An Overview of Iowa's Medicaid Waivers & Eligibility Requirements

Medicaid Waivers from America’s Heartland

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Medicaid Waivers from America's Heartland

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Summary: Regina Woodard provides an overview of Iowa's Medicaid waivers for the elderly and disabled, including HBCS Health & Disability, Elderly, Physical Disability, and Brain Injury Waivers. Regina also highlights the CCO, CDAC and PACE waivers, including eligibility requirements and how to apply.

Author: Regina Woodard exclusively for Assisted Living Directory

Regina is a regular contributor to Assisted Living Directory

In the midst of the American Heartland, there is the 29th state of Iowa, former home to an agricultural economy that transitioned to that of advanced manufacturing, processing, financial services, information technology, biotechnology, and green energy production. Iowa is the 26th most extensive state in land area and has been listed as one of the safest states to live.

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It should be no surprise then that the state takes great care of its citizens, especially its seniors, providing several different means and ways to achieve affordable care. Here are just some of the ways Iowa is helping their senior population.

The main service that Iowa offers is that of its Home and Community Based Services (HCBS), which are Medicaid programs that offer more choices on how and where participants receive services. These services help seniors stay in their homes and the community instead of needing to go to an institution. On a whole, the HCBS offers seven different waivers for those who are elderly or disabled, with four of them dedicated to Iowa seniors.

Iowa Medicaid Waiver Overview

HCBS Health & Disability Waiver

The HCBS Health and Disability waiver (HCBS HD) is intended for individuals who would require care in an institution or nursing facility to stay within their own homes or communities. Members are able to have a DHS service worker or case manager that works with the individual and their families on a service plan that is customized to their needs. Some of the services that the waiver provides include adult day care, consumer directed attendant care, counseling services, meal delivery, home health, home/vehicle modifications, medical monitoring and treatment, respite, and personal emergency response systems.

To be eligible, participants must be a resident of Iowa, a US citizen or have legal entry into the US, receiving social security benefits, eligible for Medicaid, have total costs not exceeding $950 a month for nursing level care, and $2765 a month for skilled level care.


HCBS Elderly Waiver

The HCBS Elderly waiver, as with the HCBS HD waiver, is intended to keep individuals in their homes or communities instead of going into an institution or a nursing facility. Services provided by this waiver include adult day care, assistive devices, on call assisted living, case management, emergency response systems, home/vehicle modifications, meal delivery, home health, nursing care, respite, senior companions, and transportation.

To be eligible, individuals must be a resident of the state of Iowa, a US citizen or have legal entry into the US, be 65 years of age or older, be eligible for Medicaid if they were in a medical institution.


HCBS Physical Disability Waiver

As with the above waivers, the HCBS PD helps to allow individuals the ability to stay in their home or their communities. The services for this waiver include consumer directed attendant care, home/vehicle modifications, personal emergency response systems, specialized medical equipment, and transportation.

To be eligible for this waiver, individuals must be a resident of Iowa, a US citizen or have legal entry into the US, have a physical disability, be eligible for Medicaid, and between the ages of 18 and 64 years. Individuals cannot be eligible for the Intellectual Disability waiver that is also offered by the HCBS.


HCBS Brain Injury Waiver

The HCBS BI is another waiver offered by the state of Iowa to keep individuals within their homes or communities instead of being medically institutionalized. Services under this waiver are much like the others, including adult day care, behavioral programming, case management, family counseling, home/vehicle modifications, personal emergency response systems, respite, specialized medical equipment, and transportation. Eligible individuals must be residents of Iowa, a US citizen or allowed legal entry into the US, be determined to have a diagnosis of a brain injury as confirmed by the Iowa Medicaid Enterprise/Medical Services Unit, be eligible for Medicaid, and be between the ages of one month and 64 years.


CCO

Within the HCBS waiver programs, members can get control over a targeted amount of Medicaid dollars to create a plan to meet their needs. Known as the Consumer Choices Option, this helps to give more control over how waiver dollars are spent, allows for family members or friends to be paid for home care, as well as the flexibility to purchase goods and services that meet their needs.


CDAC

The Consumer Directed Attendant Care (CDAC) is another waiver program within HCBS that allows for individuals to help within their own homes. Services are designed to help individuals do the things they would do if they were able, allowing them to remain in their homes.


PACE

The Program of All-inclusive Care for the Elderly (PACE) is a program that helps to bring individuals and health providers together for preventive care, primary care, social services, long term services, and recreation, again with the result of keeping those individuals within their own homes.

To be eligible for PACE, members need to be 55 or older, reside in an area that offers PACE, have or be eligible for Medicaid or Medicare, and meet the requirements for nursing facility level of care.

All HCBS waivers require an application process, which begins with applying for Medicaid, with some help from an Income Maintenance work at the local Department of Human Services agencies. Assessments are made as to see which waiver works for the individual and their families. You can also go to the online DHS benefits portal to sign up. Resources Wikipedia - Iowa Home and Community Based Services HCBS Waiver Programs CCO CDAC PACE

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