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Medicaid — Community Waivers Plan

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The Medicaid Community Waivers Plan helps elderly persons and persons who are blind or have disabilities to continue living in their own homes or in the community, rather than in state institutions or nursing homes. If you are enrolled in Medicaid through the Community Waivers Plan, Medicaid may pay for certain supportive services. 

You may be able to enroll in Community Waivers if you are an elderly person or a person who is blind or has a disability and you:

  • Meet income and asset rules specific to the Community Waivers Plan (see Income and Assets);
  • Meet the same rules used to qualify for Medicaid coverage of nursing home care;
  • Are a citizen or qualified immigrant and are a resident of Wisconsin; and
  • Live in your own home or in the community.

You may be able to enroll in a Community Waivers Plan, if you are enrolled in Medicaid or Supplemental Security Income (SSI).

Income and Assets

If you are not enrolled in Medicaid or SSI, the following income and asset rules be used as guidelines. The income amounts may change slightly from year to year. Starting January 1, 2009, the amounts are:

  • Your assets cannot total more than $2,000.
  • If your gross monthly income is $2,022, or under, you may be able to enroll. You may have to pay a share of the medical costs, depending on your income.
  • If your gross monthly income is more than $2,022, but your medical cost reduce your monthly income to less than $592, you may be able to enroll. In most cases, you will have to spend a portion of your income on medical services each month before being able to enroll in Medicaid. 

Note: The income/asset rules for minors are based on the child’s assets and income only. A minor child with a disability must also meet all rules for the Community Waivers Plans.

If you are married and live with your spouse and you are enrolled in a Community Waivers Plan, your spouse’s income and many of your joint assets may be protected. Ask your local agency for information on Spousal Impoverishment protection or go to dhs.wi.gov/medicaid/Publications/p-10063.htm.

Cost-Sharing

If you are a Community Waivers participant, you may have to pay some of your medical costs depending on your income. This is called “cost-sharing”. Only your income will be used to determine how much you have to pay.

The local agency in the county where you live will make the decision on your application for Community Waivers. Ask about any of the rules that are not clear to you.

For More Information:

Information provided in this document is general. To find more detailed information regarding the Community Waivers Plans, please contact your local agency. To find the address of your local agency or Medicaid outstation site go to dhs.wi.gov/em/customerhelp or call Member Services at 1-800-362-3002.

DHS is an equal opportunity service provider. If you have a disability and need to access this information in an alternate format, or need it translated to another language, contact (608) 266-3356 or 1-888-701-1251 TTY. All translation services are free of charge.

For civil rights questions call (608) 266-9372 or 1-888-701-1251 TTY.

P-10059 (09/09)