Medicaid Waiver Programs

What is a Medicaid Waiver?

The Federal Government originally created Medicaid to pay medical bills for low-income Americans. Congress has expanded Medicaid to also include the elderly, people with disabilities, children, and pregnant women. Mental retardation is one of the disabilities that usually qualifies a person to receive Medicaid.

 

Medicaid is a federal program that is run by each state. Although it is not a requirement, all 50 states do participate in the Medicaid program. The main rules for Medicaid are made at the national level. Medicaid is different in each state, however, since individual states can set up their own policies. As a result, there are many different laws and rules about Medicaid. Sometimes the government allows exceptions to certain rules so people can get needed services. These are called Medicaid waivers.

 

The first Medicaid waiver was given to a little girl from Iowa named Katie Beckett who lived most of the first 3 years of her life in a hospital hooked up to equipment to help her breathe. Katie could have just as easily and more cheaply been cared for in her home, but a Medicaid regulation allowed her medical expenses to be paid for only when she was hospitalized. Her mother lobbied in Washington, and President Ronald Reagan demanded that the income limit rule for Medicaid be "waived." By making this exception to the rule, Katie got home just in time to celebrate Christmas, 1981 and spend the rest of her childhood with her family. Plus, this was a huge savings for Medicaid to pay for Katie's care in the home instead of in the hospital.

 

The Medicaid waiver programs began shortly thereafter in 1982 when President Reagan signed the Katie Beckett waiver into effect. This made Medicaid funds available to similar families with special needs children who otherwise did not qualify for assistance and care in the home. Since then, states have developed a variety of Medicaid waivers which have allowed people to receive needed services in their homes and communities rather than in an institutional setting. Each state has different waiver programs with different eligibility requirements and services. Texas has several Medicaid waiver programs, two of which are provided by the Andrews Center:

HCS - Home and Community Based SErvices

TxHmL - Texas Home Living

 

How can someone get a Medicaid Waiver program?

 

The Mental Retardation Authority department of the Andrews Center maintains a waiting list (interest list) for the HCS waiver program. To place a name on the waiting list, contact the waiting list coordinator at:

Also, the MR Intake staff can tell you about other Medicaid waiver programs that other agencies provide.