How to Apply for a Medicaid Waiver in Indiana

Indiana Medicaid is a government program that reimburses medical care costs to eligible people. Waiver services allow adults and children with disabilities to live at home or in the community rather than in long-term care facilities. Indiana has two types of Medicaid waivers: (1) waivers for children and adults with medical needs and (2) waivers for children and adults with developmental disabilities (conditions from early childhood such as cerebral palsy, autism or intellectual impairments). The application process can seem daunting due to bureaucratic jargon and a seemingly unending succession of application forms.

Things You'll Need

• Telephone and/or Internet access
• School and medical records

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Instructions

Apply for Services for Intellectual and Developmental Disabilities

• 1

  Developmental disabilities include autism, cerebral palsy, intellectual disability, epilepsy or a similar disability that originated before adulthood and is expected to continue indefinitely.

  Locate the nearest Bureau of Developmental Disabilities Services (BDDS) district office. Call the central Indianapolis office at [phone] or visit http://www.in.gov/fssa/ddrs/4088.htm to identify the office nearest you.

• 2

  Contact the staff of the nearest BDDS district office. Request the application for long-term care services and make an appointment for help completing the application form. There will be other forms to complete as well to determine eligibility. You will be assigned a case manager to help with the application process.

• 3

  Collect documents to provide to the Bureau of Developmental Disabilities Services case manager to determine eligibility. Look for documentation from schools, hospitals, doctors and therapists. The Arc, a community-based organization of and for people with intellectual and developmental disabilities, can help you identify which information to bring with you to your BDDS appointment. The Indiana chapter (http://www.arcind.org) can be reached by phone at [phone]. Check http://www.thearc.org/NetCommunity/Page.aspx?&pid=303 to find a local chapter. Parental income and resources will not be considered when determining eligibility for children applying for Medicaid waiver services. However, if the applicant has resources or independent income (such as through Social Security benefits), you will need financial documentation.

• 4

  Keep your appointment with your case manager and complete the applications for developmental services and for long-term care (waiver services). Bring the documentation you have collected to determine eligibility.

• 5

  Wait as the BDDS district office staff determines whether the applicant has a developmental disability as defined by Indiana. If eligible, the district staff also will determine eligibility for ICF/MR level of care waivers. (The acronym stands for Intermediate Care Facility for those with Mental Retardation, but the applicant does not have to have an intellectual disability. It simply means that without the home and community-based services these waivers provide, the applicant would be at risk for placement in an institution.) There are three Indiana Medicaid waivers that require the ICF/MR level of care: the Autism Waiver (AU), the Developmental Disabilities Waiver (DD), and the Support Services (SS) Waiver. You may apply for one or all of the waivers, if appropriate. The ICF/MR level of care is based upon a physician-completed medical form, the Developmental Disabilities Profile, and the documentation you provided to determine Indiana developmental disabilities eligibility.

• 6

  Wait to see if the BDDS staff determines that the applicant is eligible for a ICF/MR level of care waiver, in which case it will place the applicant on a waiting list for the appropriate waiver or waivers. The waiting lists for the three ICF/MR level of care waivers (AU, DD and SS) are statewide. Some individuals are given higher priority, such as if the primary caregiver is elderly. The local BDDS office determines who qualifies for higher priority.

To Apply for an Aged & Disabled Waiver or a Traumatic Brain Injury Waiver

• 7

  Locate the nearest Area Agency on Aging for your community. The Indiana Association of Area Agency on Aging's website (http://www.iaaaa.org/locations.asp) has this information, or call [phone].

• 8

  Contact your local Area Agency on Aging. Ask for an application for long-term care services, and make an appointment to meet with a case manager to complete the application. You may apply for one or both of the waivers, if this is appropriate.

• 9

  Locate your local Division of Family Resources (DFR) to apply for Medicaid eligibility, if the applicant is not already eligible under one of these categories: Aged, Blind, or Disabled. All applicants seeking either the Aged & Disabled waiver or the Traumatic Brain Injury waiver also must apply for Medicaid. When applying for Medicaid to satisfy Medicaid Waiver eligibility, only the applicant's income and resources will be considered, not those of parents, children or spouse.

• 10

  Keep your appointment with your Area Agency on Aging case manager, who will help you complete the application for long-term care services. A level of care will be determined, based upon a physical examination and a physician's recommendation. The case manager will provide the necessary form to be completed by the physician. Both the Aged & Disabled and the Traumatic Brain Injury waivers require a nursing facility level of care, meaning that the applicant would be at risk for nursing facility placement without the services these waivers provide.

• 11

  Wait to see if the Area Agency on Aging determines that the applicant is eligible for the Medicaid waiver. If so, the applicant will be placed on a waiting list for that waiver, if slots are not immediately available.