Mississippi Elderly and Disabled (E&D) Medicaid 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

The Mississippi Elderly and Disabled (E&D) Medicaid Waiver program is designed to help low income elderly and / or disabled individuals that require nursing home care, but would prefer to remain living at home or in their community instead of in a nursing facility. It does so by providing care services and support to individuals and their primary caregivers. Benefits include services such as adult day care, transportation assistance, caregiver respite, home health, and home delivered meals.

Medicaid HCBS Waivers, such as this one, are approved to service a specific numbers of individuals. Once that limit has been reached a wait list is created. As of 2016, a wait list has been reported.

 Did You Know?  73% of men over 65 are married, but only 42% of women over 65 are.

Eligibility Guidelines

Mississippi's E&D Waiver considers multiple factors for eligibility purposes. The following is current for the year 2017.

Age & Functional Ability – while the waiver is open to persons 21 years or older, persons 65 or older are subjected to a different impairment requirement. Those 21 - 64 years of age must be disabled as designated by Social Security. Those over 64 need not be fully disabled but must require the level of care typically provided in a nursing home.

Income - for 2017, the monthly income limit for a single applicant is $2,205. This amount is equal to 300% of the Federal Benefit Rate (FBR). Married couples can have their incomes assessed separately and can distribute joint income to a spouse, provided that spouse is not also applying for Medicaid, effectively lowering the applicant's income. This is called the Monthly Maintenance Needs Allowance or MMNA and in 2017, non-applicant spouses are permitted monthly income up to $3,022.50.

Assets – single, widowed or divorced applicants are permitted up to $4,000 in countable assets. Some assets are considered exempt, such as the applicant’s home, given it is valued under $560,000 and occupied by the owner, a single vehicle, and other personal belongings such as furniture, clothing and household furnishing. Married applicants whose spouses are not applying, can distribute joint assets to the non-applicants up to a countable resource limit of $120,900. This is called the Community Spouse Resource Allowance.

Asset Transfers - transfers of financial assets that took place in the 60 months preceding application are subject to review to determine if the applicant simply gave away their assets or sold asset under market value in an attempt to qualify. It is quite common for applicants to have unknowingly violated Medicaid’s “lookback” penalty rules. Medicaid will penalize these persons by delaying the onset of their Medicaid eligibility for months or even years (thereby forcing them to pay for their own care).

Mississippi residents who exceed the financial limits, but cannot afford their cost of care, are in a difficult position, as Mississippi is one of several states that does not offer residents a Medically Needy Medicaid program. The only option for families that find themselves in this situation is to work with a professional Medicaid planner. These individuals can help families qualify for Medicaid by re-organizing their financial holdings so that the applicant becomes financially compliant with Medicaid limits.  Learn more.

 

Benefits and Services

Each applicant is assessed and approved for different services under the E&D waiver. The following services are potentially available to all beneficiaries. These are selected to maximize the recipient's ability to live independent of nursing homes. Unlike many Waivers, these services are not available to be participant directed.  In other words, the state chooses the care providers not the participants.

  • Adult Day Services / Adult Day Care
  • Case Management
  • Expanded Home Health Services – speech and physical therapy, nursing services
  • Home Delivered Meals
  • Personal Care – assistance with routine activities, such as dressing, bathing, and eating, meal preparation, housecleaning
  • Institutional and In-Home Respite
  • Transition Assistance – from a nursing home facility back into the community
  • Transportation

 

How to Apply / Learn More

This program is available statewide in all Mississippi counties.  One can learn more or apply for services from the Elderly and Disabled Waiver by contacting the Division of Medicaid Long Term Care at 800-421-2408.  A brochure is available for download here.

 Mississippi seniors might find alternative assistance from the In Home Care Services / Homemaker Program.