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How to Apply: Medicaid I/DD Waiver Admission

General Qualification Criteria for Medicaid I/DD Waiver Admission

Once you have been found eligible for DDD and been assigned a case manager, you may apply for the Medicaid 1915(c) Home and Community-Based Services (HCBS) Waiver for individuals with intellectual and developmental disabilities (Medicaid I/DD Waiver). Eligibility for the Medicaid I/DD Waiver is determined by the Department of Human Services, Med-QUEST Division (MQD) . You must meet the following criteria:

  • Assessed to need services at the Intermediate Care Facility for Individuals with Intellectual Disabilities (ICF-IID) Level of Care
  • Eligible for Medicaid coverage through MQD/Eligibility Branch
  • Eligible for Long Term Care (LTC) benefit through Medicaid

How to Apply for Medicaid I/DD Waiver

Step 1: Inform your case manager of your interest in applying for the Medicaid I/DD Waiver

Your case manager will help you complete and sign the Request to Participate in Home and Community-Based Services for People with Intellectual and Developmental Disabilities form.

Step 2: Participate in the ICF-IID Level of Care Assessment

Your case manager will inform you of the required documents and submit them for an ICF-IID Level of Care authorization approved by the Medical Director of MQD.

Step 3: Apply for Medicaid coverage and Long Term Care benefit

Upon approval of ICF-IID Level of Care, your case manager will assist you in applying for Medicaid coverage, if applicable, and Long Term Care benefit .

Step 4: Receive eligibility determination

The MQD eligibility worker will determine if you are eligible for services through the Medicaid I/DD Waiver by determining eligibility for Medicaid coverage and Long Term Care benefit.

  • If you are eligible for Medicaid I/DD Waiver services, your case manager will work with you to get services started within 90 days from the date that Long Term Care eligibility determination is made.
  • If you are not eligible for Medicaid I/DD Waiver services, you have the right to appeal the decision within 90 days of the dated MQD notice. You may also re-apply at a later time if your situation changes and new information is available.

Important Note: If you are eligible for Medicaid I/DD Waiver services, MQD is required to reassess eligibility every year to ensure that you continue to meet the eligibility requirements for Medicaid coverage and Long Term Care benefit.