A Comprehensive Guide to Medicaid Waiver Waitlists in Texas – Texas HCS 101

by Mary Jenkins  - April 27, 2023

A Comprehensive Guide to Guide To Medicaid Waiver Waitlists in Texas

A Comprehensive Guide to Medicaid Waiver Waitlists in Texas - Texas HCS 101 1 May 2024

As the population of Texas continues to grow, so does the demand for Medicaid waiver services. Unfortunately, the state’s Medicaid waiver waitlists are becoming increasingly long. This comprehensive guide provides an overview of the Medicaid waiver waitlists in Texas, as well as information on how to get on (and off) of them. By the end of this article you will have a solid understanding of:

  • How the Medicaid waiver system works in Texas
  • What services are available through Medicaid waivers
  • How to get on a Medicaid waiver waitlist in Texas
  • What to do if you are on a Medicaid waiver waitlist in Texas

What is a Medicaid Waiver?

A Comprehensive Guide to Medicaid Waiver Waitlists in Texas - Texas HCS 101 3 May 2024

In simple terms, a Medicaid waiver allows states to provide Medicaid coverage to groups of people who would not normally be eligible for the program. In exchange for this flexibility, the federal government provides additional funding to the state.

In Texas, there are six different types of Medicaid waiver programs:

  • Community Living Assistance and Support Services (CLASS) Waiver
  • Home and Community-based Services (HCS) Waiver
  • Texas Home Living (TxHmL) Waiver
  • Star+Plus Waiver
  • Medically Dependent Child Program (MDCP)
  • Deaf-Blind with Multiple Disabilities (DBMD)

Each of these programs has different eligibility requirements and provides different services. However, all six programs are designed to help people with disabilities live as independently as possible in their homes and communities. Most Medicaid waiver programs fall under the management of the Texas Health and Human Services Commission (HHSC).

What Services Are Available Through Medicaid Waivers?

A Comprehensive Guide to Medicaid Waiver Waitlists in Texas - Texas HCS 101 5 May 2024

The services available through Medicaid waiver programs vary depending on the program. However, all programs are designed to help people with disabilities live as independently as possible in their homes and communities.

Some of the most common services offered through Medicaid waiver programs include:

  • Personal care services
  • Respite care
  • Transportation
  • Occupational therapy
  • Physical therapy
  • Speech therapy
  • Nutritional counseling
  • Case management
  • Behavioral health services
  • Day habilitation
  • Supported living
  • Community integration

How Do You Get on a Medicaid Waiver Waitlist in Texas?

A Comprehensive Guide to Medicaid Waiver Waitlists in Texas - Texas HCS 101 7 May 2024

There are three main ways to get on a Medicaid waiver waitlist in Texas:

1. Contact your Local IDD Authority (LIDDA)

2. Contact a local waiver services provider

3. Contact your local Medicaid office

How to Find Your LIDDA

Here is a map of all of the Local IDD Authority (LIDDA) offices in the state of Texas. Choose the LIDDA closest to your area to contact them for more information about Medicaid waiver services.

What to Do If You Are on a Medicaid Waiver Waitlist in Texas

A Comprehensive Guide to Medicaid Waiver Waitlists in Texas - Texas HCS 101 9 May 2024

If you are on a Medicaid waiver waitlist in Texas, there are several things you can do to improve your chances of getting off the waitlist and into a program:

Stay in contact with your Local IDD Authority (LIDDA) or waiver services provider

Staying in contact with your LIDDA or waiver services provider is the best way to ensure that you are kept up-to-date on any changes in the status of your application or waitlist status. As the old saying goes, “The squeaky wheel gets the grease.”

Advocate for yourself or your loved one

If you are on a Medicaid waiver waitlist in Texas, it is important to advocate for yourself or your loved one. This means staying informed about the waiver process and knowing your rights, as well as contacting your elected officials and letting them know about the importance of Medicaid waiver programs.

Keep your Medicaid eligibility up to date

It is important to keep your Medicaid eligibility up to date, even if you are on a waitlist for a Medicaid waiver program. This will ensure that you do not lose your place on the waitlist, and it will also make it easier to transition into a program once you are off the waitlist.

Be prepared to provide documentation of your disability

When you are applying for a Medicaid waiver, it is important to be prepared to provide documentation of your disability. This can include a doctor’s letter, educational records, or any other documentation that shows that you meet the eligibility requirements for the program you are applying for.

Be prepared for your ICAP assessment

If you are applying for a Medicaid waiver in Texas, you will need to undergo an ICAP assessment. This assessment is used to determine your level of care and whether you are eligible for the waiver program you are applying for. Be prepared to answer questions about your medical history, functional abilities, and living situation.

Be flexible with your service needs and preferences

When you are on a Medicaid waiver waitlist in Texas, it is important to be flexible with your service needs and preferences. This means being open to trying different types of services, as well as different providers. It is also important to remember that not all services are available in all areas.

Have a backup plan

It is always a good idea to have a backup plan, especially if you are on a Medicaid waiver waitlist. This backup plan could include private insurance, long-term care insurance, or other sources of funding. Having a backup plan will help you be prepared in case you do not get off the waitlist in time.

Stay positive and have hope

It can be easy to feel discouraged when you are on a Medicaid waiver waitlist. However, it is important to stay positive and have hope. Remember that there are people who care about you and want to see you succeed.

How Long Might You Be on the Medicaid Waiver Waitlist in Texas?

A Comprehensive Guide to Medicaid Waiver Waitlists in Texas - Texas HCS 101 11 May 2024

The length of time you might be on a Medicaid waiver waitlist in Texas depends on several factors, including the type of waiver you are applying for and the number of people ahead of you on the waitlist. In some cases, you may only be on the waitlist for a few months. However, in other cases, you may be on the waitlist for several years.

April 2022 Interest List Counts, by Years on List

Here is the official Medicaid waiver interest list count by years on the list courtesy of Texas HHSC’s website:

A Comprehensive Guide to Medicaid Waiver Waitlists in Texas - Texas HCS 101 13 May 2024

 

What Happens If You Get Off the Waitlist?

A Comprehensive Guide to Medicaid Waiver Waitlists in Texas - Texas HCS 101 15 May 2024

If you are fortunate enough to get off the Medicaid waiver waitlist in Texas, you will be able to enroll in the waiver program you applied for. This means that you will be able to receive the services and support you need. If you have any questions about the waiver program you are enrolled in, be sure to contact your case manager or service provider.

What Happens If You Do Not Get Off the Waitlist?

A Comprehensive Guide to Medicaid Waiver Waitlists in Texas - Texas HCS 101 17 May 2024

If you do not get off the Medicaid waiver waitlist in Texas, you will not be able to enroll in the waiver program you applied for. However, this does not mean that you will not be able to receive services and support. There are many community-based programs and services available to people with disabilities in Texas, and you are allowed to be on multiple waitlists. Additionally, you can always reapply for the waiver program you are interested in.

What If You Can’t Get Off the Medicaid Waiver Waitlist in Texas?

A Comprehensive Guide to Medicaid Waiver Waitlists in Texas - Texas HCS 101 19 May 2024

If you are unable to get off the Medicaid waiver waitlist in Texas, there are still options available to you. One option is to appeal the decision. Another option is to find a different type of program that may be a better fit for your needs. Finally, you can always try to get on a different waitlist.

Conclusion

A Comprehensive Guide to Medicaid Waiver Waitlists in Texas - Texas HCS 101 21 May 2024

No one can predict how long they will be on a Medicaid waiver waitlist in Texas, but by being prepared and flexible, you can increase your chances of getting off the list quickly. If for some reason you are unable to get off the waitlist, there are still options available to you. Stay positive and have hope, as the people who care about you want to see you succeed.

About Above and Beyond Caring

A Comprehensive Guide to Medicaid Waiver Waitlists in Texas - Texas HCS 101 23 May 2024

Above and Beyond Caring is a Texas Home and Community-based Services (HCS) provider that has helped individuals with intellectual and developmental disabilities live and thrive in their communities since 2007. Our mission is to provide high quality, individualized supports and services to people with disabilities that enable them to live their best lives possible, and we are dedicated to helping our clients live their best lives possible. Call us today at (979) 202-0055 to learn more about our services or to get started on your journey to getting off the Medicaid waiver waitlist.

About Mary Jenkins

Mary Jenkins has over 25 years experience helping individuals with IDD live and thrive in their community. She founded Above and Beyond Caring in 2007 to provide Texas HCS services in the Texas Gulf Coast area. She is also the Director of the Community Inclusion Project, a 501c3 nonprofit dedicated to ensuring all individuals have access to their community. She is passionate about her work and believes that everyone deserves the opportunity to be a part of, and contribute to, the world around them. Mary is a tireless advocate who is passionate about helping individuals with IDD live fuller, more meaningful lives.

A Comprehensive Guide to Medicaid Waiver Waitlists in Texas - Texas HCS 101 25 May 2024
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