Page Reviewed / Updated - Feb. 2019
Nevada Medicaid's Home and Community Based Waiver Program helps older state residents avoid institutional (nursing home) placement by offering a range of support services that help them to remain living in their homes or in the homes of family members. Health care, medical care, and nursing services are not included benefits of this waiver, as it is intended to provide non-medical care services only. Instead, services such as personal care (at home or in approved state assisted living communities), adult day care, and chore services help families care for loved ones at home or help frail, elderly persons maintain their independence.
Under this waiver, participant direction of services is permitted, but only in an extremely limited capacity, not in the traditional sense of the phrase. Program participants have the option to choose from approved service providers, but their power is not so broad as to be able to choose whomever they’d like as their care providers. This is worth mentioning because in many states “cash and counseling” or “participant direction” allows the care recipients to hire family members. This is not the case with NV’s Waiver.
This program is also referred to as simply the HCB Waiver, Home and Community Based Waiver for the Frail Elderly (HCBW-FE) and was formerly called CHIP. It is administered by the Aging and Disability Services Division (ADSD).
This waiver, which is statewide, has qualification requirements with regards to the applicant's:
Residence – individuals must be residents of the state of Nevada
Age - individuals must be at least 65 years old.
Disability Status - individuals are subject to a medical review, the outcome of which must qualify them for nursing home care. Without the waiver services, they would require nursing home placement within 30 days of the medical review.
Income – In 2019, a single, divorced or widowed applicant is permitted to have up to $2,313 in monthly income or annually $27,756. Married applicants can have their incomes considered separately when only one spouse is applying for Medicaid assistance. Applicants can transfer some of their income to their non-applicant spouses as a living allowance (called formally the Minimum Monthly Maintenance Needs Allowance (MMMNA)). In 2019, up to $3,161 / month can be transferred to the non-applying spouse.
Assets – As with income, asset limits vary based on marital status. Single applicants are permitted only $2,000 in countable assets. This amount has not changed in 2019. (There are exemptions, such as one's home and vehicle). However, when just one spouse of a married couple applies for Medicaid; the non-applicant spouse can take possession of joint assets up to a value of $126,420 in 2019. (This is in addition to the $2,000 in assets the applicant spouse is able to retain). This rule is intended to prevent spouses from having to “go broke” to qualify their loved one for Medicaid. Because a home is such a substantial asset, some clarification on home ownership may be helpful. Homes are exempt if the owner lives in the home. Therefore, for single persons entering a nursing home or assisted living, their home is not exempt since they will not be living in it, unless they have intent to return to living in it. For married couples, if one spouse remains living in the home the home is exempt. The value of their home equity is not counted towards the asset limit (as long as their equity is less than $585,000).
Each Medicaid Waiver recipient is approved for a customized suite of services intended to meet their non-medical needs. These can include:
Details about each benefit in available in this manual. Readers should be aware that this is a large file and not intended for mobile devices. Nor is the language written for a consumer audience. It is highly technical but offers complete information.
Nevada residents who qualify for Medicaid should contact their regional Aging and Disability Office to begin the application process. As of 2019, it has been reported that there is a wait list for this waiver. However, the number of participants has increased to approximately 2,400. Interested persons should check with their local county office to find out the latest information on waiting and processing times.
Some limited additional information about this waiver is available on the Nevada Aging and Disability website.