What Is an HCBS Waiver?
How 1915(c) and other home- and community-based Medicaid authorities can support long-term care outside institutions.
Home and Community-Based Services allow eligible Medicaid beneficiaries to receive long-term services and supports in their homes or community settings rather than only in institutions.
How a 1915(c) waiver works
A state applies to CMS for authority to operate a waiver for a defined population. The state identifies who may enroll, which services are covered, how providers qualify, and how health and welfare will be protected.
Why programs differ by state
- States can target different age, disability, or clinical groups.
- Covered services and provider networks vary.
- Enrollment may be capped, which can create waiting lists.
- Some states use managed long-term services and supports instead of a stand-alone waiver.
Common HCBS services
Direct supports
- Personal care
- Homemaker services
- Respite
- Adult day services
- Supported living
Clinical and coordination
- Case management
- Nursing
- Therapies
- Medical equipment
- Transportation
Waiver does not mean automatic eligibility
A person must still satisfy the waiver's financial, functional, residency, and target-population requirements and obtain an approved service plan.
This page provides general educational information, not legal or benefits advice. Medicaid rules and program availability change. Verify current details with the appropriate state agency and qualified professionals.