Applying for a waiver can be a tricky and confusing process. Once a waiver is approved, navigating waivered services can feel even more complicated.
In Minnesota, Medicaid Home and Community‑Based Services (HCBS) waivers allow the state to create alternatives to placing Medicaid‑eligible individuals in hospitals, nursing facilities, or Intermediate Care Facilities for Persons with Developmental Disabilities (ICFs/DD). These waivers provide service options that are not available under regular Medical Assistance, and they are targeted to people with specific needs or diagnoses.
Minnesota’s waiver programs include:
- CADI — Community Access for Disability Inclusion
- CAC — Community Alternative Care
- DD — Developmental Disability
- TBI — Traumatic Brain Injury
- EW — Elderly Waiver (65+ only; not compatible with IHS)
- AC — Alternative Care (65+ only; not compatible with IHS)
Eligibility begins with determining the need to support a person’s health, safety, welfare, skill development, and the cost of services. Additional factors include disability status, funding parameters, and county or state policies.
In Minnesota, the waiver application process starts with a MnCHOICES assessment, followed by an application for Medical Assistance. Once eligibility is confirmed, the applicant is assigned a waiver case manager who helps initiate services. Annual assessments and renewals are required to maintain waiver status.
After enrollment, case managers help individuals understand which waivered services they qualify for. Common waivered service categories include:
- Employment & Day Programs
- Daily Assistance such as PCA
- Supportive Services & Independent Living Skills
- Specialized Equipment
- Therapies & Home Health
- Behavioral Support