New Mexico’s CoLTS C Waiver (CCW) Program: Requirements and Qualifications
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.
CoLTS C Waiver Description
New Mexico's Medicaid CoLTS C (Coordination of Long Term Services) waiver program was until recently called the Disabled and Elderly Waiver. This program provides support to enable older adults and individuals with disabilities remain living in their own homes and communities instead of being placed in a nursing home. It also helps nursing home residents to return to their homes if they choose to do so. The waiver is managed by the state's Human Services Department (HSD).
Self-direction of care is available through an associated program called Mi Via
. Mi Via allows CoLTS C Waiver program participants to choose their own care providers to meet their functional, medical, and social needs.
The CoLTS C Waiver has eligibility criteria related to the applicant's age, level of impairment and finances. Age
- applicants must be at least 65 years of age. Level of Impairment
- applicants are assessed as having a need for nursing home level care Finances
- CoLTS C has the same financial criteria as New Mexico Institutional Medicaid. In 2013, the monthly income limit is $2,130. Note that this is significantly higher than the limit for Aged, Blind and Disabled (ABD) Medicaid at $710 / month. The countable resource limit is $2,000 for both ABD and Institutional Medicaid. Exceptions to the Financial Limits
- there are several exceptions to these limits. Married couples with only one of the two partners applying for CoLTS or Medicaid can structure their finances to provide the non-applicant with the majority of income and assets. This enables them to continue living independently concurrently lowering the applicant's income and assets to the eligibility limit. Non-applicants can have up to $115,920 in assets. Also worth noting is this exception that one's house and car are not counted towards the asset limit.
Another exception exists through the use of income trusts and asset conversions. Applicants can allocate their income which exceeds the limit into a Pooled Income Trust. They can also convert assets over the limit into exempt assets. For example, final expense insurance and burial plots may be considered exempt. Pre-planning for these expenses can lower one's countable resources to the appropriate level.
*Caution* asset conversions and trusts are complicated. It is very easy to structure these incorrectly and New Mexico Medicaid does a thorough review of each applicant's finances. It is strongly advised that families wishing to qualify using these techniques find Medicaid planning assistance
Services / Benefits
Each applicant receives a customized care plan. Possible benefits for CoLTS C Waiver participants include the following:
-Adult Day Health
-Emergency Response System
-In Home Respite
-Personal Care Services
-Private Duty Nursing (RN/LPN)
Waiver Availability / How to Apply
CoLTS C is available statewide in all counties, but it has a limit on total participation and therefore waiting lists may exist. To learn more about the program, check wait list status or apply, one can contact their local Aging & Disability Resource Center
(ADRC), call 800-432-2080 or visit the CoLTS website
Use our Locator Tool to Find Other Options for which You're Eligible
Page Reviewed / Updated - Feb. 2013