The "Elderly Waiver" Program
Authored By: Legal Hotline for Older Iowans
You don't have to wear ruby slippers and live in the Land of Oz to know "There's no place like home!" As you age, everyday tasks can become more difficult and you may need assistance to safely stay at home. If you or a loved one are 65 or over and facing the disturbing possibility of having to move to a nursing home, you will want to look into the "Elderly Waiver" Program.
The Elderly Waiver Program is a state funded, Medicaid program administered by the Department of Human Services (DHS) and local Area Agencies on Aging. It can provide a wide range of services tailored to your special needs. For example, services can include:
- adult day care,
- assistive devices,
- home health aides,
- homemaker services,
- transportation, and
- respite services.
The amount of services you can receive will be limited based on the overall cost of the services and whether they are available in your area. Other benefits include Medicaid payment of some medical costs and the ability to buy your prescription medications for a very low co-payment .
To get help from this program, you must be 65 or over and need the kind of services that a nursing home provides. If you are unmarried, you must meet the general Medicaid income and asset requirements. In 2010, a single person must have income of less than $2,022 per month and assets of $2,000 or less, not including a house, household goods, a vehicle and certain burial funds. If you are married and only one of you needs help, the asset limits are much more complicated. Depending on your ages and incomes, you may be able to have a great deal more in assets - $100,000 or more - and still qualify.
If you are having a hard time living on your own and don't want to live in a nursing home, you should go to the Department of Human Services and apply for the Elderly Waiver Program. You should also contact your local Area Agency on Aging. A case manager at the Area Agency on Aging will develop a case plan and assess the level of care you need.
The Iowa Foundation for Medical Care will review the assessment to determine whether you meet the required level of care. DHS will decide if you meet the other eligibility criteria. Applications are usually processed within 30 days. Sometimes applicants are denied Elderly Waiver services because DHS finds they are not eligible or because the Iowa Foundation for medical Care determines the level of care requirement is not met. If this occurs, you have the right to appeal the decision. It is very important to file an appeal within a certain period of time, and with the correct party. T
he rules for Elderly Waiver Program eligibility can be complex and confusing. Please contact the Legal Hotline for Older Iowans to receive advice about your particular situation. If you have questions, contact the Legal Hotline for Older Iowans at 1-800-992-8161, 1111 Ninth St., Ste. 230, Des Moines, IA 50314. The Legal Hotline is a project of Iowa Legal Aid.