Question 1

What is the Indiana Medicaid waiver?

Accepted Answer

The Indiana Medicaid waiver allows individuals with disabilities of all ages who choose to live in their own home as opposed to an institution (i.e. nursing facility, group home, etc.) to receive Medicaid-funded services that they otherwise would've received at an institution. These Medicaid-funded services take place both in the individuals home and out in the community, with the intent to assist them in being as independent as possible and live in the least restrictive environment, while maintaining safety and comfort in their own home.

Essentially, the waiver program through Indiana Medicaid "waives" the institution option in order for Medicaid to fully fund home and community-based services, such as recreational therapy and behavior management, while the individual continues to live at home.

While Indiana Medicaid has many waivers that provide services to many people, recreational therapy and behavior management services can be found on the Community Integration and Habilitation Waiver (https://www.in.gov/medicaid/members/home-and-community-based-services/community-integration-and-habilitation-waiver)and the Family Supports Waiver,(https://www.in.gov/medicaid/members/home-and-community-based-services/family-supports-waiver) which is under the Division of Disability and Rehabilitative Services.

Question 2

Am I eligible to receive Medicaid waiver funding?

Accepted Answer

To be eligible for DDRS (https://www.in.gov/fssa/ddrs/)Medicaid waiver funding (which is the division of Medicaid that offers recreational therapy and behavior management services), individuals must:
 • Be diagnosed with an intellectual disability prior to the age of 22.
 • Reside in or be transitioning into an HCBS-compliant setting (non-institutionalized).
 • Have income no greater than 300% of the maximum Supplemental Security Income amount (parental income for children under 18 years of age is disregarded).
 • Meet the Level of Care (LOC) requirements (explained below).

Level of Care (LOC) is the minimum need an individual must have to be considered eligible for waiver services. This is evaluated when you initially apply and annually after approval. For the purposes of LOC, an individual must have a disability that:
 • Results in impairment of functioning similar to that of a person who has an intellectual disability, including autism, epilepsy, cerebral palsy, or a similar condition (other than mental illness).
 • Originates before the person is 22 years of age.
 • Has continued or is expected to continue indefinitely.
 • Substantially limits the person's ability to engage independently in at least three of six life areas:
    • Self-care
    • Receptive/expressive language
    • Learning
    • Mobility
    • Self-direction
    • Capacity for independent living
 • Requires access to 24-hour assistance, as needed.

Source: Indiana Medicaid (https://www.in.gov/medicaid/members/home-and-community-based-services/family-supports-waiver/)

Question 3

How can I apply for the Indiana Medicaid waiver?

Accepted Answer

Applying for the Indiana Medicaid waiver can be done by one of the following options:
 • Complete an online application.(https://bddsgateway.fssa.in.gov)
 • Print, complete, and mail a paper application (https://forms.in.gov/Download.aspx?id=10691)to your local BDS office.(https://www.in.gov/fssa/ddrs/developmental-disability-services/bureau-of-developmental-disabilities-services/)

For more thorough information regarding the application process, please check out our Waiver Process (https://www.newleafrt.com/waiverprocess)page, or this document (https://www.in.gov/medicaid/providers/files/modules/ddrs-hcbs-waivers.pdf)and search for "Application and Start of Waiver Services" in the table of contents.

Question 4

There are too many acronyms to understand, help!

Accepted Answer

The waiver is full of acronyms and the vocabulary can be difficult to understand. Below are some of the most common acronyms used amongst Indiana Medicaid waiver providers. If you ever need further clarification, please don't hesitate to contact us!(https://www.newleafrt.com/contact)

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