Benefits & Financial Support

Medicaid Waivers by State

Every state has Medicaid waiver programs that can fund home care, therapy, respite, and more for your child with a disability. Most families never apply because they don't know these programs exist.

What Is a Medicaid Waiver?

A Medicaid waiver — officially called a Home and Community-Based Services (HCBS) waiver — allows your state to fund services that regular Medicaid doesn't cover.

Regular Medicaid pays for medical care. A waiver pays for living supports — the things that help your child (or adult) with a disability live at home and participate in the community.

Without a waiver, families often pay out-of-pocket for services that could be covered. Applying early — even before your child needs services — is critical because most states have long waitlists.

What waivers can fund:

In-home personal care and support aides
Respite care (planned breaks for caregivers)
Applied Behavior Analysis (ABA) therapy
Supported employment and job coaching
Day programs and community activities
Home modifications (ramps, accessible bathrooms)
Assistive technology and adaptive equipment
Transportation to services
Family training and support
Behavioral health services

How to Apply for a Medicaid Waiver

The process varies by state, but these steps apply almost everywhere.

1

Find your state's waiver program

Use the table below to find your state's primary waiver and click the Apply link. Each state has different waivers — some are diagnosis-specific (autism-only), others are broad (all developmental disabilities).

2

Apply immediately — even if you don't need services yet

Your place on the waitlist is typically based on your application date. Many waitlists are 3–10 years long. Applying early protects your child's place in line.

3

Gather documentation

You will need your child's diagnosis documentation, medical records, current Medicaid or insurance information, and possibly a physician's letter confirming the diagnosis and level of need.

4

Complete the functional needs assessment

Most states require a level-of-care evaluation to confirm your child meets the clinical criteria for the waiver. This is usually done by a state assessor or contracted agency — it is not something you need to prepare for, just answer honestly.

5

Apply for Katie Beckett if income is an issue

If your family earns too much for regular Medicaid, ask specifically about Katie Beckett / TEFRA Medicaid, which evaluates the child's income only. Most states offer this for children with significant disabilities.

6

Follow up regularly

Once on the waitlist, follow up with your state's office every 6 months to confirm your application is still active. Some waitlists purge inactive applicants. Keep your contact information updated.

Medicaid Waivers by State

Find your state below. Click the Apply / Learn More link to go directly to your state's program page. Waiver names and availability change — always confirm current information with your state office.

StatePrimary Waiver Program(s)Apply / Learn More
AlabamaAlabama NOW Waiver, Living at Home WaiverVisit State Site →
AlaskaIDD Waiver, Alaskans Living IndependentlyVisit State Site →
ArizonaDDD ALTCS (Arizona Long Term Care System)Visit State Site →
ArkansasARChoices in Homecare, RSPMI WaiverVisit State Site →
CaliforniaRegional Center Services (state-funded), HCBA WaiverVisit State Site →
ColoradoChildren's Extensive Support (CES), Supported Living Services (SLS)Visit State Site →
ConnecticutABI Waiver, Personal Care Assistance, DDS WaiverVisit State Site →
DelawareDiamond State Health Plan Plus, DDDS WaiverVisit State Site →
FloridaiBudget Florida (DD Waiver), Agency for Persons with DisabilitiesVisit State Site →
GeorgiaNOW Waiver, COMP Waiver (Comprehensive Supports)Visit State Site →
HawaiiCommunity First Choice (CFC), Med-QUEST DD WaiverVisit State Site →
IdahoChildren's HCBS Waiver, Aged & Disabled WaiverVisit State Site →
IllinoisHome Services Program, CILA (Community Integrated Living Arrangement)Visit State Site →
IndianaAutism Waiver, Family Supports Waiver, Community Integration & HabilitationVisit State Site →
IowaIntellectual Disability Waiver, Brain Injury Waiver, Children's Mental Health WaiverVisit State Site →
KansasHCBS Autism Waiver, Physical Disability Waiver, Frail Elderly WaiverVisit State Site →
KentuckySupports for Community Living (SCL), Michelle P Waiver, HCBS WaiverVisit State Site →
LouisianaNew Opportunities Waiver (NOW), EPSDT WaiverVisit State Site →
MaineMaineCare Home & Community Benefits, Office of Aging & DisabilityVisit State Site →
MarylandCommunity Supports Waiver, Community Pathways Waiver, Family Supports WaiverVisit State Site →
MassachusettsAdult Supports Waiver, Autism Waiver, DDS Day & Employment SupportsVisit State Site →
MichiganMI Choice Waiver, Habilitation Supports Waiver (HSW)Visit State Site →
MinnesotaCADI Waiver, Brain Injury Waiver, DD Waiver, Elderly WaiverVisit State Site →
MississippiIntellectual Disabilities / DD Waiver, TBI WaiverVisit State Site →
MissouriDivision of DD Comprehensive Waiver, Supported Living WaiverVisit State Site →
MontanaHCBS DD Waiver, Comprehensive DD WaiverVisit State Site →
NebraskaAged and Disabled Waiver, BLTC Waiver, Development Disabilities WaiverVisit State Site →
NevadaHCBS DD Waiver, Physical Disability WaiverVisit State Site →
New HampshireDevelopmental Services Waiver, In Home Supports WaiverVisit State Site →
New JerseySupports Program, Community Care Waiver (DDD)Visit State Site →
New MexicoDD Waiver, Mi Via Waiver (self-directed)Visit State Site →
New YorkOPWDD HCBS Waiver, Care at Home Waiver, TBI WaiverVisit State Site →
North CarolinaCAP-C Waiver (children), Innovations Waiver, TBI WaiverVisit State Site →
North DakotaBasic Care Waiver, DD Waiver, SPED WaiverVisit State Site →
OhioSELF Waiver, Level 1 Waiver, Individual Options (IO) WaiverVisit State Site →
OklahomaDD Services Waiver, ADvantage Waiver, In-Home Supports WaiverVisit State Site →
OregonK Plan (Oregon Integrated and Supported Health Plan), ODDS ServicesVisit State Site →
PennsylvaniaAdult Autism Waiver, Consolidated Waiver, P/FDS WaiverVisit State Site →
Rhode IslandCPWMS Waiver, DD Services, Medicaid Home & Community-Based ServicesVisit State Site →
South CarolinaIntellectual Disability & Related Disabilities Waiver, Community Choices WaiverVisit State Site →
South DakotaHCBS MRDD Waiver, Child Care WaiverVisit State Site →
TennesseeDIDD Waiver, Employment and Community First CHOICESVisit State Site →
TexasHome & Community-based Services (HCS), Texas Home Living (TxHmL), STAR+PLUS HCBSVisit State Site →
UtahDSPD New Waiver, DSPD Supported Living, Medicaid HCBSVisit State Site →
VermontGlobal Commitment to Health (DD Services), Choices for CareVisit State Site →
VirginiaDD Waiver, Community Living Waiver, Building Independence WaiverVisit State Site →
WashingtonDDA HCBS Waiver, Individual & Family ServicesVisit State Site →
West VirginiaID/DD Waiver, Intellectual & Developmental Disabilities WaiverVisit State Site →
WisconsinCLTS Waiver (children), iCare, Family Care, IRIS (self-directed)Visit State Site →
WyomingHCBS Intellectual Disability Waiver, Assisted Living WaiverVisit State Site →

Waiver program names and eligibility requirements change frequently. Always verify current information directly with your state's Medicaid or disability services office. You can also search your state at Medicaid.gov.

Tips for Navigating the Waitlist

Most families wait years for waiver services. These strategies can help.

Apply the day of diagnosis

Don't wait until your child needs services. The waitlist clock starts the day you apply. Many families wish they had applied years earlier.

Apply in multiple categories

Some states have separate waivers for different diagnoses or needs (autism-specific, general DD, children's). If your child potentially qualifies for more than one, apply for all of them.

Check for crisis or emergency slots

Most states have a small number of crisis placements for families in emergency situations — caregiver illness, housing crisis, or immediate safety risk. Ask your state office if you qualify.

Contact your state representative

Your elected state representative can sometimes help move things along or clarify your waitlist status. Their office may have a constituent services contact who handles Medicaid cases.

Look into bridge programs

While you wait, ask about intermediate programs: state-funded (not waiver) services, Early Intervention, school-based services, and Medicaid State Plan services that don't require a waiver.

Join a parent advocacy group

Other parents in your state often know about funding opportunities, unofficial timelines, and strategies the state doesn't advertise. Connect with your state's DD advocacy coalition.

Frequently Asked Questions

What is a Medicaid waiver?

A Medicaid waiver (officially called a Home and Community-Based Services waiver, or HCBS waiver) allows states to provide services not typically covered by regular Medicaid — such as in-home support, respite care, ABA therapy, assistive technology, and day programs. Without a waiver, Medicaid primarily pays for medical care. With a waiver, it can fund a much broader range of disability-related supports.

How is a Medicaid waiver different from regular Medicaid?

Regular Medicaid covers medical services — doctor visits, hospitalizations, prescriptions, and some therapies. A Medicaid waiver expands that to include home and community-based services: personal care aides, respite care, supported employment, behavioral therapy, home modifications, specialized equipment, and more. Waivers are designed to help people with disabilities live at home rather than in institutional settings.

Does my child automatically get a waiver if they have Medicaid?

No. A Medicaid waiver is a separate application and eligibility process from regular Medicaid. Your child must apply specifically for the waiver, meet eligibility requirements (usually based on diagnosis and level of need), and in most states, wait on a waitlist. Having regular Medicaid does not guarantee waiver services.

How long are Medicaid waiver waitlists?

Waitlists vary enormously by state and waiver type — from a few months to 10+ years. Texas, Florida, and several other large states have waitlists measured in years. Some states (like Oregon and Washington) have redesigned their systems to reduce waits. The most important thing: apply as early as possible. Your place on the waitlist is typically based on application date, so every day you wait to apply is a day lost.

Can my child get a Medicaid waiver if our family income is too high for regular Medicaid?

Possibly. The Katie Beckett program (also called TEFRA) is a Medicaid pathway that evaluates eligibility based on the child's income and resources only — not the parents'. This is specifically designed for children with significant disabilities whose families would otherwise earn too much to qualify. Not all states have Katie Beckett, but most do. Contact your state Medicaid office to ask.

What should I do if my waiver application is denied?

You have the right to appeal a denial. Request a hearing in writing within the timeframe specified in your denial letter (usually 30–90 days). Bring documentation of your child's diagnosis, functional limitations, and service needs. Consider contacting your state's Disability Rights organization or a Medicaid advocacy group for free help with appeals. Denials are often successfully reversed on appeal.

Need Help Navigating Benefits for Your Child?

Our IEP Review Service includes a one-on-one session with Tabaitha McKeever — a certified special education teacher who can help you understand your child's rights and next steps.

Disclaimer: The information on this page is for general educational purposes only and does not constitute legal, financial, or medical advice. Medicaid waiver programs, eligibility requirements, and waitlist procedures change frequently and vary significantly by state. Program names, services covered, and application processes listed here may have changed since this page was last updated. Always verify current information directly with your state's Medicaid office or disability services agency. Special Clarity is not a law firm and does not provide legal representation or advocacy services.