Medicaid and Medicaid Waivers

Programs
Written By Grace Kestler
The information here will help you make sense of Indiana’s Medicaid and Medicaid Waivers programs.

The information here will help you make sense of Indiana’s Medicaid and Medicaid Waivers programs.

Understanding Medicaid & Medicaid Waivers

Getting access to the help you and your family needs can be confusing. It can be difficult to navigate government assistance programs, but with the information on this page you’ll have a better understanding of Medicaid and Medicaid Waivers and improve your ability to get the benefits that are available to you.

The Medicaid and Medicaid Waiver rules regularly change. To find the most up-to-date information about Medicaid and Medicaid Waivers in Indiana, please consult the website for Indiana Medicaid website for Members.

If there’s a particular section you’d like to read first, click one of the links below to jump to that section:

What is Medicaid?

Medicaid is essentially health insurance for certain groups of people, primarily these people are elderly or have a disability of some sort. It started in January 1970 and has grown and changed continually since then.

Most people who receive Medicaid are low income earners or don’t own many assets. However, sometimes the way eligibility is determined allows people to receive benefits who seem to have a lot of assets. It can get complicated when determining who is actually eligible for Medicaid and who isn’t.

Each flavor of Medicaid comes with its own set of rules and procedures. With the Affordable Care Act (ACA, commonly referred to as Obamacare), there were major changes to how Medicaid eligibility is determined for some categories of Medicaid. These changes focused on simplifying the process of obtaining and receiving Medicaid benefits.

Can children be eligible for Medicaid and Medicaid Waivers if the parents aren’t low-income earners?

When a child, who’s under 18 years old, with a disability applies for Medicaid that child’s income may be the only income used for the determination. Since most children don’t have income they’ll be able to pass the financial tests for Medicaid.

This is explained further in the Indiana Medicaid Policy Manual (section 2035.20.00):

2035.20.00 HOME AND COMMUNITY-BASED SERVICE WAIVERS (MED 1)

Parental income and resources are not considered when determining the Medicaid eligibility of individuals less than 18 years of age who are being considered for Home and Community-Based Services (HCBS). Parents should be asked early in the interview if they want retroactive Medicaid coverage for the child. If retroactive coverage prior to the waiver effective date is requested, the parents must provide verification of their income and resources. Generally most parents do not want retroactive coverage for the child prior to the waiver and are resistant about being asked any questions about themselves. If the parents do not want the retroactive coverage, they are not required to provide information about their own finances for those retroactive months.

As each screen is completed, the questions will relate to the situation of the child only, if retroactive coverage is not desired.

If you are a parent applying for Medicaid for a child and don’t want to include your income and resources in the eligibility determination, then you should state during the Medicaid interview that you don’t wish to pursue retroactive coverage for the child.

Since the rules of Medicaid continue to change, you should follow the direction and advice of Medicaid staff during the application process. If household income, is requested, then you may be eligible for additional benefits or for another reason need to provide that information in order to receive the benefits you’ve requested.

Retroactive coverage provides Medicaid benefits for up to three (3) months prior to the application date. Since these months are before the effective begin date of coverage under the Home and Community-Based Services (HCBS) Waiver, the parent’s income and resources would be included.

If eligibility is determined for retroactive months, then income and resources will need to be verified with documentation. This can extend the process to complete the application for Medicaid, so if you aren’t interested in pursuing retroactive coverage then may be able to finish the process more quickly.

What are the different types of Medicaid?

When you apply for Medicaid, information about you and your family is collected. There’s quite a bit of information required to complete the Medicaid process, so be prepared to gather and provide documentation in order to complete the process. In fact, you can apply for Medicaid with only a few pieces of information and the system will mail you a list of everything else you need to provide.

Once you apply for benefits and provide all the requested information, your eligibility will be determined by the state’s computer system. It will look at everything you’ve provided and figure out if you’re eligible for Medicaid and, if you are eligible, which category of Medicaid you’ll receive.

The system is set up to find the best benefits for you, in the event that you’re eligible for multiple categories of Medicaid. In the next section (as of June 1st, 2018), you can learn about the different categories of Medicaid.

Categories of Medicaid

There are over 35 different categories of Medicaid utilized in Indiana as of the time of this writing. The most relevant categories of Medicaid for individuals with intellectual or developmental disabilities are categories related to disability.

You and your family members may be eligible for different categories of Medicaid when you apply. As new things happen in your life, you may change from one category to another as well.

Generally, you can think of each category of Medicaid as having one (or a few) specific criteria for eligibility. For instance, the Medicaid category for individuals who are blind requires that you’re medically considered blind. If you aren’t blind you won’t be determined eligible for this category regardless of the remaining financial and non-financial requirements.

Here are links to descriptions of the Medicaid category groups mentioned on this page:

MED 1 Categories - MASI, MA A, MA B, MA D, MADW, MADI, and MA R

MED 1 categories of Medicaid include more traditional types of Medicaid. The rules to determine eligibility for these categories is different than newer categories, but

  • MASI - Medicaid for Individuals who are receiving Supplemental Security Income (SSI)

    • If you or a family member is considered disabled according to the Social Security Administration (SSA) and receives Supplemental Security Income (SSI), then a change in Medicaid rules means you’re eligibility determination will be streamlined. Since the rules to become eligible for Supplemental Security Income (SSI) are more strict than the rules for Medicaid, you can begin receiving Medicaid benefits more quickly than you otherwise would.

  • MA A - Medicaid for Individuals who are 65 years old or older

    • For individuals who are 65 years old or older, you will have eligibility determined for the Aged category of Medicaid, MA A.

  • MA B - Medicaid for Individuals who are blind

    • For individuals who are blind, the MA B category is the primary category for which you’ll have eligibility determined.

  • MA D - Medicaid for Individuals who are disabled

  • MADW - Medicaid for Individuals who are disabled but are working

    • There are multiple categories for individuals with disabilities and MADW is one of them. MADW is for individuals who are disabled but are able to continue working.

  • MADI - Medicaid for Individuals whose disability has improved

    • Another category for individuals who are disabled is MADI. The MADI category is for individuals whose disability has improved, but is still present. Individuals cannot be determined eligible MADI directly, they would need to be eligible for a different category of Medicaid and then transition to MADI when their disability is considered improved.

  • MA R - Medicaid for Individuals who are eligible for the Residential Care Assistance Program (RCAP)

    • The final category of Medicaid in the MED 1 group is MA R. To receive MA R, individuals must be eligible for Room and Board Assistance (RBA) and be aged, blind, or disabled (according to the aged, blind, and disability rules found in the MA A, MA B, or MA D categories).

MED 2 Categories - MA Q

MED 2 contains a single Medicaid category. This category provides benefits for groups of refugees who’ve relocated to Indiana.

  • MA Q - Medicaid for Refugees

    • This Medicaid category provides medical benefits for refugees for the first eight (8) months they’re in the United States.

MED 3 Categories / MAGI Categories - MAGF, MA F, MAGP, MAMA, MA X, MA Y, MA Z, MA 2, MA 9, MA10, MA O, MA E, MA14, MA15, MASP, MASB, MAPC, MARP, MARB, and MANA

The MED 3 categories of Medicaid include the Healthy Indiana Plan (HIP) and other categories that use the Modified Adjusted Gross Income (MAGI) budgeting rules for the financial eligibility determination.

  • MAGF - Medicaid for low-income families

    • If you or your family make very little money, then you could be determined eligible for the MAGF category.

  • MA F - Transitional Medical Assistance (TMA)

    • To avoid individuals losing health coverage when they earn more money (such as taking on a new job), the Transitional Medical Assistance (TMA) category was created. This category allows you to continue receiving Medicaid despite an increase in income.

  • MAGP - Medicaid for pregnant women

    • In order to provide medical benefits for women who are pregnant, a special category for pregnant women was developed.

  • MA X - Medicaid for newborns whose mother is receiving Medicaid

    • For children who are born to a mother who receive Medicaid, Indiana provides Medicaid for the newborn without being subject to financial requirements.

  • MA Y - Medicaid for newborns whose mother is not receiving Medicaid

    • When a child is born to a mother who’s not receiving Medicaid, that child may be eligible for the MA Y category. This category provides benefits up to the child’s first birthday as long as the family’s circumstances don’t drastically change.

  • MA Z - Medicaid for children from 1 to 5 years old

    • When a child ages out of the MA Y or MA X category and is still eligible for Medicaid, he or she will have eligibility determined for the MA Z category of Medicaid which covers children aged 1 to 5 years old.

  • MA 2 - Medicaid for children from 6 to 18 years old

    • The category that follows MA Z is MA 2, this category covers children from age 6 to 18 years old. A child who is receiving MA Z benefits will transition to MA 2 if his or her family’s income is below a specific threshold.

  • MA 9 - Medicaid for children from 1 to 18 years old

    • Similar to other children’s categories, MA 9 covers children from age 1 to 18 years old, but has a higher income limit for financial eligibility purposes.

  • MA10 - Children’s Health Insurance Plan (CHIP)

    • Another children’s category, covering children up to age 18 is MA10, the category for the Children’s Health Insurance Plan (CHIP). According to specific eligibility criteria, families with children in MA10 may be required to pay a monthly payment known as a premium to continue receiving health coverage.

  • MA O - Medicaid for Children in Psychiatric Facilities

    • Children who are under 21 years old and reside in a psychiatric facility can be eligible for the MA O category of Medicaid until age 22 as long as they remain in the psychiatric facility.

  • MA E - Medicaid for Family Planning

    • MA E is a unique category of Medicaid, it provides benefits related to family planning. Individuals who are eligible for this category can receive products like oral contraceptives and services that help them plan for pregnancies.

  • MA14 - Medicaid for Foster Care Independence

    • When a child is a ward of a state other than Indiana on his or her 18th birthday, he or she can receive Medicaid in the MA14 category until his or her 21st birthday.

  • MA15 - Medicaid for Former Foster Care Children up to age 26

    • If a child was in foster care and received Medicaid on his or her 18th birthday, he or she can continue to receive Medicaid until his or her 27th birthday.

  • MAMA - Healthy Indiana Plan (HIP) Medicaid for pregnant women

    • Women who are receiving coverage through the Healthy Indiana Plan (HIP) and become pregnant will be moved to the MAMA category. This category allows coverage to continue through the end of the pregnancy. If her or her family income increases while she’s pregnant, then she’ll continue to receive coverage in the MAGP category mentioned above.

  • MASP - Healthy Indiana Plan (HIP) Medicaid - State Plus

    • Adults who are eligible for the Healthy Indiana Plan (HIP) and are low-income parents and caretaker relatives, are eligible for transitional medical assistance (TMA), or are considered medically frail can be eligible for the MASP category which provides additional benefits when compared to the basic flavors of the Healthy Indiana Plan (HIP).

  • MASB - Healthy Indiana Plan (HIP) Medicaid - State Basic

    • When an individual doesn’t make the monthly Personal Wellness and Responsibility (POWER) Account payments and has income below a certain threshold, the person will move to the State Basic category of the Healthy Indiana Plan (HIP).

  • MAPC - Healthy Indiana Plan (HIP) Medicaid - State Plan Plus with Co-Pays

    • If a person who was previously eligible for the MASP category and does not make the monthly Personal Wellness and Responsibility (POWER) Account payments (and meets a few additional criteria), he or she will move to the MAPC category. This category provides State Plan Plus benefits but requires Co-Pays.

  • MARP - Healthy Indiana Plan (HIP) Medicaid - Regular Plus

    • Adults who do not meet the criteria to be considered for the State Plan versions of the Healthy Indiana Plan (HIP) will be considered in the MARP category of the Healthy Indiana Plan (HIP).

  • MARB - Healthy Indiana Plan (HIP) Medicaid - Regular Basic

    • An adult who was previously eligible for the Regular Plus category of the Healthy Indiana Plan (HIP) and fails to make the monthly Personal Wellness and Responsibility (POWER) Account payments will transition to the Regular Basic category, MARB.

  • MANA - Healthy Indiana Plan (HIP) Medicaid for Native Americans

    • A special category of the Healthy Indiana Plan (HIP) was created for Native Americans and Alaska Natives who wish to: “be covered under fee-for-service rather than managed care.”

MED 4 Categories - MA L, MA J, MA G, and MA I

The Med 4 categories provide benefits for individuals who are receiving Medicare. Unlike other categories of Medicaid, some of the MED 4 categories can coexist with other categories of Medicaid.

  • MA L - Qualified Medicare Beneficiary (QMB)

    • A person who receives Medicare Part A can receive the MA L category of Medicaid. When a person is eligible for MA L, Medicaid will pay for certain costs associated with Medicare coverage. A person can receive benefits in this category at the same time they’re receiving another category of Medicaid.

  • MA J - Specified Low-Income Medicare Beneficiary (SLMB)

    • Another category that covers certain expenses related to Medicare is the MA J category. This category pays for a set of Medicare expenses. Just like the MA L category, a person can receive benefits in this category at the same time they’re receiving another category of Medicaid.

  • MA G - Qualified Disabled Working Individual (QDWI)

    • Just like the other categories in the MED 4 group, eligibility in the MA G category will cover certain expenses related to Medicare. Unlike MA L and MA J, however, MA G benefits cannot coexist with MA L and MA J.

  • MA I - Qualified Individuals (QI)

    • The final MED 4 category, MA I, also covers a certain portion of Medicare expenses. Like MA G, though, people receiving MA I are not able to receive benefits in another category of Medicaid while they’re receiving MA I benefits.

Other Medicaid Categories - MA 4, MA 8, MA12

There are three categories of Medicaid that are slightly different from the categories found in the previously mentioned groupings. These categories have specific requirements for who can receive benefits and have different eligibility rules as well.

  • MA 4 - IV-E Foster Care Children

    • Children in foster care who are eligible under Title IV-E of the Social Security Act can receive Medicaid benefits under the MA 4 Medicaid category. The MA 4 category does not have an income limit to make sure this vulnerable population continues to be covered under medical benefits.

  • MA 8 - Children in the Adoption Assistance Program

    • A child in the adoption assistance program can be eligible for Medicaid under the MA 8 category of Medicaid. Like MA 4, This category does not have an income limit to ensure that children in this situation won’t lose health coverage.

  • MA12 - Medicaid for individuals who have been diagnosed with Breast or Cervical Cancer

    • Women who have been diagnosed with Breast or Cervical Cancer and meet certain additional criteria can receive benefits under the MA12 category of Medicaid.

Medicaid Benefit Packages

When you’re determined eligible for Medicaid, you’ll receive medical benefits through something called benefit packages. Just like insurance, these packages have different levels of benefits and coverage. To simplify finding service providers (e.g., doctors) that accept Medicaid, the state provides an online search tool called the Indiana Health Coverage Programs (IHCP) Provider Locator.

Take note, depending on what type of Medicaid you have, you may need to find medical providers through your health plan rather than through the Indiana Health Coverage Programs (IHCP) Provider Locator:

If you are enrolled in Healthy Indiana Plan (HIP), Hoosier Care Connect, or Hoosier Healthwise, you should contact your health plan to find medical providers in your plan’s provider network. You may use this site to find dental providers but must call the provider to ensure that he or she is accepting your coverage type.

When you perform a search on the Indiana Health Coverage Programs (IHCP) Provider Locator, under the “Program or Delivery System” section, you’ll see the following:

The information that follows comes from the Indiana Health Coverage Programs Member Eligibility and Benefit Coverage Provider Reference Manual (found in the Eligibility and Benefits Module section on the linked page).

Medicaid

Sometimes referred to as “Full Medicaid” or “Traditional Medicaid”, this is the fee-for-service benefit package that individuals who receive Home and Community-Based Services (HCBS) Waivers will have.

This benefit package covers the following groups (see Section 2: Fee-for-Service Programs and Benefits in the Indiana Health Coverage Programs Member Eligibility and Benefit Coverage Provider Reference Manual):

The Traditional Medicaid program provides coverage for healthcare services rendered to individuals in the following groups who meet eligibility criteria, such as specific income guidelines:

• Persons in long-term care (LTC) facilities and other institutions, such as a nursing facility (NF) or an intermediate care facility for individuals with intellectual disability (ICF/IID)

• Persons eligible for Hoosier Healthwise who qualify for IHCP hospice benefits

• Persons eligible for a Home and Community-Based Services (HCBS) waiver program, including those with a waiver liability

• Persons with end-stage renal disease (ESRD), including those with a waiver liability

• Persons with both Medicare and Medicaid (dual eligibility)

• Persons enrolled in the Breast or Cervical Cancer Treatment Program

• Refugees who do not qualify for any other aid category

• Children receiving adoption assistance

• Wards of the State who opt out of Hoosier Care Connect

• Foster children

• Former foster children who turned 18 years of age while in foster care, are under age 26 (or under age 21, if the foster care was outside of Indiana), and opt out of Hoosier Care Connect

Hoosier Care Connect (HCC)

Generally, individuals who are in the categories of Medicaid that usually receive the “Full Medicaid” or “Traditional Medicaid” benefit package but don’t meet certain criteria like residing in an institution or receiving a Home and Community-Based Services (HCBS) Waiver will receive the Hoosier Care Connect benefit package (see Section 3: Managed Care Programs in the Indiana Health Coverage Programs Member Eligibility and Benefit Coverage Provider Reference Manual):

Hoosier Care Connect is a risk-based managed care program designed to improve the quality of care and clinical outcomes for members eligible for the IHCP on the basis of age, blindness, or disability. Hoosier Care Connect members pick and MCE [Managed Care Entity] and a primary doctor. The MCE [Managed Care Entity] assists members in coordinating their healthcare benefits and tailoring the benefits to individual needs, circumstances, and preferences. Hoosier Care Connect members receive full Medicaid State Plan benefits, in addition to care coordination services and other FSSA-approved enhanced benefits developed by the MCEs [Managed Care Entities].

Individuals in the following groups who meet eligibility criteria (including income guidelines, when applicable) and who do not reside in an institution, are not receiving services through a home and community-based services (HCBS) waiver, and are not enrolled in Medicare will be enrolled in Hoosier Care Connect:

• Aged individuals (age 65 and over)

• Blind individuals

• Disabled individuals

• Individuals receiving Supplemental Security Income (SSI)

• Individuals enrolled in Medicaid for Employees with Disabilities (M.E.D. Works)

Hoosier Healthwise (HHW)

The Hoosier Healthwise (HHW) Managed Care Program is the primary benefit package for MED 3 categories of Medicaid. Section 3: Managed Care Programs in the Indiana Health Coverage Programs Member Eligibility and Benefit Coverage Provider Reference Manual provides additional information about this benefit package:

The Hoosier Healthwise program provides coverage for children and for pregnant women who earn too much to qualify for HIP (138% FPL) but remain Medicaid eligible by having family income under 208% FPL.

Hoosier Healthwise assignment is mandatory for aid categories that include children and children who are eligible for the Children’s Health Insurance Program (CHIP), unless they are a member of an exempted group. The specific eligibility aid category (based on household income/size) determines the benefit package.

The following IHCP members are excluded from mandatory assignment to Hoosier Healthwise managed care:

• Individuals in nursing homes and other institutions, such as PRTFs and ICFs/IID

• Individuals receiving psychiatric treatment in a state hospital

• Immigrants who qualify for Emergency Services Only (Package E) coverage

• Individuals receiving HCBS waiver services  Individuals who are eligible for and opt to receive IHCP hospice services

• Members with HCBS waiver liability or end-stage renal disease (ESRD) waiver liability

• Members eligible for the Family Planning Eligibility Program

Healthy Indiana Plan (HIP)

The Healthy Indiana Plan (HIP), as found in Section 3: Managed Care Programs in the Indiana Health Coverage Programs Member Eligibility and Benefit Coverage Provider Reference Manual, is described as follows:

HIP [Healthy Indiana Plan] is a program sponsored by the state of Indiana that provides an affordable healthcare choice to thousands of individuals throughout Indiana. HIP [Healthy Indiana Plan] provides health insurance for adults ages 19 through 64 whose income is at or under 138% of the federal poverty level (FPL), who are not on Medicare, and who do not qualify for another Medicaid program. HIP [Healthy Indiana Plan] is a managed care program with vision and dental services, when applicable, carved into the managed care arrangement. Indiana offers HIP [Healthy Indiana Plan] members a comprehensive benefit package through a deductible health plan paired with a personal healthcare account called a Personal Wellness and Responsibility (POWER) Account (sometimes referred to as a PAC).

As mentioned in the MED 3 Categories of Medicaid section, the Healthy Indiana Plan (HIP) is comprised of a few different benefit plans that provide different types of services and coverage.

Package C

Package C is the benefit package for the MA10 category of Medicaid (see Section 3: Managed Care Programs in the Indiana Health Coverage Programs Member Eligibility and Benefit Coverage Provider Reference Manual for additional information):

Hoosier Healthwise Package C – Children’s Health Plan (SCHIP) provides preventive, primary, and acute healthcare coverage to children who meet the following eligibility criteria:

• The child must be younger than 19 years old.

• The child’s family income must be between 158% and 250% of the federal poverty level.

• The child must not have creditable health coverage or have had creditable health coverage at any time during a waiting period lasting no longer than 90 days.

• The child’s family must financially satisfy payment of monthly premiums.

Package C members fall under the State Children’s Health Insurance Program (SCHIP).

What is the definition of developmental disabilities in Indiana?

As referenced in the Home and Community-Based Services Waivers Provider Reference Manual (Section 4.2 p. 18):

Per Indiana Code IC 12-7-2-61, “developmental disability” means a severe, chronic disability of an individual that meets all the following conditions:

• Is attributable to:

– Intellectual/developmental disability, cerebral palsy, epilepsy, or autism, or

– Any other condition (other than a sole diagnosis of mental illness) found to be closely related to intellectual/developmental disability, because this condition results in similar impairment of general intellectual/developmental functioning or adaptive behavior, or requires treatment or services similar to those required for a person with an intellectual/developmental disability.

• Is manifested before the individual is 22 years of age

• Is likely to continue indefinitely

• Results in substantial functional limitations in at least three of the following areas of major life activities:

– Self-care
– Understanding and use of language
– Learning
– Mobility
– Self-direction
– Capacity for independent living
– Economic self-sufficiency

An individual with an intellectual/developmental disability must also be found to meet the federal LOC [Level of Care] requirements for admission into an ICF/IID [Intermediate Care Facilities for Individuals with Intellectual Disabilities] and be approved for entrance into the waiver program before receiving waiver-funded services through an Indiana Medicaid HCBS [Home and Community-Based Services] waiver program operated by the DDRS [Division of Disability and Rehabilitative Services].

What is the Level of Care requirement for admission into an Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF/IID)?

As stated on the Indiana Medicaid for Members Community Integration and Habilitation Waiver Page:

For the purposes of ICF/IID level of care, a person must have a disability that:

• Results in impairment of functioning similar to that of a person who is intellectually disabled, including autism spectrum disorder, epilepsy, cerebral palsy, or a similar condition (other than mental illness)

• Originates before the person is twenty-two (22) years of age

• Has continued or is expected to continue indefinitely

• Substantially limits a person's ability to function normally in society in three of the six major life areas: self-care, receptive and expressive language, learning, mobility, self-direction, and capacity for independent living.

• Requires access to 24-hour assistance, as needed.

What are Medicaid Waivers?

In the early stages of the Medicaid program (during the 1970s) people, when families were unable to cover the cost of caring for individuals with disabilities the people with disabilities were often sent to live in long-term care facilities. Medicaid would cover the cost of a person living in one of these facility but would not, at that point in time, cover the cost of services provided to individuals outside of these facilities.

Under the idea that many people with disabilities could live and thrive in the community, the Medicaid waiver program was started in 1981 to allow these people to avoid institutionalization while still being able to receive the services they need. These waivers, known as Home and Community-Based Services (HCBS) Waivers focus on providing services to individuals living in the community.

The Arc of Indiana created an Introduction to Indiana’s Medicaid Waiver Program for Home and Community Based Services Guide (pdf). This document includes a description of the waiver programs in Indiana with contact information for relevant agencies in the state. It also has a section on Charting the LifeCourse, a tool that helps create a plan for a good life.

For people with intellectual and/or developmental disabilities, there are two waivers managed by the Bureau of Developmental Disabilities Service (BDDS): the Family Supports Waiver (FSW) and the Community Integration and Habilitation (CIH) Waiver.

The Division of Aging manages two waivers as well: the Traumatic Brain Injury (TBI) Waiver and the Aged and Disabled (A&D) Waiver.

In order to be eligible for a Medicaid Waiver you must apply and be determined eligible for Medicaid. Further, you need to be determined eligible for specific categories of Medicaid which are explained in the following section.

Categories of Medicaid required to become eligible for Medicaid Waivers

As found in the Indiana Medicaid Policy Manual (section 3310.00.00), there are certain categories of Medicaid a person must be eligible for in order to receive a Home and Community-Based Services Waiver. The categories are the following:

Bureau of Developmental Disabilities Services (BDDS)

The Bureau of Developmental Disabilities Services (BDDS), a division of the Developmental Disability Rehabilitation Services (DDRS) manages two waivers that aim to provide services for individuals with intellectual and developmental disabilities. The waiver programs are designed to help people live independently. In addition to running the waiver programs, the Bureau of Developmental Disabilities Services (BDDS) also makes sure service providers are meeting standards of quality throughout the state.

Family Supports Waiver (FSW)

The Family Supports Waiver (FSW) is a Home and Community-Based Services (HCBS) waiver focusing on providing “limited, non-residential supports to individuals with developmental disabilities who live with their families or in other settings with informal supports” (from the Indiana Medicaid Family Supports Waiver Page).

Which services are available with the Family Supports Waiver (FSW)?

As referenced in the Home and Community-Based Services Waivers Provider Reference Manual (Section 4.5 on p. 19), the services available to individuals who are eligible for the Family Supports Waiver (FSW) are the following:

• Adult Day Services
• Behavioral Support Services
• Case Management
• Community-Based Habilitation − Group
• Community-Based Habilitation – Individual
• Extended Services
• Facility-Based Habilitation − Group
• Facility-Based Habilitation − Individual
• Facility-Based Support Services
• Family and Caregiver Training
• Intensive Behavioral Intervention
• Music Therapy
• Occupational Therapy
• Participant Assistance and Care
• Personal Emergency Response System
• Physical Therapy
• Prevocational Services
• Psychological Therapy
• Recreational Therapy
• Respite
• Specialized Medical Equipment and Supplies
• Speech/Language Therapy
• Transportation
• Workplace Assistance

Community Integration and Habilitation Waiver (CIH)

The Community Integration and Habilitation (CIH) Waiver is a Home and Community-Based Services (HCBS) waiver focusing on providing “services that enable individuals to remain in their homes or community-based settings and also assists individuals who are transitioning from state-operated facilities or other institutions into community settings” as mentioned on the Indiana Medicaid Community Integration and Habilitation Waiver Page.

Which services are available with the Community Integration and Habilitation Waiver (CIH)?

As referenced in the Home and Community-Based Services Waivers Provider Reference Manual (Section 4.6 on p. 21), the services available to individuals who are eligible for the Community Integration and Habilitation Waiver (CIH) are the following:

• Adult Day Services
• Behavioral Support Services
• Case Management
• Community-Based Habilitation − Group
• Community-Based Habilitation – Individual
• Community Transition
• Electronic Monitoring
• Environmental Modifications
• Extended Services
• Facility-Based Habilitation − Group
• Facility-Based Habilitation − Individual
• Facility-Based Support Services
• Family and Caregiver Training
• Intensive Behavioral Intervention
• Music Therapy
• Occupational Therapy
• Personal Emergency Response System
• Physical Therapy
• Prevocational Services
• Psychological Therapy
• Rent and Food for Unrelated Live-In Caregiver
• Residential Habilitation and Support (provided hourly)
• Residential Habilitation and Support – Daily (RHS Daily)
• Recreational Therapy
• Respite
• Specialized Medical Equipment and Supplies
• Speech/Language Therapy
• Structured Family Caregiving
• Transportation
• Wellness Coordination
• Workplace Assistance

How do I apply for a Medicaid Waiver?

Starting February 2021, you can now apply for Medicaid Waivers through a new Bureau of Developmental Disabilities Services (BDDS) online application gateway: https://bddsgateway.fssa.in.gov/.

Using the online application gateway is the quickest way to apply for services and you should prefer applying through the online application. Additional information and a video tutorial can be found on the Bureau of Developmental Disabilities Services (BDDS) home page: https://www.in.gov/fssa/ddrs/developmental-disability-services/.

Applying for Services Offline

If you prefer to apply for waivers offline, you can also contact the Bureau of Developmental Disabilities Services (BDDS) regional office for the region where you live. Call 800-545-7763 and you’ll be directed to the correct local office to begin the application process.

Bartholomew County is in District 8. The District 8 regional office contact information is found below:

1452 Vaxter Avenue
Clarksville, IN 47129-7721
Phone: 812-283-1040
Toll Free: 877-218-3529 (V/VRS/711)
Toll Free Fax: 855-525-9376

For people who don't reside in Bartholomew County, an online map, showing the district for each county, is available.

When you contact the regional office, you'll receive an application packet with the forms and information you'll need to complete to apply for Medicaid Waivers. The Developmental Disability Rehabilitation Services (DDRS) Forms page contains links to the relevant forms. There are direct links in the Forms included in the Medicaid Waiver Application Packet section below to specific forms as well.

Forms Included in the Medicaid Waiver Application Packet

If You Need Help Applying for a Waiver Program

If you need assistance completing the waiver application, contact The Arc of Indiana at 317-977-2375 or 800-382-9100 and ask to speak to a Family Advocate. You can also reach out to The Arc of Bartholomew County to receive an application.

Waiver Waitlist

Once you've applied and are determined eligible to receive a waiver, you may be placed on a waitlist. Due to funding allocations, you may be on the waitlist for a long time. It isn't uncommon for applicants to stay on the waitlist for 12 months or longer.

Bureau of Developmental Disabilities Services (BDDS) Online Waitlist Portal

Since you may be on the waitlist for a while, the state created a Waitlist Web Portal to keep your information up-to-date and confirm waiver application dates.

If your information changes, you'll need to click the "Help Desk" link in the portal to make the updates. It can take 5-7 business days for updates to be made, so after you've requested changes be sure to check back and confirm that the new information is populated.

References & Quick Links

Medicaid

Medicaid Policy

Medicaid Service Providers

Medicaid Waivers

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