Program Description
The Virginia Commonwealth Coordinated Care Plus Medicaid Waiver provides services to elderly residents and individuals with physical disabilities in the community to prevent the premature institutionalization of these groups. Many services are available via this waiver, including assistance with the Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs), such as bathing, grooming, dressing, light housecleaning, preparation of meals, and monitoring of medications.
Self-Directed Care
CCC+ allows for consumer direction of personal assistance services and respite care services, meaning eligible applicants can choose the caregiver from whom they receive services. This includes friends and select relatives. Spouses and legal guardians cannot be hired to provide care, but the adult children who wish to work as caregivers for their aging parents can be compensated for their caregiving efforts.
Medicaid and Medicare
Full Medicaid benefits are available via CCC+ and include behavioral health services and medical benefits. For those who are also on Medicare, there is an option to coordinate Medicaid and Medicare services through one health plan. However, one does not have to choose this option. (Those who are on both Medicaid and Medicare are commonly referred to as dual eligible.)
Managed Care
This statewide Home and Community Based Services (HCBS) Medicaid waiver is a long-term managed care program that operates via six managed care organizations (MCOs). For those who are eligible, program participation is mandatory.
Eligibility Guidelines
General Requirements
To be eligible for the Commonwealth Coordinated Care Plus Medicaid Waiver, one must:
- Be a Virginia resident 65 years of age or older OR under the age of 65 and disabled.
- Require a nursing home level of care or a hospital level of care. (An applicant qualifies for the hospital level of care if they require a medical device to replace a critical bodily function.)
Financial Requirements
Income Limits
The income limit is set at 300% of the Federal Benefit Rate (FBR). In 2024, this is equivalent to $2,829 a month for an individual. For a couple with both spouses applying, each spouse is allowed $2,829 a month.
Asset Limits
The asset (resource) limit, as of 2024, is $2,000 for an individual and $4,000 for a couple with both spouses as applicants.
While this asset figure might seem low, there are several resources that are considered non-countable. Examples include one’s primary home (given the applicant or his or her spouse lives in it and the home is valued at or under $713,000), household furnishings, personal effects, and an automobile.
Over the Financial Limits?
For those who are over the income and / or asset limit(s), this does not mean automatic disqualification from CCC+. Applicants with high medical bills may still qualify via the Medically Needy Pathway. In very simple terms, this means that one can deduct out-of-pocket medical costs from one’s income, effectively lowering his or her countable income.
If one is over the income and / or asset limit(s), it is highly recommended that he or she consult with a professional Medicaid Planner, who can assist in reallocating income and assets in order to meet eligibility requirements.
Benefits and Services
Both care services and benefits to help promote independence are available via the CCC+ Medicaid Waiver. In addition to case management, the below services and benefits may be provided. As mentioned previously, personal care assistance and respite care may be self-directed by the program participant.
- Adult Day Health / Adult Day Care
- Personal Care Assistance
- Respite Care
- Assistive Technology / Durable Medical Equipment
- Technology Assistive Services
- Home / Vehicle Modifications
- Personal Emergency Response Systems (PERS or commonly called Medical Alert services)
- Skilled Private Duty Nursing
- Transition Services (assistance moving from an institution, such as a nursing home, back into the community
Medical and behavioral health services are also available via CCC+. These benefits may include counseling, diagnostic testing (x-rays and lab work), emergency care, medical transportation, therapies (physical, occupational, and speech), prescription drugs, eye exams, and more.
How to Apply / Learn More
The Commonwealth Coordinated Care Plus Medicaid Waiver is mandatory for all Virginia residents who are eligible. For more information about CCC+, click here, or call the Department of Medical Assistance Services at 804-786-7933.
To apply, one should contact their local Department of Social Services’ office. Or begin an online application here.
