Medicaid Waivers are created by states to address unmet needs of people with chronic conditions who can’t find health insurance coverage suitable to their needs in the private sector or in other publicly funded programs.  They are called waivers because, for the most part, income eligibility criteria are less stringent (“waived”) than in the regular, low income Medicaid programs.

An individual may have private insurance or a regular Medicaid program and still also be eligible for a waiver program.  The waiver would cover health care costs that aren’t ordinarily covered in private insurance or regular Medicaid programs.

Clients must meet financial, medical, and program criteria to access services under a waiver. The applicant must also be at risk of placement in a nursing facility, hospital, or ICF/MR (intermediate care facility for the mentally retarded). A client who receives services through a waiver is also eligible for all basic Medicaid services. When a client chooses to receive services covered by a waiver, the services must be provided by certified Medicaid providers or by a Medicaid contracting managed care organization.

Each waiver has an enrollment limit. There may be a waiting list for any particular waiver.  Applicants may apply for more than one waiver, but may only receive services through one waiver at a time.

To see a complete list of Medicaid Waivers and eligibility criteria, please follow this link. http://www.colorado.gov/cs/Satellite/HCPF/HCPF/1213781362679 If you have additional questions, please contact ASC’s information and referral line at 720-214-0794 ext 21.