Alaskans Living Independently (ALI) Medicaid Waiver

 What is a Medicaid Waiver?
Medicaid Waivers, also known as Home and Community Based Services (HCBS) Waivers and Waiver Funded Services, allow qualifying program participants to receive services out of the nursing homes. Medicaid’s standard benefit is to pay for nursing home residential care. However, when available, Medicaid Waivers help to provide more options for individuals. The cost of the care outside of a nursing home needs to be less than the cost of care in a nursing home.

Program Description

The Alaskans Living Independently (ALI) Waiver is intended to assist seniors 65 years of age and older or adults 21 years of age to 64 years of age who are physically disabled, and in need of nursing home level care. Through this statewide Medicaid waiver, services are provided, such as care coordination, adult day care, and respite, that allow the individual to continue to live at home, while also providing support to the caregivers. Modifications to the home to help promote independence, like ramps and widening of the doors, home delivered meals, and personal response systems, are also covered benefits of this waiver.

ALI allows eligible individuals to choose their own care providers, given he or she is qualified. Care providers can be family members including an adult child, sibling or in some cases even spouses. However, there are some restrictions to this self-directed care.

It is not a requirement of the program that the participant remain living at home. They can reside in an assisted living community (more formally referred to as "residential supportive living"), but this may limit the range of services for which they are eligible. They cannot reside in a nursing home.

This Medicaid waiver program is administered by the State of Alaska Senior and Disabilities Services (DSDS). Alaskans Living Independently was created as a replacement for two previous state Medicaid programs: Older Alaskans Program and the Adults with Physical Disabilities Medicaid Waiver. To avoid confusion, it is worth mentioning that Medicaid in the state of Alaska is sometimes referred to as DenaliCare.


Eligibility Guidelines

Medicaid eligibility is complicated and the requirements change based on individual criteria such as age and marital status. What follows is accurate for 2017 for Alaskan residents aged 65 or older and those under 65 who are physically disabled as designated by Social Security. To be eligible for the Alaskans Living Independently wavier, an individual must:

1) Care Needs - Require nursing home level care. In other words, if not for the services provided by this wavier, it would be necessary for the individual to reside in a nursing home.

2a) Assets - If single, have countable assets valued at no more than $2,000. This excludes the value of their home provided they reside in the home and the value of their home equity does not exceed $560,000.

2b) Assets - If married, and their spouse is not seeking Medicaid, the applicant is permitted $2,000 and their spouse is permitted to retain up to $120,900 of their joint assets.

3a) Income - If single, have monthly income not exceeding $2,205.

3b) Income - If married, the Medicaid applicant is permitted up to $2,205 in monthly income and their non-applicant spouse is permitted an additional $3,022.50.

4) Asset Transfers - They cannot have gifted or sold assets under market value in the preceding 60 months for the purposes of lowering their assets to gain Medicaid eligibility.

Families who exceed these limits can very likely still become Medicaid eligible. This applies to both families exceeding the income limits or the asset limits. There are many exceptions and workarounds that help families who require care to receive that care. It is strongly suggested that families in this situation contact a Medicaid planning professional prior to applying for the program. Learn more.  

Benefits and Services
  • Adult Day Care - Also referred to as Adult Day Services
  • Care Coordination
  • Respite Care - May be in-home or at a facility, such as a nursing home
  • Chore Services - Scrubbing floors/walls, moving furniture, snow removal, etc.
  • Environmental Modifications - Ramps, grab-bars, walk-in tubs, etc.
  • Meals - home delivered or served in a group setting
  • Residential Supported Living - 24 hour care access in a setting that is not an institution
  • Specialized Medical Equipment and Supplies
  • Personal Emergency Response System 
  • In-home Specialized Private Duty Nursing
  • Transportation


How to Apply / Learn More

The Alaskans Living Independently Waiver is not an entitlement, which means the number of people that can receive services via this waiver is limited, and there may be a wait list. Individuals on the wait list will be prioritized based on those who are most in need of services.

For more information about this waiver, click here.  For additional information or to apply, call the Alaska Department of Health and Social Services Senior and Disability Services. Click here to find the number of your local office.