Page Reviewed / Updated – April 02, 2020

Waiver Description

The Virginia Elderly and Disabled Medicaid Waiver provides community-based care services to nursing home eligible seniors who choose to live in their own homes or with family members. The program provides a variety of assistance options to help them do so including personal care, fall monitoring or personal emergency response services, and adult day care. 

Under the waiver, participants can choose who they want to provide their personal care. Even some family members can be hired and be compensated for their work.

Consumer Direction means that the participant can choose some of their care providers. In some cases, they can pay a relative for the personal care they provided. This type of program is occasionally referred to as Cash and Counseling or Self-Direction and it is popular with families due to the increased choice of caregivers and care environments. It also has the potential to reduce public sector costs by leveraging family caregivers.  

Eligibility Guidelines

While open to disabled adults of any age, this program is primarily targeted towards those 65 and older. It is not necessary for these individuals to be completely disabled; however, they must require the level of care provided in nursing homes. When seniors apply, they are required to take an in-person assessment to verify their need for assistance. As with all Medicaid programs, there are also financial requirements. Income Limits for Medicaid Long Term Care Services Elderly, disabled and blind Virginia residents can qualify for Medicaid if their gross monthly incomes are less than $2205. Depending on their medical expenses, individuals can qualify with monthly incomes well above the categorical income limit. Families are encouraged to keep detailed records for required care and reoccurring, unreimbursed medical expenses that are incurred on behalf of the elderly individual. Asset Limits for Medicaid Long Term Care Services Individuals applying for Medicaid are permitted up to $2,000 in countable assets, married couples up to $3,000 and, married couples with only one spouse applying, can protect half of their joint resources up to $120,900. Countable resources do not include their home, if at least one spouse lives in it and the value of their home equity does not exceed $560,000. The primary vehicle and final expense plans are also excluded for their countable assets.  

Benefits and Services

This waiver is intended to prevent persons from moving into nursing homes. The available services are selected to maximize their ability to age in place in their homes. While services are determined specifically for each applicant, they may include:
  • Adult Day Care – supervised care in a group environment during normal working hours
  • Medication Monitoring – oversight and administration of required prescription drugs
  • Personal Care Aide Services – assistance with the activities of daily living
  • Respite Care – temporary caregiving services provided to relief the primary family member or caregiver
  • Personal Emergency Response System – automated electronic monitoring and notification of emergency situations. Learn more about top medical alert systems here.
  • Transition Coordination -should the individual be moving out of skilled nursing into a private home which may include minor home modifications
Individuals who currently reside in a nursing home and are using services from this waiver to return to living at home may also receive assistance for home modifications that increase their independence and safety. As an example, this might include a walk-in tub replacement for a shower, wheelchair ramp, or stair glide.   

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How to Apply / Learn More

This waiver is available statewide across Virginia. However, most waivers are created with a limited number of slots available. Eligible individuals may find themselves on a waiting list for services. To learn more or apply for this waiver, contact your county department of social services. As part of the process, a county social worker conducts an in-person assessment of the applicant in their place of living. Additional information about this program is available here.