Delaware Amended Elderly and Disabled (E&D) Waiver - Eligibility and Benefits

Important Update: In July 2014, Delaware Medicaid dissolved this Medicaid waiver and moved all participants to be part of the Diamond State Health Plan (DSHP) - Plus. We maintain the following page for historical purposes only. All new Medicaid applicants will be directed towards the Medicaid Managed Care option instead of this waiver.

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 Delaware residents remain living at home or in assisted living.

This home and community based waiver program is administered by the Division of Services for Aging and Adults with Physical Disabilities (DSAAPD) . The Amended Elderly and Disabled Waiver combines 3 former waivers: Elderly and Disabled, Assisted Living and Acquired Brian Injury.

The new Amended E&D Waiver is designed for older persons that require a nursing home level of care. Participants can choose to receive that care in their home or in an assisted living community instead of in a nursing home, provided the cost of those services do not exceed a certain percentage for the same services in a nursing home.

This waiver also allows for consumer or participant direction. This means participants are given the flexibility to select and hire their own care providers. In some cases, family members can be hired to provide personal care. Typically, spouses are not eligible but the adult children (of aging parents) can work as paid caregivers.

 

Eligibility Guidelines

In addition to being a Delaware resident and requiring nursing home level care, persons must be financially qualified for the Amended E & D Waiver. These qualifications are the same as for Delaware Long Term Care Medicaid.

Single Applicant Limits - In 2015, monthly income must be less than $1,832, or 250% of the Supplemental Security Income. Liquid or countable resources are limited to a value of $2,000.

Married Applicants (with one spouse seeking Medicaid) - the single applicant assets and income limits still apply however, these individuals can allocate their joint income and assets to their spouses to provide them with both a living stipend and a resource reserve up to $119,220. This can effectively lower the applicant's income and assets to the level necessary to be eligible for the Amended E & D Waiver.

Delaware does not offer a Medically Needy program, therefore individuals who exceed the limits and cannot afford their cost of care have only the option of Medicaid planning to help them qualify. Medicaid planners have the financial expertise and knowledge of Medicaid law so that they are able to re-structure an applicant's resources using trusts, non-countable assets and annuities so their clients become financially eligible. Find assistance qualifying for Amended E & D Waiver.

 

Benefits and Services

Some relatives are permitted to be hired as personal care providers. 

The services available to waiver participants vary with need. Individuals are assessed and provided with a care plan which outlines the specific benefits for which they are eligible. These can include any of the following services listed below.   Family members, including the adult children, can be paid for providing caregiving services.

  • Adult Day Services (social and medical)
  • Assisted Living
  • Case Management
  • Cognitive Services
  • Day Habilitation
  • Personal Care
  • Personal Emergency Response System
  • Respite Care (for the primary caregiver)
  • Specialized Medical Equipment and Disposable Supplies

 

How to Apply / Learn More

The Amended E & D Waiver has no geographic restrictions within the state. However, waivers are approved by the Center for Medicare and Medicaid Services with enrollment caps. This means a limited number of slots are available to applicants and a waiting list may exist. To learn more and to apply interested parties should contact their Delaware Aging and Disability Resource Center.

Persons ineligible or wait-listed for this program may find assistance from CARE Delaware or the Adult Day Care and Alzheimer's Day Treatment Program.