Medicaid Waiver Programs

Medicaid Waiver Programs let states use Medicaid funds for long-term home and community-based services for people with disabilities or special healthcare needs in order to help them live in the community.

There are seven different Texas Medicaid waiver programs that offer an excellent opportunity for a child with special-health care needs to live and receive services at home or in the community, rather than in a nursing home or other institution.

We strongly suggest that you add your child to the waiver interest list(s) for any program(s) that may be beneficial to you and your child. The interest lists are sometimes called "waiting lists" because there can be a 15+ year wait for services. You can always decline the services once your child moves to the top of the list.

Medicaid is a jointly funded state-federal program signed into law along with Medicare in 1965 by President Lyndon B. Johnson. Medicaid began as an assistance program to help individuals with low income but it has grown to provide health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities.

Since the early 1980s, programs known as Medicaid waivers have given states the flexibility to waive certain Medicaid requirements to provide care for people who otherwise might not qualify for Medicaid. This is why they are called "waivers". For example, Medicaid eligibility is based solely on family income; however, all but one waiver is based on only the child’s income rather than family income. Your child’s income means any money that they personally have earned or are paid.

Before the creation of waiver programs, people had to live in hospitals, nursing homes, or other institutions like state-supported living centers or residential treatment centers so Medicaid would pay for long-term services. Through waiver programs, Medicaid now pays for a comprehensive range of services in the home and community rather than in an institutional setting.

Some of the services you can get with a waiver are:
Personal care for help with things like bathing or dressing
Nursing care
Home modifications like ramps
Car modifications
Respite care
Certain therapies

Besides getting these additional services, people also get full Medicaid health-care benefits. This is a huge help for children and adults who have complicated medical needs and no other health insurance.