Waiver Description
The Nevada Home and Community Based Services (HCBS) Waiver for Persons with Physical Disabilities (PD) is often also referred to as the Physical Disability Waiver. It is a program for low-income, physically disabled Nevada residents. This program allows individuals who require a nursing home level of care to remain living at home, in the home of a relative, or in an assisted living residence, by providing care and other supportive services, such as assistance with personal activities of daily living, housecleaning, errands, meal preparation, and more.
Under this waiver, participants can direct their own care, or they may designate a personal care representative to do so in their place. Friends and family, with the exception of spouses and legal guardians, can be hired and paid to provide care.
Another program that may be of interest to a broader spectrum of older Nevada residents is the Frail Elderly Waiver. This program provides services similar to the ones provided by the Persons with Physical Disabilities waiver. However, unlike the HCBS-PD Waiver, which has no age limitations, individuals must be 65 years of age or older to be eligible for the Frail Elderly Waiver. There is also no requirement of being physically disabled, only that an applicant requires a nursing home level of care. Make note, applicants are only able to receive services via only one home and community based services waiver even if they are found to be eligible for both.
Eligibility Guidelines
In order to be eligible for the HCBS Persons with Physical Disabilities Waiver, there are both functional and financial requirements that Nevada residents must meet.
General Requirements
Applicants must be assessed and diagnosed as disabled by a physician. They must also require a nursing home level of care, and if not for the care provided by the waiver, be at risk of nursing home placement.
Financial Requirements
Income Limits
In 2024, a single applicant must not have monthly income in excess of $2,829. This amount is equivalent to 300% of the current Federal Benefit Rate (FBR). If both spouses of a married couple are applying for benefits, each spouse is considered as a single applicant. Therefore, each spouse is allowed up to $2,829 per month in income.
When one spouse of a married couple is not applying for Medicaid assistance, a part (or all) of the applicant spouse’s income may be transferred to the non-applicant spouse, up to $3,853.50 per month, as a living allowance. This is intended to bring the non-applicant’s monthly income up to that amount. If the spouse’s income is already at $3,853.50, the monthly transfer is not permitted.
Another approach available in Nevada to reduce one’s income in order to qualify for Medicaid is to use a Miller Trust. Learn more.
Asset Limits
In 2024, assets are limited to $2,000 for a single individual and $3,000 for a couple with both spouses as applicants. If only one spouse of a married couple is applying for this waiver, the applicant spouse is able to keep $2,000 in assets, and the non-applicant spouse is allowed up to $154,140 in jointly owned assets. (Learn more here about Medicaid and jointly owned assets).
However, certain assets are considered exempt, such as one’s home, provided the applicant, or his / her spouse, lives in the home and the home equity is not valued over $713,000. A vehicle, household items, personal effects, and a burial policy up to $1,500 are also considered exempt items.
Over the Financial Limits?
Persons whose assets exceed these limits, or married couples in which only one spouse requires care, should consider working with a Medicaid planning professional, as certain assets of considerably higher value can be allocated to a non-applicant spouse.
Please note that Medicaid has a look-back rule, which prohibits the transfer of assets without payment or under fair market value for 60 months preceding one’s Medicaid application date. This rule is to prevent applicants from trying to meet the asset limit in this way. Violating this rule can result in a period of disqualification from benefits.
Benefits and Services
A variety of care and support services are available under the Physical Disabilities Waiver. These services must be approved in the beneficiary’s plan of care and can include the following:
- Assisted Living Services
- Attendant Care – assistance with activities associated with daily living, such as mobility, bathing, dressing, light cleaning, etc.
- Case Management
- Chore Services – minor home repairs, yard cleaning, window washing, etc.
- Home Modifications – addition of wheelchair ramps, grab bars, remodeling of bathrooms to allow wheelchair access, etc.
- Homemaker Services – housecleaning, grocery shopping, meal preparation, laundry
- Meal Delivery
- Personal Emergency Response Systems (PERS)
- Respite Care – up to 120 hours / year in the home or residence of the beneficiary
- Specialized Home Care Supplies / Durable Medical Equipment
How to Apply / Learn More
Although a bit technical and difficult to comprehend, one can download a file to learn more about the HCBS for Persons with Physical Disabilities Waiver. Additionally, further info can be found here.
An online application can be found here. Applications should be submitted to your local Aging and Disability Services Division office.
Once accepted, program beneficiaries should expect annual reassessments of their functional ability and care requirements.
