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If you are elderly or disabled, Medicaid waiver programs can provide Medicaid coverage for many different services that help you stay in your home. The Department for Medicaid Services provides the following waiver programs:

​Eligibility

You may be eligible for Medicaid waiver services if: 

  • You have written certification from a physician that if Medicaid waiver services were not available, you would be admitted to a nursing facility in the immediate future.
  • You meet the nursing facility level of care defined by Section 4 of 907 KAR 1:022.
  • You choose to be at home and receive waiver services.
  • You meet the income and resource limitations required by the program.

Apply

You can apply for Medicaid online using the Benefind Self Service Portal or at your local Department for Community Based Services Office. At the time of application, an individual or family should have:

  • Social Security Number;
  • Proof of Identity (drivers license);
  • Proof of Citizenship (birth certificate);
  • Health Insurance;
  • Medical bills
  • Income
  • Resources
  • Life insurance policies or burial reserves

A Medicaid application is more likely to be processed sooner if the individual or family provides the above information.

Attention all Waiver Providers - T​he Department for Medicaid Services (DMS) is considering conducting a study of provider payment and rate-setting methodologies for home and community based services (HCBS) delivered via 1915(c) waivers. This study may include an evaluation of DMS' current methodologies against national best practices. Should DMS choose to initiate this study, it will work with Navigant Consulting, Inc. (Navigant) to begin the study this summer. This letter listed below outlines the process Naviqant would use IF DMS elects to implement Navigant's recommendation to conduct a study of HCBS payment and rate-setting methodologies.

Read the Multi Provider Letter - 1915 C Rate Study (May 1, 2018)

Attention HCB and SCL Waiver Providers - Please see guidance for providers and use the referenced forms below to transition physical therapy, occupational therapy and speech language pathology services from the Waivers to State Plan. This applies only to members in the HCB and SCL Waiver.

If you have any questions about transition of prior authorizations or billing, please email HPE. If you have questions about the State Plan therapy benefit, please contact DMS Division of Policy and Operations by email or by phone at 502-564-6890

Update: (Feb. 15, 2017) - Please view the presentation and the materials from the SCL Waiver Transition webinar

Update: (May 31, 2016) - Please view the Presentations materials from the HCBS Waiver Transition Webinar.

(Mar. 17, 2016) - Provider type 76 - Multi-Therapy Agency, is expected to be effective in June 2016. Providers may begin submitting applications to enroll in Medicaid as this provider type on May 15, 2016 but applications will be held and will not be processed until state regulations are final. The information provided for this provider type is subject to change pending adoption of state regulations.

For more information about the new therapy process, please read the

If you have questions about the therapy process, contact the Department of Medicaid Services at 502-564-7540. If you have any questions regarding enrollment after May 15, 2016, please contact Provider Enrollment at 1-877-838-5085.

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