Page Reviewed / Updated – November 16, 2010

Waiver Description

Wyoming ‘s Medicaid Home and Community Based (HCBS) Waiver is also referred to as the Long Term Care Waiver and the Elderly and Physically Disabled Long Term Care Waiver. This is a Medicaid program and Medicaid in Wyoming is also called Equality Care.

The objective of this waiver is to “prevent the premature institutionalization of individuals.” Phrased differently, this waiver provides services to help individuals remain living at home, even though they are medically eligible for nursing home care. Receiving care at home is generally preferred by the elderly and has the potential to reduce care costs for the state as family caregivers are utilized instead of nursing home employees. Services provided under this program help not only the program participant, but also assist family member in caring for them. For example, respite care, adult day care, and personal emergency response services all help to reduce the workload for family caregivers.

This waiver has a self-directed care option associated with it called the Consumer Directed Care Option, meaning the care recipient can choose their care providers for certain types of services. In Wyoming, this includes personal care assistance. In some cases, family members can be hired to provide personal care.

Eligibility Guidelines

Qualifying for the HCBS Waiver means qualifying for institutional or long term care Medicaid. To do this, there are requirements regarding the applicant’s residence, level of impairment and their income and assets.

Residence – must be a resident of the state of Wyoming.

Level of Impairment – this requirement is dependent on the applicant’s age. Those under 65 must be physically disabled. Persons 65 and over must have a need for nursing home care (and willing to receive that care outside of a nursing home).

Income and Assets (Single Applicant) – as of 2017, a single applicant’s income is limited to 300% of the Federal Benefit Rate / Supplemental Security Income rate, which is equivalent to $2,205 / month. A single applicant is also limited to $2,000 in countable assets, which includes checking and savings accounts, and other liquid assets. Certain assets, such as an applicant’s primary home, given it is valued under $560,000 and is lived in by the applicant, is considered exempt.

Income and Assets (Married Applicant) – if an applicant is married and their husband or wife is not applying for Medicaid, the rules are different. Joint income and assets can be allocated to the healthy partner as a living allowance and a financial reserve. This is called the Minimum Monthly Maintenance Needs Allowance and the Community Spouse Resource Allowance. In 2017, these are limited to $3,022.50 in income per month and $120,900 in assets.

Persons over these limits might gain entrance into Equality Care and receive assistance under the HCBS Waiver by allocating income over the limit into a Pooled Income Trust. This helps to lowers the applicant’s income to a Medicaid compliant level. A similar process can be employed to become asset-compliant. Assets over the countable resources limit may be able to be changed in form so they become non-countable or exempt assets. This is a process called Medicaid planning and for most families, assistance is required to engage in Medicaid planning successfully.  Read more.

Benefits and Services

Waiver participants are eligible for the following services.  Personal care can be self-directed. 

  • Adult day care – supervision in a group environment during normal business hours
  • Case management – assistance with coordination and administration of services
  • Home delivered meals – can be hot or prepared
  • Non-medical transportation – for a variety of purposes
  • Personal care – assistance with the activities of daily living
  • Personal emergency response system – 24/7 on call service
  • Respite care – temporary caregiving to relieve the primary caregiver
  • Skilled nursing services – on a temporary basis only


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How to Apply / Learn More

This waiver is available to residents throughout Wyoming, although it is possible that a waiting list for services may exist. One can apply online through the Wyoming Medicaid Office.

The state also publishes some limited information about the program here.