Colorado Medicaid Waiver for the Elderly, Blind and Disabled

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

 This program helps nursing home qualified persons to remain living at home or in assisted living communities.

This Medicaid waiver is designed to help the elderly who have physical or neurological impairments that could qualify them to receive nursing home care. Individuals elect to receive care services at home or in alternative care facilities, such as assisted living, instead of in a nursing home environment. In addition to choosing their care environment, under this programs individuals have the option to "consumer direct" or self-direct their own care services. Meaning, they can hire and manage some of their own care providers. As an example, they can elect from whom they receive personal care, but not necessarily who provides them with non-medical transportation.

Services covered under this waiver are selected to enable participants to maintain their independence outside of nursing homes. As such, personal emergency response services (PERS) and home modifications are covered, as well as a broad category of assistance referred to as In-Home Support Services (IHSS).  IHSS includes help with home-related tasks, such as laundry, house cleaning, and personal care, such as bathing and eating.

This waiver's full, official name is Home and Community-Based Services waiver for Persons who are Elderly, Blind and Disabled (HCBS-EBD). 

 

Eligibility Guidelines

To be eligible for this waiver, an applicant must be a resident of Colorado. This waiver also considers age, income, financial assets, and functional ability as eligibility criteria.

Age and Functional Ability - while open to persons 18 and older who are disabled, those 65 years of age and older need not be designated officially as having a "disability," rather they must be assessed and found in need of nursing home level care. Persons living with HIV or AIDS can also automatically qualify for this even if they are not over 65 or legally defined as having a disability by the Social Security Administration.

Income and Assets - Single applicants may not have a gross monthly income greater than $2,205 each month. An applicant may have up to $2,000 in countable assets, which includes bank accounts, investment accounts, and retirement accounts. If the applicant is married, and the spouse is not applying, they are permitted to retain the first $24,180 in joint wealth and up to $120,900. Some of the applicant’s monthly income can be allocated to the non-applying spouse to provide them with a living allowance—up to $3,022—when they have less than this amount.

Persons who exceed the limits might still qualify by allocating excess income into a Miller Income Trust. Countable assets in exceed of the limits may be converted to exempt assets or annuity income. These techniques both will likely require expert guidance from a Medicaid planning professional. Interested individuals should find help in advance of applying. Find assistance qualifying for Medicaid.

 

Benefits and Services

As the objective of the Elderly, Blind and Disabled Waiver is to prevent nursing home placement, the benefits are selected to enable individuals to continue living in the community and to support their family members who provide caregiving assistance. Participant-directed options exist. Services can include:

  • Adult Day Care / Adult Day Health Care
  • Alternative Care Facilities / Assisted Living Residence - Assistance with activities of daily living, laundry, housecleaning, etc. Room and board costs are not covered. 
  • Community Transition Services - Nursing home back into the community
  • Personal Emergency Response System (PERS)
  • Home Modifications to Increase Access -Widening of doorways, addition of ramps, etc.
  • Homemaker Services - Cleaning, laundry, preparation of meals, shopping, etc.
  • In Home Support Services (IHSS)
  • Non-Medical Transportation Coordination and Assistance
  • Personal Care - Assistance with bathing, dressing, eating, etc.
  • Respite Care for Family Caregivers - In-home and out of home
  • Medication Reminders

 

How to Apply / Learn More

This waiver is available statewide in all counties. It has been structured to aid approximately 25,000 state residents. However, because it is not considered an entitlement program, eligibility does not ensure availability. Otherwise qualified applicants may have to wait to start their benefits if there is an interest list.  

To apply, contact the Colorado Single Entry Point in your local region. Limited information about this waiver is also available on the Colorado State Government website.


Colorado families might also be interested in the CDASS Program and can receive caregiving assistance from Colorado Respite Coalition.