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HCBS Waiver Programs

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    HCBS Waiver Programs

    Who They Help

    To qualify for a Home and Community-Based Services (HCBS) waiver, you must need a level of care normally provided by a hospital, nursing home, or other care facility. However, the goal of the waiver is to help you live in your own place in the community, such as your own home or apartment, instead of a care facility. As such, you must show that you need services a waiver program can provide to help you live in the community.

    Each waiver helps people with specific conditions and situations:

    • The Elderly Waiver is for people who are 65 or older.
    • The Health and Disability Waiver is for people under age 65 who are blind or disabled and have a disability determination.
    • The Physical Disability Waiver is for people ages 18 to 64 who are blind or have a physical disability, have a disability determination, and are not eligible for the Intellectual Disability waiver.
    • The Intellectual Disability Waiver is for people who have a primary diagnosis of an intellectual disability.
    • The AIDS/HIV Waiver is for people who have AIDS or HIV.
    • The Brain Injury Waiver is for people with a brain injury.
    • The Children’s Mental Health Waiver is for children under 18 who have a serious mental, behavioral, or emotional disorder.
    Waivers are changing, but it won’t affect your eligibility

    Iowa is changing its waiver system soon: instead of seven separate waivers that help people with different conditions, there will be three waivers based on age: one waiver for people 65 or older, one waiver for adults under 65, and one waiver for children.

    This will not affect your eligibility or application. If you qualify for one of these seven waivers, you will still also qualify for the new waiver for your age group. The services you get from the waiver will depend on your needs and your condition.

    These changes are planned to start sometime in 2026 and continue into 2027. Read more about them on the Iowa Health and Human Services website.

    Financial Eligibility

    To qualify for a waiver program, you usually must have limited income and resources. If you get Supplemental Security Income (SSI) benefits or State Supplementary Assistance, you automatically meet these financial requirements.

    If you get Medicaid for Employed People with Disabilities (MEPD), you can qualify even if your income and resources are higher than the regular limits. Learn more about MEPD.

    If you don’t get SSI, State Supplementary Assistance, or MEPD, you must:

    • Have $2,982 or less a month in income, and
    • Have $2,000 or less in resources if you are single ($3,000 or less for couples).
      • Note: If you are under 21, the resources of your family members are not counted in most cases.
      • Note: 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. Learn more about ABLE accounts on DB101.
    Waiver services are usually free

    Most people who qualify for waivers pay nothing for their approved waiver services. However, some people may have to pay some of the cost, depending on their income. If you have to pay for services, the amount is based on how much more monthly gross income you have than the waiver income limit ($2,982 per month). Note: If you have Medicaid for Employed People with Disabilities (MEPD), you don’t have to pay any of the cost of your waiver services.

    Learn more

    Disability-Based Medicaid

    There are more ways to qualify for Medicaid if you have a disability.

    Medicaid for Employed People with Disabilities (MEPD)

    MEPD is Medicaid for people with disabilities who work.

    Getting Past the Myths

    Get the facts about how benefits support work.