Long Term Care Waiver

Hi Again,

Here's the info Judy & Marilyn requested about the Waivers. Remember, this is Virginia, and your state will be different.
All you have to do is pull up your states Medicaid site and search for waivers. There are a lot of different ones, but only 2 in Virginia apply to Spina Bifida. (I just got back on the Medicaid Website and they have combined the two waivers into one that covers everything, so that must be why there is a waiting list now!!)

I also forgot to mention that if you qualify for the waiver, you will automatically receive Medicaid, which pays for the Long Term Care. The advantage to this is that they also pay for any medical bills not covered by your primary insurance. If you already have Medicaid, then nothing will change since they already cover you.

Some people are opposed to having Medicaid because they think there is some sort of stigma attached to it. Please don't feel that way. We all know how expensive it is to care for a disabled child, and you have to take help where you can get it. For the first 19 years of Sarah's life, we didn't have Medicaid, and the medical bills, especially during her first years, were unbelievable. The copays for just one surgery can set you back for years, not to mention 15-30 surgeries that are normal for our kids!!!!!

From the VA Medicaid Website:

Medicaid Waivers were developed to encourage people with disabilities and the elderly to access services in their homes and communities. Medicaid is a joint federal-state program. Medicaid Waivers provide funding to serve people who are eligible for long-term care in institutions such as hospitals, nursing facilities, and intermediate-care facilities. Through Medicaid Waivers, states can “waive” certain requirements including the requirement that individuals live in institutions in order to receive Medicaid funding.

The financial eligibility requirements for waivers are quite different from the financial eligibility requirements for regular Medicaid coverage. Regardless of the age of the person with a disability, financial eligibility for a Medicaid Waiver is based on the individual’s income and assets only. Other sources of income and assets, such as those of the individual’s parents, are disregarded. A person with a disability may have income equal to 300% of the maximum Supplemental Security Income (SSI) payment amount, and up to $2,000 in available assets such as savings, stocks, and bonds. If a child’s parents or caregivers have an income that is too high to qualify the family for Medicaid, the child with a disability may still receive a waiver slot. Having a waiver does not affect any other government funds for which a person is eligible.

Individual & Family Developmental Disabilities Support (DD or IFDDS) Waiver

Services available: day support, companion services (agency or consumer directed), supported employment, in-home residential support, therapeutic consultation, personal care services (agency or consumer directed), respite care (agency or consumer directed), supported employment, skilled nursing services, attendant services, family and caregiver training, crisis supervision, environmental modifications, assistive technology, personal emergency response system (PERS), and prevocational services. Support coordination is also provided.

Eligibility: The DD Waiver provides services to individuals 6 years of age and older who have a diagnosis of a developmental disability and do not have a diagnosis of mental retardation. Individuals also must require the level of care provided in an intermediate- care facility for persons with mental retardation or other related conditions (ICF/MR). Children who do not have a diagnosis of mental retardation, and have received services through the MR/ID Waiver, become ineligible for the MR/ID Waiver when they reach the age of 6. At that time, they can be screened for eligibility for the DD Waiver; if found eligible they will receive a DD waiver slot without being placed on the DD waiver waiting list.

I hope that helps explain it a little better. As in Judy's case, Virginia will now have to wait forever before receiving these services because they combined the waivers. Your state may not be that way yet, so check it out as soon as possible to avoid potential delays!!

Blessings,