Wyoming Medicaid Home and Community Based Services

Page Reviewed / Updated - Mar. 2014

What is a Medicaid Waiver?
For persons with limited financial resources, Medicaid pays for nursing home care. For those who wish to live at home or in assisted living, sometimes Medicaid will pay for care in those locations if it can be obtained at a lower cost than in a nursing home. It does this through "Medicaid Waivers" which are also called Home and Community Based Services (HCBS Waivers) or Waiver Funded Services.

Waiver Description

Wyoming 's HCBS Waiver is also referred to as the Long Term Care Waiver and the Elderly and Physically Disabled Long Term Care Waiver.   This is a Medicaid program and Medicaid in Wyoming is also called Equality Care.
The objective of this waiver to "prevent the premature institutionalization of individuals". Phrased differently, this waiver provides services to help individuals remain living at home even though they are medically eligible for nursing home care. Receiving care at home is generally preferred by the elderly and has the potential to reduce care costs for the state as family caregivers are utilized instead of nursing home employees.  Services provided under this program help not the program participant but also help families member in caring for them.  For example, respite care, adult day care and personal emergency response services all reduce the workload of family caregivers.  

This waiver has a self-directed care option associated with it called the Consumer Directed Care Option meaning the care recipient can choose their care providers for certain types of services. In Wyoming this includes personal care assistance.   In some cases, family members can be hired to provide personal care. 

Wyoming has a similar waiver for individuals wishing to reside in assisted living communities.  Learn more.

 

Eligibility Guidelines

Qualifying for the HCBS Waiver means qualifying for institutional or long term care Medicaid. To do this, there are requirements regarding the applicant's level of impairment and their income and assets.

Level of Impairment - this requirement is dependent on the applicant's age. Those under 65 must be physically disabled. Persons 65 and over must have a need for nursing home care (and willing to receive that care outside of a nursing home).

Income and Assets - in 2014, single applicants are limited to $2,163 / month in income and $2,000 in countable assets. If an applicant is married, even if their husband or wife is not applying for Medicaid, their finances are still relevant. Joint income and assets can be allocated to the healthy partner as a living allowance and a financial reserve. This is called the Minimum Monthly Maintenance Needs Allowance and the Community Spouse Resource Allowance. In 2014, these are limited to $2,931 in income per month and $117, 240 in assets.

Persons over these limits might gain entrance into Equality Care and receive assistance under the HCBS Waiver by allocating income over the limit into a Pooled Income Trust. This helps to lowers the applicant's income to a Medicaid compliant level. A similar process can be employed to become asset-complaint. Assets over the countable resources limit may be able to be changed in form so they become non-countable or exempt assets. This is a process called Medicaid planning and for most families assistance is required to engage in Medicaid planning successfully.  Read more.


Benefits and Services

Waiver participants are eligible for the following services.  Personal care can be self-directed. 

  • Adult day care - supervision in a group environment during normal business hours
  • Case management - assistance with coordination and administration of services
  • Home delivered meals - can be hot or prepared
  • Non-Medical Transportation - for a variety of purposes
  • Personal care - assistance with the activities of daily living
  • Personal emergency response system - 24/7 on call service
  • Respite care - temporary caregiving to relief the primary caregiver
  • Skilled nursing services - on a temporary basis only

 

How to Apply / Learn More

This waiver is available to residents throughout Wyoming although it is possible that a waiting list for services exist. One can apply through the Wyoming Aging and Disability Resource Centers (WyADRC) by calling 877-435-7851 or apply online.