Virginia Elderly or Disabled with Consumer Direction (EDCD) Waiver
What are Medicaid Waivers?
Medicaid pays for long term care services in nursing homes. For nursing home qualified persons that choose to live at home or in a residential community, Medicaid will pay for those services if they can be obtained at a lower cost. These are called Home and Community Based Services, Waiver Funded Services, Medicaid Waivers or simply Waivers.
EDCD Waiver Overview
This Virginia Medicaid waiver provides community-based care services to those nursing home eligible seniors that choose to live in their own homes or communities. Consumer Direction means that the participant is able to choose some of their care providers. In some cases, they are able to pay their related caregiver for the personal care they provided. This type of program is occasionally referred to as Cash and Counseling or Self-Direction and it is becoming increasingly popular with families due to the increased choice. It is also popular with state officials because it has the potential to reduce costs by leveraging family caregivers.
Waiver Eligibility Guidelines
While open to disabled adults of any age, this program is primarily targeted towards those 65 and older. It is not necessary for these individuals to be completely disabled however they must require the level of care provided in nursing homes. As with all Medicaid programs, there are also financial requirements.
2013 Virginia Medicaid Income Limits
Elderly, disabled and blind state residents can fully qualify for Medicaid if their monthly incomes are less than $745. However, depending on their medical expenses, some individuals can qualify with monthly income up to $2,130 or in rare instances even in excess of that amount.
2013 Virginia Medicaid Asset Limits
Individuals applying for Medicaid are permitted up to $2,000 in countable assets, married couples up to $3,000 and married couples with only one spouse applying up to $115,920. Countable assets do not include their home provided at least one spouse lives in it and provided their home equity is valued at less than $536,000. The primary vehicle and final expense plans are also excluded for their countable assets.
IMPORTANT* if one's income or assets exceed these limits, many individuals might still qualify for Medicaid. There are Medicaid eligibility experts that help families to structure their financial assets so that they can qualify. Given the high cost of care, doing this can prevent many families from becoming destitute. Excess income can be allocated to pooled income trusts
, and excess assets can be converted to exempt annuities. For families in this situation, we strongly encourage them to find Medicaid planning assistance
Services / Benefits
This waiver is intended to prevent persons from moving into nursing homes. The available services are selected to maximize their ability to age in place in their homes. While services are determined specifically for each applicant, they may include:
- Adult Day Care - supervised care in a group environment during normal working hours
- Medication Monitoring - oversight and administration of required prescription drugs
- Personal Care Aide Services - assistance with the activities of daily living
- Respite Care - temporary caregiving services provided to relief the primary family member or caregiver
- Personal Emergency Response System - automated electronic monitoring and notification of emergency situations
- Transition Coordination -should the individual be moving out of skilled nursing into a private home
Program Availability / How to Apply
This waiver is available statewide across Virginia. However, most waivers are created with a limited number of slots available. Eligible individuals may find themselves on a waiting list for services. To learn more or apply for this waiver, contact your local Department of Social Services
Use our Locator Tool to Find Other Options for which You're Eligible
Page Reviewed / Updated - Jan. 2013