RI's Home and Community Care Medicaid 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.
Elderly Rhode Island residents can receive a variety of care services and support through the Home and Community Care Program. This program is intended as an alternative to nursing homes and therefore services are provided to individuals living at home or "in the community". By the rules of the program, "in the community" includes assisted living residences. Having said that, most of the benefits of the program are selected to support individuals at home. For example, assisted living residents would not be able to receive financial assistance for home modifications.
This program is under the jurisdiction of the Rhode Island Division of Elderly Affairs. This division also offers another option for Medicaid eligible seniors called the RIte @ Home Program
The Home and Community Care Program has multiple layers of eligibility requirements. Age
- Applicants must be 65 or older.Residency
- Applicants are required to be legal residents of the state of Rhode Island. However, there is no duration of residency requirement.Functional Ability
- This program is intended as an alternative to nursing home placement. Therefore, participants must be at risk of nursing home placement. Practically this means they require assistance to perform the activities of daily living such as bathing, grooming, eating and mobility. Typically, the inability to leave their home without considerable assistance is indicative of an individual who would qualify from a functional perspective. Financial Status
- RI Medicaid (and therefore the Home and Community Care Program) considers both the applicant's income and countable resources. In 2013, the monthly income limit for one applicant is set at approximately $1,000. The countable resources limits, which do not include a home, burial plot and some other personal effects, is set at $4,000.
Married applicants have a different set of rules, this is especially true if only one spouse is applying for Medicaid. Couples in this situation and single individuals over these limits should strongly consider consulting with a Medicaid planning expert prior
to contacting state Medicaid officials.
Services / Benefits
Follows is a list of possible benefits covered by this program. Not every participant will be eligible to receive all of these.
-Home Health Care by Certified Nursing Assistants
-Adult Day (Health) Care
-Personal Emergency Alert Systems
-Home Modifications (limited to $20,000 over 5 years)
-Assistive Technology (limited to $500 per year)
Availability / How to Apply
To apply for this program, state residents should contact the regional offices available on this webpage
. As with many Medicaid Waivers, there may be a waiting list for services. The program is available statewide.
Use our Locator Tool to Find Other Options for which You're Eligible
Page Reviewed / Updated - Jun. 2013