Medicaid Home and Community Based Waiver Guide For Participant Directed Services

Medicaid Home and Community Based Waiver Guide For Participant Directed Services

Welcome to the Medicaid Home and Community Based Services Waiver. This Guide will help you understand how the Home and Community Based Waiver works. There are a lot of new words and people you will meet on your journey. We hope this guide will help you get to know who these people are and how you can help in making sure you get the help you need when you need it. Medicaid is funded by the federal and state governments to help people have health insurance who cannot afford it or do not have health insurance offered at their workplace. A person must meet certain medical and financial conditions in order to qualify. Each state is given a choice as to how they want to design their Medicaid program. Kentucky has chosen to create options for people with disabilities to get the help they need to stay in their homes. These options are called waivers. Waivers are allowed to provide different services depending on the person’s disability. This level of need can be different from the standards needed to qualify for regular Medicaid. A waiver is able to offer services that are not included in regular Medicaid. Kentucky has six (6) waivers total. You have chosen the Home and Community Based Waiver to help you with your needs. The Home and Community Based Waiver has a set of rules to make sure the person meets the income limits and has medical needs that are the same as what the person would need for admission to a nursing home. The waiver gives the person the ability to stay in their home and get the help they need from a number of places. The first one is Traditional Home and Community Based Waiver Services. The person will get the help they need from a home health agency, an adult day care center, or any combination of them. These businesses are called providers. Over the years, the people of Kentucky asked for a different way to choose caregivers for Medicaid waivers. This self-directed option was first known in Kentucky as Consumer Directed Option, or CDO. As the waiver rules were changed, the option that allows you to be able to hire your own caregivers is now known as Participant Directed Services, or PDS.

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