Indiana Medicaid Waiver Pick List

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How Do I Apply For A Medicaid Waiver

An Introduction to Indiana’s Medicaid Waiver Program

Starting February 2021, you can now apply for Medicaid Waivers through a new Bureau of Developmental Disabilities Services online application gateway: .

Using the online application gateway is the quickest way to apply for services and you should prefer applying through the online application. Additional information and a video tutorial can be found on the Bureau of Developmental Disabilities Services home page: .

Unitedhealthcare Senior Care Options Plan

UnitedHealthcare SCO is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plans contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our SCO program.

Bureau Of Developmental Disabilities Services

The Bureau of Developmental Disabilities Services , a division of the Developmental Disability Rehabilitation Services manages two waivers that aim to provide services for individuals with intellectual and developmental disabilities. The waiver programs are designed to help people live independently. In addition to running the waiver programs, the Bureau of Developmental Disabilities Services also makes sure service providers are meeting standards of quality throughout the state.

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Community Integration And Habilitation Medicaid Waiver

The Community Integration and Habilitation waiver is to be used as a “needs based” waiver ONLY for people who meet specific criteria. To move from the Family Supports waiver onto the CIH waiver, an individual must meet specific eligibility/priority criteria which may include:

Death of primary caregiver and no other caregiver available Caregiver over 80 years of age and no other caregiver available Evidence of abuse or neglect in the current placement Extraordinary health and safety risk Eligible individuals transitioning to the community from a nursing facility, extensive support needs homes or state operated facilities Eligible individuals determined to no longer need active treatment in a group home Eligible individuals transitioning from 100% state funded services Eligible individuals aging out of Department of Education, Department of Child Services or supported group living and Eligible individuals requesting to leave a Large Private Intermediate Care Facility for Individuals with Intellectual Disabilities .

In addition to the same services approved for the FS waiver , the CIH waiver allows for a larger budget for eligible services and may provide the following additional approved services : Community Transition Rent and Food for Unrelated Live-In Caregiver Residential Habilitation and Support

Vocational Rehabilitation Services Provides Quality Individualized Services To Enhance And Support People With Disabilities To Prepare For Obtain Or Retain Employment

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The individual will work closely with a VR Counselor throughout the process. Through active participation in their rehabilitation, people with disabilities achieve greater level of independence in their work place and living environments. You do not need to be on waiver services to receive Vocational Rehabilitation!

VR is an employment program for high school students age 14 and older with an IEP, as well as adults with a diagnosed disability. VR works with individuals with any disability, including deafness, visual impairments, mental illness and physical barriers.

How does this process work?

  • An interested person can contact the local Vocational Rehabilitation office, beginning at age 14
  • Interested persons will meet with a VR Counselor to complete intake paperwork and determine eligibility
  • After being deemed eligible for VR services, individuals work with their VR Counselor to create a plan for finding employment
  • Eligible individuals choose a service provider, such as Bona Vistas WorkForce Diversity, from a Pick List.
  • The service providers employees, known as Employment Specialists, work with eligible individuals to prepare for employment. Employment Specialists help with resumes, interview skills, computer and cash register skills, and other activities. These other activities can include job shadows, internships and paid weekly work experiences
  • You do not need to be on waiver services to receive Vocational Rehabilitation
  • Area 9 Vocational Rehabilitation Services

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    Family Supports Hcbs Waiver

    The Family Supports home- and community-based services waiver provides limited, non-residential supports to individuals with developmental disabilities who live with their families or in other settings with informal supports.

    Individuals must meet HCBS waiver eligibility and Medicaid eligibility guidelines in order to be eligible for a Medicaid HCBS waiver. To be eligible individuals must:

    • Be diagnosed as having an intellectual disability prior to the age of 22
    • Reside in or transitioning into an HCBS-compliant setting
    • Have income no greater than 300% of maximum Supplemental Security Income amount
    • Meet ICF/IID level of care

    Indianas Medicaid Waiver Programs: Home And Community

    Marci Wheeler, MSW

    Indianas Medicaid Home and Community-Based Services Waiver program provides individualized supports to assist people, of all ages, to live successfully in home and community settings. In the past, Medicaid only paid for long-term care services in an institutional setting, such as nursing facilities and group homes. The waiver program “waives” the necessity of admission into an institution in order for Medicaid to pay for needed home and community-based services.Waivers fund therapeutic and other needed supports and services. HCBS Medicaid waivers make Medicaid funds available as an alternative to institutional care if supporting the individual, in the home and/or a community setting is no more than the cost of care within an institutional setting.

    Currently there are five statewide Medicaid waiver options for an individual in Indiana. One of those Waivers, however, is closed and no longer accepting new applicants. The Psychiatric Residential Treatment Facility Transition waiver is for children and youth with serious emotional disturbances or serious mental illness who transitioned from the prior Community Alternative to the PRTF Grant. As of October 1, 2012, no additional children can apply for or receive waiver services through the PRTF Transition waiver. The other four Medicaid waiver programs are accepting applications and new individuals.

    1. Meet Medicaid eligibility requirements.

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    Indiana Medicaid Waiver Process

    We understand that Indiana Medicaid and the waivers that involve recreational therapy and behavior management can be confusing. Here is a brief breakdown of how the process works, from initially obtaining Medicaid to beginning services. For more in-depth information, please contact the Bureau of Developmental Disabilities Services.

    How Do I Apply For Waiver

    Introduction to the HCBS Family Supports Waiver

    If your child has an intellectual/developmental disability, you may apply for waiver services by calling the local Bureau of Developmental Disabilities Services District Office and requesting an Application for Developmental Disabilities Services. See the state map at or call 1-800-545-7763 to locate your local office.

    Waiver application forms may also be accessed online by following this link: . It is imperative that individuals submit the entire 3-part application.

    Once an individual has submitted a waiver application, s/he is either placed on a waiting list for a waiver or deemed provisionally eligible. Applicants may apply for services and be placed on a waiting list under the FSW at any age. Because the FSW currently operates on a waiting list based on application date, families are encouraged to apply for waiver services as soon as they suspect the waiver will be needed, regardless of the childs age.

    The Bureau of Developmental Disabilities Services waitlist may take as little as a few months or as long as a year before being approved.

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    Community Integration And Habilitation Waiver

    The Community Integration and Habilitation Waiver is a Home and Community-Based Services waiver focusing on providing services that enable individuals to remain in their homes or community-based settings and also assists individuals who are transitioning from state-operated facilities or other institutions into community settings as mentioned on the Indiana Medicaid Community Integration and Habilitation Waiver Page.

    Which services are available with the Community Integration and Habilitation Waiver ?

    As referenced in the Home and Community-Based Services Waivers Provider Reference Manual , the services available to individuals who are eligible for the Community Integration and Habilitation Waiver are the following:

    Adult Day Services Workplace Assistance

    Medicaid Waivers In Central Indiana

    CICOA is the single point of entry for people seeking Medicaid Medical Model Waivers or CHOICE funds in Boone, Hamilton, Hancock, Hendricks, Johnson, Marion, Morgan and Shelby counties. Access to Medicaid Waivers depends on the type of waiver sought and the individuals eligibility for services.

    Medical Model Waivers

    Medical Model Waivers are administered by the Area Agencies on Aging , which means that access to waiver services are initiated through CICOAs case management program. Specifically, CICOA manages the A& D and TBI waivers and CHOICE programs.

    To be eligible for Medical Model Waivers, the individual must meet Medicaid requirements and be at risk of institutionalized care. A CICOA options counselor will visit the potential client and determine whether the individual is eligible to receive services based on income, level of impairment and the availability of funds. For children with disabilities under the age of 18, parental income and resources are NOT counted when determining financial eligibility.

    Once the Medicaid Waiver intake process is complete, ongoing case management can be provided through CICOA or handed off to an independent case manager, if the client so chooses.

    Developmental Disability Waivers

    Developmental Disability Waivers are initiated through the local Bureau of Developmental Disability Services . Specifically, BDDS manages the CIH and FSW waivers. Visit the Indiana BDDS website to learn more or find your local office.

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    If You Do Not Have A Medicaid Waiver

  • Contact your Bureau of Developmentally Disabled Services office located at 110 W. Ridge Rd., Gary, IN 46408. Telephone – 981-5313. If you are interested, apply for the Medicaid Waiver. *This is the entry point into the system.
  • You will be notified by mail as to what you have been approved for. Once you have been approved, please follow the steps for “If you have a Medicaid Waiver” to proceed.
  • While you are waiting to be approved for a Medicaid Waiver, you may inquire with the BDDS office as to the availability of Caregiver Support Services, which is a State funded programming providing temporary relief to the caregiver of individuals with developmental disabilities. If approved for Caregiver Support Services, please contact Linda Companiott at 219-972-8172 to inquire about receiving the services through our agency.
  • What Happens Once Im Approved For Waiver

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    Once youve chosen BehaviorWorks, the clinic will be notified that youre interested in our services. Our office will reach out to you for initial paperwork and will set up a Meet and Greet to introduce you to one of our Behavior Consultants. Our Behavior Consultant will give you specifics of how BehaviorWorks can meet your individual needs.

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    Quit Using Tobacco Or Vaping Products

    Quitting is hard, but we can help. Did you know that 20 minutes after you quit, your heart rate drops to a normal level? And within 24 hours after quitting the carbon monoxide level in your blood drops to normal.

    Talk to your doctor about quitting. Or call 1-800-QUIT-NOW to get free coaching, counseling and supplies to help you quit.

    Get The Health Care You Deserve

    Hoosier Care Connect is a program that serves members who are aged, blind or disabled, including foster children and wards of the State.

    This plan is available in all Indiana counties.

    To see if you qualify, you can:

    • Visit the State of Indianas website at in.gov/Medicaid/members
    • Call
    • Visit a local FSSA office. A list of office locations can be found here:

    We can also assist with interpreter services, including American Sign Language. To ask for help, please call , TTY 711, Monday through Friday, 8 am to 8 pm EST.

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    Preventive Care Wellness And Health Conditions Guides

    Getting to the doctor when you are healthy is important. We have guides to help you know what to expect at each well visit. You can also talk to your Member Services Advocate for support and information.

    We also have helpful guides for most health problems and conditions. You can also talk to your Member Services Advocate for support and information.

    Our educational materials can be found on myuhc.com/CommunityPlan.

    You will find condition-specific and general health topics, including:

    Physical Health

    Caring for others can be rewarding. But being a caregiver can also be difficult, can cause stress and burnout. We have a program to help you cope. We offer monthly calls. Topics include:

    • Understanding care options
    • Living with grieving and loss

    Feel free to join us on a monthly caregiver call:

    When: Third Tuesday of each monthTime: 3:00 pm EST

    Our Healthy First Steps program makes sure that both mom and baby get good medical attention.

    We will help you:

    • Get good advice on nutrition, fitness and safety
    • Choose a doctor or nurse midwife
    • Schedule visits and exams
    • Arrange rides to doctors visits
    • Connect with community resources such as Women, Infants and Children services
    • Get care after your baby is born
    • Choose a pediatrician
    • Get family planning information

    What Is The Definition Of Developmental Disabilities In Indiana

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    As referenced in the Home and Community-Based Services Waivers Provider Reference Manual :

    Per Indiana Code IC 12-7-2-61, developmental disability means a severe, chronic disability of an individual that meets all the following conditions:

    Is attributable to:

    Intellectual/developmental disability, cerebral palsy, epilepsy, or autism, or

    Any other condition found to be closely related to intellectual/developmental disability, because this condition results in similar impairment of general intellectual/developmental functioning or adaptive behavior, or requires treatment or services similar to those required for a person with an intellectual/developmental disability.

    Is manifested before the individual is 22 years of age

    Is likely to continue indefinitely

    Results in substantial functional limitations in at least three of the following areas of major life activities:

    Self-care Capacity for independent living Economic self-sufficiency

    An individual with an intellectual/developmental disability must also be found to meet the federal LOC requirements for admission into an ICF/IID and be approved for entrance into the waiver program before receiving waiver-funded services through an Indiana Medicaid HCBS waiver program operated by the DDRS .

    What is the Level of Care requirement for admission into an Intermediate Care Facility for Individuals with Intellectual Disabilities ?

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    Traumatic Brain Injury Waiver

    The Traumatic Brain Injury waiver provides home- and community-based services to individuals who, but for the provision of such services, would require institutional care. Through the use of the TBI, the Indiana Office of Medicaid Policy and Planning and the Indiana Division of Aging seek to increase availability and access to cost-effective traumatic brain injury waiver services to people who have suffered a traumatic brain injury. Indiana defines a traumatic brain injury as a trauma that has occurred as a closed or open head injury by an external event that results in damage to brain tissue, with or without injury to other body organs. Examples of external agents are: mechanical or events that result in interference with vital functions. Traumatic brain injury means a sudden insult or damage to brain function, not of a degenerative or congenital nature. The insult of damage may produce an altered state of consciousness and may result in a decrease in cognitive, behavioral, emotional or physical functioning resulting in partial or total disability not including birth trauma-related injury.

    Video Result For Indiana Medicaid Waiver Case Management

    Indiana Division of Aging CMO Medicaid training
    KI-HIPP Training for 1915 HCBS Waiver Case Managers
    Introduction to the HCBS Family Supports Waiver

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    Indiana Division of Aging CMO Medicaid training
    KI-HIPP Training for 1915 HCBS Waiver Case Managers
    Introduction to the HCBS Family Supports Waiver
    An Introduction to Indiana’s Medicaid Waiver Program
    Indiana Division of Aging CMO Case Management training

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      Completing The Waiver Application

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      To apply for BDDS services there are two options available.

      The BDDS Gateway is an online application available 24/7 where individuals and families seeking may submit an application for services. The BDDS Gateway may be accessed at: Bddsgateway.fssa.in.gov.

      To learn more about the BDDS Gateway and the online application process, review the resources below:

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      Asthma And Copd Support

      We can help you control your asthma or COPD.

      If you need help getting the services or supplies you need, contact your Member Services Advocate. We can assist with the process of getting supplies or medications, make an appointment with your doctor, or connect you with a care manager for personal support.

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