What is a Medicaid Waiver?
Medicaid Waivers, also known as Home and Community Based Services (HCBS) Waivers and Waiver Funded Services, allow qualifying program participants to receive services outside of nursing homes. Medicaid’s standard benefit is to pay for nursing home residential care. However, when available, Medicaid Waivers help to provide more options for individuals. The cost of care outside of a nursing home needs to be less than the cost of care in a nursing home.
The Minnesota Community Access for Disability Inclusion Waiver (CADI), formerly called the Community Alternatives for Disabled Individuals Waiver, is a statewide program that provides financial assistance to eligible individuals to help them with the cost of services that enable them to remain living independently. This program enables persons who would otherwise require nursing home admittance to continue living in their own home, a relative’s home, an adult foster care home, or an assisted living facility. An array of benefits are available. They include personal assistance, adult day care, homemaker services, respite care, and home modifications.
While this program is intended for individuals under the age of 65 at the time of enrollment, a senior may either continue on this waiver after the age of 65 or enroll in the Minnesota Elderly Waiver.
CADI allows for Consumer Directed Community Supports (CDCS). It allows for consumer direction or self-direction of certain services and benefits. They include vehicle and home modifications, as well as personal care services. It also includes homemaker services, respite care, and assistance with day-to-day activities. Family members, such as adult children, may be hired given they are qualified for the necessary services. Spouses and other legal guardians are eligible to be paid caregivers.
This waiver is administered by the Minnesota Department of Human Services Division of Disability Services.
To be eligible for this waiver, there are multiple criteria that must be met.
Age and Disability
Minnesota residents must be under the age of 65 and must require a nursing home level of care. Individuals must be certified as disabled by the Social Security Administration or via the state medical review team. Depending on the level of disability, it may be possible that early-onset Alzheimer’s or another type of dementia could qualify an individual as disabled. The individual must also require a greater level of support than is offered via Medical Assistance (MA), which is the Medicaid program for Minnesota for low-income residents.
Income and Assets
The CADI waiver also has income and asset requirements. Individual applicants cannot have an annual income greater than 95% of the Federal Poverty Level (FPL). As of 2022, this figure is $12,910.50 per year, or calculated monthly, the limit is $1,075.88. For married couples with both spouses as applicants, the annual income limit is $17,394.50. Calculated on a monthly basis, this figure equals $1,449.54. When just one spouse of a married couple is an applicant, the non-applicant spouse’s income is not calculated toward the income eligibility of the applicant. Furthermore, the applicant spouse is able to transfer his / her monthly income, up to $3,435 in some cases, to his / her non-applicant spouse to prevent impoverishment of that spouse. This income allowance is a spousal impoverishment rule to prevent the non-applicant spouse from becoming impoverished.
The asset limits vary with the age of the candidate. For most single participants, the individual may have assets up to $3,000 in value. Married couples (both spouses as applicants), can retain up to $6,000 in assets. Make note, if married, assets are considered jointly owned even if only one spouse of the couple is applying for waiver services. (Learn more here). However, there is a resource allowance in place to protect the non-applicant spouse, often referred to as the community spouse, from becoming impoverished. As of 2022, the non-applicant spouse can retain assets up to $137,400. This is independent of the $3,000 the applicant spouse is able to keep. Some assets are exempt, such as the applicant’s home, if the applicant (or his or her spouse) lives in the home and it is valued under $636,000.
Being over the income and / or asset limit(s) does not mean one cannot still qualify for this waiver program. Professional Medicaid planners have extensive knowledge and expertise in the restructuring of finances in order to assist one in meeting the limits. That said, it is vital one does not gift assets or sell them cheaply in an attempt to lower countable assets. Doing so can violate Medicaid’s look back period and result in Medicaid disqualification.
Benefits and Services
The CADI Waiver includes many benefits and services in a variety of settings. They include the home of an eligible applicant, the home of a family member, a foster home, or an assisted living facility. Services are covered in these living environments, but the participant’s rent and basic living costs are not covered.
- Adult Day Care / Adult Day Health
- Caregiver Living Expenses – assists with cost of food/rent for live-in caregivers
- Case Management
- Chore Services – snow removal, cleaning of gutters, etc.
- Customized Living (assisted living)
- Employment Exploration Services
- Family Counseling / Training
- Foster Care
- Home / Vehicle Modifications – installation of lifts, ramps, widening of doorways, roll-in showers, grab bars, etc.
- Home Meal Delivery
- Homemaker Services – assistance with light housecleaning, laundry, shopping, meal preparation, etc.
- Housing Access Coordination
- Independent Living Skills Training
- Non-Medical Adult Companion Services
- Night Supervision Services
- Nursing Services / Home Health Aide
- Personal Caregiving (live-in and out-of-home)
- Personal Emergency Response System (PERS)
- Prevocational Services
- Respite Care – in-home or out-of-home
- Specialized Equipment / Supplies – includes Durable Medical Equipment
- Supported Employment
- Therapies – physical, occupational, speech, respiratory, behavioral
- Transitional Services
- Non-Medical Transportation
How to Apply / Learn More
For more information about the Minnesota CADI Waiver, visit the state’s webpage.
To apply, contact your local county tribe or agency. Visit this page to find the office that serves your location. At the time of the last page update, there was no wait list for this waiver.