special financial conditions for 1915(c) HCBS waivers.
You can apply for a 1915(c) HCBS waiver online using the benefind Self-Service Portal or in-person at a Department for Community Based Services (DCBS) office, a Community Mental Health Center (CMHC), an Area Agency on Aging (AAA) or an Area Development District (ADD).
You can apply for a 1915(c) HCBS waiver for yourself or for someone else. There are some documents that are helpful to have when applying. The Medicaid Waiver Services Fact Sheet
lists those documents.
News from the 1915(c) HCBS Waiver Programs
Service authorization changes: As of Nov. 25, 2019, case managers are approving most services on person-centered service plans for 1915(c) HCBS waiver participants. DMS has released several resources for stakeholders.
- Training Materials: Service Authorization Training Notice, Service Authorization Training Webinar Recording, Service Authorization Training Guide, Service Authorization Quiz
- Frequently Asked Questions: Service Authorization Policy FAQ, System and Prior Authorization FAQ
- Service Authorization Standard Operating Procedure
- Service Authorization Crosswalks: ABI/ABI LTC, HCB, Model II, MPW, SCL
- Summary of MWMA Improvements for Providers
- MWMA Quick Reference Guides: LOC Determination, LOC Review, Creating/Modifying PCSPs, Prior Authorizations, Program Closures, and Services Requiring CHFS review
- Instructional Guide: Locating PA Information in MMIS
- Letters: Service Authorization for Participants, Service Authorization for Providers, Additional Service Authorization Guidance Letter
- Examples: Team Meeting Sign-In Sheet
If you have questions about service authorization policy, contact DMS
. If you have technical issues or questions about MWMA, please call (800) 635-2570.
1915(c) HCBS FAQ: Stakeholders can stay informed about 1915(c) HCBS waiver redesign by reading our Frequently Asked Questions (FAQ) document. The FAQ is updated regularly using questions DMS is asked about the project. If you have a question you do not see in the FAQ, please contact DMS.