The Wyoming Assisted Living Facility (ALF) waiver is designed for adults who require a nursing home level of care and who choose to live in an assisted living residence in place of a nursing home. Wyoming Medicaid, also known as EqualityCare, will pay for care services, provided that cost does not exceed the cost for the same care in a nursing home. This waiver does not pay for room and board in the assisted living residence, only the care services at level I, II and III, depending on which is appropriate for the participant.
Wyoming is undergoing changes to the Assisted Living Waiver and is projected to have transitioned participants from this waiver to a new waiver called Comprehensive Supports. This change is expected at some point in 2017. This page will be updated at that point.
The Assisted Living Facility Waiver evaluates the applicants on several levels. Most thoroughly with regards to their functional ability and their financial circumstances. In addition to being Wyoming residents and 65 years of age, or between the ages of 19 and 64 and disabled, applicants must meet the following criteria.
Functional Ability – applicants must be assessed by a public health official and found to require the level of care provided in nursing homes.
Financial Status – single applicants are limited to a maximum monthly income. In 2017, this amount is no greater than 300% of the Federal Benefit Rate, which equates to $2,205 / month. Applicants are also limited to $2,000 in countable assets. Wyoming has a 5-year look back period to ensure applicants do not give away assets or sell them under market value in order to qualify for Medicaid. However, some items are considered exempt, such as an applicant’s home, provided it is valued at less than $560,000, burial plots, and certain personal items, such as a wedding ring. Unfortunately for single applicants, a home must be lived in by its owner to be considered exempt. Since one cannot simultaneously reside in an assisted living residence and at home, for persons in this situation, there home would be counted as an asset.
Married applicants have a different set of requirements intended to enable a healthy spouse to continue to support oneself. Under these circumstances the single applicant’s asset limits apply to the applicant, but the non-applicant is permitted to retain $120,900 in countable resources. A certain amount of the couple’s joint income may be considered as belonging to the non-applicant as well. This both supports the non-applicant and lowers the applicant’s income level helping him or her to qualify. In 2017, $3022.50 per month of income can be shifted to the non-applicant spouse.
Qualifying When Over the Limit – Wyoming residents might still qualify for the Assisted Living Facility Waiver if they are over the financial limits. Income in excess of the limit, which cannot be provided to a spouse, can be placed into a qualifying income trust. This helps to lower the applicant’s income to the appropriate amount. While excess assets cannot be given away, it is possible to convert some of these assets to non-countable assets. These approaches are called Medicaid Planning. Learn more.
The following benefits are available via the Assisted Living Facility Waiver and help eligible individuals to remain living outside of a nursing home.
The ALF Waiver does not pay for room and board costs in assisted living, only care services that are necessary for the participant.
The Assisted Living Facility Waiver is available to residents across Wyoming. However, interested parties should be aware that 1) there are a limited number of approved residences and 2) there are a limited number of spaces available at each residence. Approved applicants may be required to wait for services.