Health Information Center

Family Manual Fact Sheet – Medicaid Waivers in Illinois

 

Family Manual Fact Sheet – Medicaid Waivers in Illinois

 

A waiver “waives” or allows for change from the rules for Medicaid reimbursement for services. Waivers are written by states to allow federal money to support individuals with similar needs in home and community settings.  The Medicaid funding was originally for services provided in nursing home settings before waivers. When a state wants to institute a new waiver program, the rules for the waiver have to be written, approved through state channels, and then submitted for approval from the federal government. It’s a long and difficult process.

Eligibility criteria for Illinois waiver programs include:

  1. Individuals must be U.S. citizens or legal aliens and residents of the state of Illinois.
  2. Individuals must meet Medicaid financial eligibility criteria.
  3. Individuals must require an institutional level of care as specified by each waiver.
  4. Individuals’ service needs must be able to be provided cost-effectively.

Illinois has nine HCBS waivers. Each waiver is designed for individuals who fit a prescribed set of criteria and each waiver has rules and regulations regarding the specific services for which the funding can pay.

  1. Children and Young Adults with Developmental Disabilities-Support Waiver
  2. Children and Young Adults with Developmental Disabilities-Residential Waiver
  3. Children that are Technology Dependent/Medically Fragile
  4. Persons with Disabilities/Physical Disabilities
  5. Persons with Brain Injuries (BI)
  6. Adults with Developmental Disabilities
  7. Persons who are Elderly
  8. Persons with HIV or AIDS
  9. Supportive Living Facilities

For more information about the waivers and the services that can be funded through them, see the link below to the Illinois Healthcare and Family Services (HFS) website page devoted to waiver services. For each waiver, there is a link to a Fact Sheet and the full text of the waiver description.  If you do not have access to the internet, you may call the Bureau of Interagency Coordination at 217-557-1868 with questions.  http://www.hfs.illinois.gov/hcbswaivers   Not all waiver programs are managed by the same state agency. To find out which state agency operates each waiver, please note the “Operating State Agency” listed on the HFS Fact Sheets.

 

 

Additional information about Illinois waiver programs can be found on the following sites as well.

Center for Personal Assistance Services:   Phone :  415-502-7190 http://pascenter.org/state_based_stats/medicaid_waivers_info.php?state=illinois