Program Update – Important Changes to this Waiver
As of July 1, 2014, this waiver is no longer active under the State of Nevada Medicaid system. Elderly Nevada residents who need help to afford their care should consider the Home and Community Based Waiver for the Elderly. This waiver’s benefits include both options for home care and support with the cost of care at an assisted living community. The information on this page is for historical information purposes only.
What is a Medicaid Waiver?
For persons with limited financial resources, Medicaid pays for nursing home care. For those who wish to live at home or in assisted living, sometimes Medicaid will pay for care in those locations if it can be obtained at a lower cost than in a nursing home. It does this through “Medicaid Waivers” which are also called Home and Community Based Services (HCBS Waivers) or Waiver Funded Services.
Waiver Description
This is one of several Nevada Medicaid waivers designed to help older state residents. Under the Assisted Living Waiver, services are provided to the elderly in assisted living residences in the interest of preventing or delaying the need for nursing home care. Generally speaking, families prefer their loved ones to reside in assisted living over nursing home residences as assisted living offers increased mobility and better social activities. State officials prefer it as well albeit for different reasons. The cost to care for an individual in assisted living is less expensive than nursing home care.
Personal care in assisted living is a covered benefit but room and board fees are not.
In addition to personal care, under the AL Waiver, participants can receive homemaker and chore services, engage in social and recreational activities and receive assistance with medication. The fees for room & board in assisted living is not covered.
Eligibility Guidelines
In addition to being 65+ years old, Nevada residents must require nursing home level care, but reside in or be willing to move into an assisted living community. They must also be financially qualified. The AL Waiver has the same financial restrictions as Nevada Medicaid.
Nevada Medicaid Income Limits – applicants must have monthly income less than 300% of the federal poverty level. For 2014, this equals to $2,163. Persons who have income over this amount can possibly still qualify by transferring excess income to their husband or wife provided they are not also seeking Medicaid. Alternatively, income over the limit can be allocated to a qualifying income trust. This can effectively lower their countable income to a Medicaid acceptable level.
Nevada Medicaid Assets Limits – single applicants have a countable resource limit for 2014 of $2,000. This figure can be somewhat misleading as many high-value assets are or can be considered exempt. For example, the applicant’s home and real estate, provided it is valued at less than $543,000 and lived in by at least one of the title holders, is not counted. As with income, joint assets can be transferred to a husband or wife who is not applying for Medicaid assistance up to $117,240 in 2014.
Past Asset Transfers – applicant’s asset transfers (other than those made to a husband or wife as previously described) are reviewed to ensure the applicant did not simply transfer their assets from their name to qualify for the Assisted Living Waiver. This asset review looks at the previous 60 months preceding application.
Persons interested in obtaining Nevada’s Assisted Living Waiver but are unsure if they will qualify financially should contact a Medicaid planning professional for assistance prior to application. Learn more.
Benefits and Services
In addition to case management, Nevada’s Assisted Living Waiver provides for assistance with the activities of daily living in a residential care environment. This include personal help with bathing, grooming, eating, medication reminders, mobility and recreational activities. Room and board in assisted living is not covered. The assisted living community must be willing to accept the Medicaid reimbursement rate for the services provided.
How to Apply / Learn More
This waiver is available statewide across Nevada. One may expect to wait several months for approval and / or for a spot to become available. Waiting list for services have existed in the past, but as of early 2014, there were slots available for new participants.
To apply for the program, individuals should contact their Aging and Disability Services Division (ADSD) regional offices. Some limited additional information about the waiver is available on the Aging and Disability Services Division webpage.
Did You Know? US Governments spend 1/4 billion dollars per year solely on the licensing and regulation of care homes.
