Important Update: As of July 1, 2017, the Elderly or Disabled with Consumer Direction Medicaid Waiver and the Technology Assisted Medicaid Waiver were merged and became the Commonwealth Coordinated Care (CCC) Plus Medicaid Waiver. This webpage is maintained only for historical purposes. To learn more about the CCC program, click here.
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.
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.
Important: if one's assets exceed Medicaid's limits, there are expert benefits counselors who can help. Given the high cost of care, proper planning can prevent many families from becoming destitute. In Virginia, excess assets can be converted to exempt annuities. Read more.
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
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.
Did You Know? Seniors are eligibile to receive free, non-binding quotes for bathroom safety modifications. Get started now.
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.