Oklahoma’s ADvantage Program Waiver: Qualifications and Services
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.
ADvantage Program Waiver Description
This Oklahoma Medicaid waiver is designed to help frail elders remain living in their homes instead of in a nursing home environment by providing a variety of long term care services. Participants in the program have the option to let the state manage the care services they receive or self-directing their own care.
Self-direction, also referred to as participant direction or Cash and Counseling, is through the associated program; Consumer-Directed Personal Assistance Services & Supports (CD-PASS). Under the CD-PASS program, participants are free to choose their own personal care providers. Family members, with some exceptions, are eligible to be hired and paid to provide personal care services to the participant. Readers should be aware the CD-PASS option is being rolled out by county and might not yet be available statewide.
ADvantage Program Waiver Eligibility Guidelines
Age, functional ability, income and assets are all qualifying criteria for the ADvantage Program. Age and functional ability are related. Persons 21 and over are eligible if they are designated as disabled by the Social Security Administration. Persons 65 and over do not require full disability; instead they must have a need for the level of care provided in nursing homes.
Financially, the ADvantage Waiver requires that applicants qualify for Oklahoma's Institutional Medicaid. Medicaid in Oklahoma is also referred to as SoonerCare. The SoonerCare income limit for 2013 for a single applicant is $2,130 / month. The countable resources limit is $2,000. If the individual is married and their spouse is not applying for Medicaid, the spouse is allowed to have higher income and more assets. They can retain up to $115,920 in countable resources and joint income can be allocated to the non-applicant spouse as a monthly needs allowance for living expenses.
Persons in this split spouse situation may want to work with a Medicaid planner to ensure the "Community Spouse" retains adequate resources on which to live.
Persons who do not qualify for Medicaid financially, might be interested in Medicaid planning assistance as these experts can usually help them to re-structure their assets so that they qualify. Find Medicaid planning help here
Services / Benefits
The ADvantage Waiver is intended to help the elderly remain living at home, therefore the available benefits are selected with that goal in mind. Waiver participants can be approved to receive any of the following:
-Adult Day Health Care
-Disposable Medical Supplies
-Home Modifications for Improved Access
-Home Delivered Meals
-Personal Assistance Services
-Specialized Medical Equipment
Availability / How to Apply
The ADvantage Waiver is a SoonerCare program managed by the Oklahoma Department of Human Services. While available throughout Oklahoma, waiting lists may exist. To apply, contact your local Human Services Office
or call 1-800-435-4711.
Use our Locator Tool to Find Other Options for which You're Eligible
Page Reviewed / Updated - Feb. 2013