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’s Waiver for the Frail Elderly helps older state residents avoid institutional (nursing home) placement by offering a range of support services that help them remain living in their home or in the home of a family member. 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 homemaker services (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.
Eligibility Guidelines
General Requirements
Residence
Individuals must be residents of the state of Nevada
Age
Individuals must be at least 65 years old.
Disability Status
Individuals must require the level of care provided in a nursing home, and without the waiver services, they would need placement in a home within 30 days.
Financial Requirements
Income Limits
In 2024, a single, divorced or widowed applicant is permitted to have up to $2,829 in monthly income. Married applicants with both spouses applying are each allowed $2,829 a month.
For a married applicant with only one spouse applying, only the income of the applicant spouse is considered for eligibility. Further, the applicant spouse can transfer some of their income to their non-applicant spouse as a living allowance (formally called the Minimum Monthly Maintenance Needs Allowance). In 2024, this amount is $3,853.50 a month. If the non-applicant spouse already has monthly income equal to, or above, this figure, a transfer of income is not permitted from the applicant spouse.
Asset Limits
As with income, asset limits vary based on marital status. Single applicants are permitted only $2,000 in countable assets. (There are exemptions, such as one’s home and vehicle). However, when just one spouse of a married couple is applying for Medicaid, the non-applicant spouse can take possession of joint assets up to a value of $154,140, in 2024. (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 “going broke” to qualify their loved one for Medicaid.
Since 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. For single persons entering a nursing home or assisted living, their home is not exempt since they will not be living in it. However, an exception exists if the home equity value is under $713,000 and they have intent to return to living in it. For married couples, as long as one spouse remains living in the home, it is exempt.
It is important to mention that assets should not be given away or sold for less than fair market value in an attempt to meet Medicaid’s asset limit. Doing so is in violation of Medicaid’s 60-month look-back period and can result in a denial or delay of Medicaid benefits.
Over the Financial Limits?
Persons who exceed these financial limits can still become Medicaid eligible by re-structuring their finances to meet the guidelines. This is called Medicaid planning, and there are both public and private professionals who can help. Read 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
- Adult Day Care (but not Adult Day Medical Care)
- Case Management
- Chore Services (cleaning windows, minor home repairs, shampooing carpets)
- Homemaker Services (shopping, housecleaning, laundry, preparing meals)
- Augmented Personal Care (commonly referred to as assisted living)
- Personal Emergency Response System (fall and wandering notifications)
- Respite Care
- Home Delivered Meals
How to Apply / Learn More
Nevada residents who qualify for Medicaid should contact their regional Aging and Disability Office to begin the application process. A wait list for this waiver may exist. 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 Department of Health and Human Services’ website.
