Common Pitfalls

Waiver programs have an income limit and a resource limit. Your income must be $2,982 a month or less and you must have $2,000 or less in resources ($3,000 for a couple).

If your income or resources are over these limits and you work, you may qualify through Medicaid for Employed People with Disabilities (MEPD), which has much higher limits.

If your disability began before you turned 46, you can open an ABLE account where you can save up to $20,000 in resources each year and not have it counted by Medicaid.

Make sure your income and resources don’t cause you to lose your eligibility for your waiver!

You may qualify for a Medicaid waiver program even if you don’t qualify for regular disability-based Medicaid, because the income limit for waiver programs is higher than the regular Medicaid income limit.

If you have limited income and resources and need a level of care that is equal to the level of care at a nursing home or a hospital, you should look into Medicaid waivers. You may qualify for a waiver’s benefits and services even if you don’t have Medicaid coverage.

Also, if you have earned income from working, you may qualify for Medicaid for Employed People with Disabilities (MEPD), which has much higher income and resource limits than regular Medicaid and waivers. You can qualify for a waiver through MEPD even if your income or resources are over the waiver limits.

Waivers have a limited number of spots, and there is usually a waiting list for the program you want to enroll in.

If you are on the waiting list and you have an emergency or urgent need for services, you may be eligible to apply for waitlist priority. Complete the Waiver Priority Need Assessment (WPNA) form and turn it into your local Health and Human Services (HHS) office.

If your address changes while you are on the waiting list, make sure to update your information with your local Health and Human Services (HHS) office.

When you apply for Medicaid and Medicaid waivers, you need to explain your disability and your level of need. You should document your medical condition as much as possible. Keep track of your diagnosis, medical appointments, supplies, services, and general independence. Consider starting a journal or having a place where you can write down when something new happens related to your disability.

Fill out and return all forms and other paperwork related to your benefits on time. This includes annual eligibility paperwork for Medicaid, waivers, or other similar services. Talk to your case manager or the agency in charge of your waiver program if you have questions about paperwork or due dates.