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Medicaid HCBS Waivers (Home and Community-Based Services)

Federal Medicaid waiver program under Section 1915(c) allowing states to provide home and community-based services as an alternative to institutional care. Services include respite care, personal care assistance, adult day health, home modifications, and more. States design their own waivers within federal guidelines.

Medicaid 1915(c) HCBS waivers let states, within broad federal guidelines, provide long-term services and supports in a person's home or community rather than an institutional setting. Medicaid.gov says nearly all states and DC offer HCBS waivers and about 257 waiver programs are active nationwide. States may target waiver populations, cap waiver slots, and set additional eligibility criteria; eligible individuals must meet the state's institutional level-of-care standard. Covered services can include case management, homemaker, home health aide, personal care, adult day health, habilitation, respite care, and other services that help avoid or transition from institutional care. Federal 1915(c) waiver materials model a common special income level as up to 300% of the SSI Federal Benefit Rate; for 2026, SSA lists the individual SSI federal amount at $994/month, making the 300% reference amount $2,982/month before state-specific rules. State income thresholds, waitlists, payment rates, and self-direction/family-caregiver payment rules belong in the state waiver inventory.

Eligibility

  • U.S. citizenship or qualified immigrant status required
  • Care recipient must have a qualifying disability

Questions to ask the program

These are questions to ask the program, not a verdict on your eligibility. Confirm the current rules directly with the program.

  • What are the current income and asset limits, and whose income counts? — Our record lists gross monthly limit around $2,982 for a household of one — limits change, so confirm the current figures.
  • What counts as a qualifying disability or level of care need, and what documentation shows it?
  • Which citizenship or immigration statuses does the program accept, and which documents show it?
  • Is there a caregiver-specific department, coordinator, or support line? Ask for it by name. — Many agencies have one that isn’t advertised on the website.
  • What documents do you need from us to start an application?
  • Is there a waitlist right now, and how long is it?

Services

Medicaid 1915(c) HCBS waivers let states, within broad federal guidelines, provide long-term services and supports in a person's home or community rather than an institutional setting. Medicaid.gov says nearly all states and DC offer HCBS waivers and about 257 waiver programs are active nationwide. States may target waiver populations, cap waiver slots, and set additional eligibility criteria; eligible individuals must meet the state's institutional level-of-care standard. Covered services can include case management, homemaker, home health aide, personal care, adult day health, habilitation, respite care, and other services that help avoid or transition from institutional care. Federal 1915(c) waiver materials model a common special income level as up to 300% of the SSI Federal Benefit Rate; for 2026, SSA lists the individual SSI federal amount at $994/month, making the 300% reference amount $2,982/month before state-specific rules. State income thresholds, waitlists, payment rates, and self-direction/family-caregiver payment rules belong in the state waiver inventory.

How to apply

Use the official program page for application details: official program page.

  • medicaid (depends_on): Must be Medicaid-eligible or meet institutional level of care