Waiver Description
The Assisted Living Waiver is a Mississippi Medicaid Home and Community Based Services (HCBS) Medicaid waiver program. It is designed to help both low-income adults with disabilities and the elderly who require significant assistance with completing their Activities of Daily Living (ADLs), such as eating and maintaining personal hygiene. By providing participants personal care and other supportive services in assisted living communities, it allows them to remain living in the community rather than being placed in a nursing home.
Residences that qualify as “assisted living” include state-approved assisted living residences that accept Medicaid, licensed personal care homes, community residential care facilities, and congregate housing. These residences are commonly referred to as Personal Care Home-Assisted Living (PCH-AL) facilities.
HCBS waivers, including this one, are not entitlements. Unlike institutional or nursing home Medicaid, being eligible for services does not automatically mean that services will be available. For the past several years, a waiting list for the Assisted Living Waiver has existed, although the average time spent on the waiting list is less than in many states with similar waivers. Depending on the area in which one lives, the wait time will vary from a few months to a few years.
HCBS Waivers, including this one, are not entitlements. Unlike institutional or nursing home Medicaid, being eligible for services does not automatically mean that services will be available. For the past several years, a waiting list for the Assisted Living Waiver has existed, although the average time spent on the waiting list is less than in many states with similar waivers. There are three different regions within the state of Mississippi that have their own AL Waiver waiting lists, so depending on the area in which one lives, the wait time will vary from a few months to a few years.
What is a Medicaid Waiver?
Medicaid Waivers, also known as Home and Community Based Services (HCBS) Waivers, allow qualifying program participants to receive services outside of a nursing home. Medicaid’s standard benefit is to pay for nursing home care. However, those who wish to live at home, in assisted living or in adult foster care, sometimes Medicaid will pay for nursing-home-level care in those locations if it can be obtained at a lower cost than in a nursing home.
Eligibility Guidelines
In order to be eligible for the Assisted Living waiver, applicants must be residents of Mississippi. This state considers the applicant’s monthly income, countable assets, age, and level of impairment when determining eligible participants for this waiver.
General Requirements
Age
Applicants must be at least 21 years of age. If the applicant is not disabled, the applicant must be a minimum of 65 years of age. There is no maximum age limit.
Level of Impairment
Participants must require the level of care provided in a nursing home. Areas of screening to determine eligibility may include an individual’s capacity to perform their Instrumental Activities of Daily Living (IADLs), such as the ability to prepare one’s own meal or to grocery shop, as well as ADLs, such as grooming, mobility, and toiletry. Other areas may include deficits in cognition, medical conditions, and sensory deficits.
Financial Requirements
Income Limits
Individuals must meet the Mississippi Medicaid income limit for individuals who require nursing home care. For 2024, an applicant’s monthly income must be less than 300% of the Federal Benefit Rate (FBR). This means an applicant cannot have monthly income greater than $2,829.
Married applicants whose husband or wife is not seeking Medicaid can allocate some of their income to their spouse who is not applying. As of 2024, this amount can be as great as $3,853.50 a month. This figure is known as the Maximum Monthly Maintenance Needs Allowance (MMMNA). This can effectively lower the applicant’s income to within the limits necessary for the Assisted Living Waiver. If the spouse’s income is already at this amount, the monthly transfer is not permitted.
Asset Limits
Asset calculations are more complex than income. Medicaid defines assets as either “countable” or “exempt.” Countable assets include savings, stocks, second homes, land that one’s primary home isn’t on and doesn’t produce income, and most other things of value. It is perhaps easier to list those assets that are exempt (not counted toward the asset limit). These include personal items, home furnishings, burial plots, two motor vehicles, low-value life insurance policies (face value under $10,000), and most importantly, a home, provided the equity value is less than $713,000 in 2024.
The countable asset limit for a single applicant is $4,000. For those who are married, assets are considered jointly owned. The non-applicant spouse of a married couple is permitted to have up to $154,140 in assets. This is called the Community Spouse Resource Allowance (CSRA). Joint assets can be allocated to the non-applicant spouse up to this amount. In addition, the applicant spouse is able to retain $2,000 in assets. When both spouses are applying, their assets are limited to $6,000.
Over the Financial Limits?
Persons who exceed these financial limits can still become Medicaid eligible by re-structuring their finances to meet the guidelines. This is called Medicaid planning, and there are both public and private professionals who can help. Read more.
However, Medicaid has a 60-month look-back period in which all transfers within this time frame are scrutinized. Assets are not allowed to be gifted in order to meet financial requirements, otherwise the individual will be penalized with a period of Medicaid ineligibility. Because of this rule, it is strongly advised that an applicant consult a Medicaid planner if they are wishing to re-allocate assets.
Benefits and Services
Beneficiaries of the Assisted Living Waiver can receive the following types of care and support. Be aware that waiver participants are expected to contribute financially to their room and board costs in assisted living.
- Attendant Care
- Case Management
- Chore Services
- Homemaker Services
- Medication Administration and Oversight
- Personal Care
- 24-hour Supervision
- Personal Emergency Response Services
- Temporary Skilled Nursing Services
- Therapeutic Social and Recreational Activities
- Transportation Assistance
How to Apply / Learn More
The Assisted Living Waiver is available in all Mississippi counties. However, this is not an entitlement program; persons who meet the requirements may be placed on a waitlist. Limited information can be found on the program’s webpage. More program details can be found on this downloadable PDF.
This waiver is administered by the Mississippi Division of Medicaid (DOM), Bureau of Long Term Care. To apply, contact them at 800-421-2408. Alternatively, one can contact their local area agency on aging.
