Nevada Home and Community Based Waiver for the Frail Elderly (HCBW-FE)

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

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).


Eligibility Guidelines

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 65 years old

Disability Status - individuals are subject to a medical review, the outcome of which must qualify them for nursing home care.

Income – In 2018, a single, divorced or widowed applicant is permitted to have update $2,250 in monthly income or annually $27,000. Married applicants can have their incomes considered separately when only one spouse is applying for Medicaid assistance. The applicant can transfer some of their income to their spouse as a living allowance (called formally the Minimum Monthly Maintenance Needs Allowance (MMMNA)). In 2018, up to $3,090 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 2018 (there are exemptions such as a home & vehicle). However, married applicants can take possession of joint assets up to a value of $123,600 in 2018. 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. 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 $572,000).

Over these Limits?
For families who cannot afford the cost of care for a loved one but are financially ineligible for Nevada Medicaid, there is the option of working with a Medicaid planner. There is both public and private assistance available to help families re-structure their finances to become Medicaid compliant.  Learn more


Benefits and Services

Each Medicaid Waiver recipient is approved for a customized suite of services intended to meet their non-medical needs. These can include:

  • Adult Companion / Respite Care
  • Adult Day Care (but not Adult Day Medical Care)
  • Case Management
  • Chore Services 
  • Homemaker Services (shopping, housecleaning, preparing meals)
  • Laundry and Housekeeping
  • Meal Preparation (and organization such as container labeling with date and re-heat instructions)
  • Personal / Attendant Care (help bathing, grooming, eating, and toileting
  • Augmented Personal Care (commonly referred to as assisted living)
  • Personal Emergency Response System (fall and wandering notifications)
  • Shopping for Groceries and other Essential Goods

 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.


How to Apply / Learn More

Nevada residents who qualify for Medicaid should contact their regional Aging and Disability Office to begin the application process.  As of 2018, it has been reported that there is a wait list for this waiver. However, the number of participants has increased to approximately 2,400. One 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.

Residents who do not qualify for Medicaid should consider working with a Medicaid planning professional to help them gain eligibility or investigate other programs such as the COPEHomemaker and the PAS Program.