Medicaid Long Term Care Coverage for Home Modifications & Assistive Technology
Summary
Home modifications can become necessary for people who are older or have a chronic illness, and almost every state has a Medicaid program that will help pay for these modifications. Wheelchair ramps, widening of hallways, grab bars, and even simple improvements like brighter lighting are all home modifications that might help your loved one remain living independently, so they are all likely to be covered by Medicaid. Every state has different rules, but one guiding principle for Medicaid Long Term Care across the country is the goal of keeping people in their homes and delaying the move to nursing homes for as long as possible. Changing a house to make it safer and more accessible fulfills that goal.
Table of Contents
Last Updated: Jun 05, 2023
What Defines a Home Modification According to Medicaid?
In addition to home modifications like wheel chair ramps, some items that might be considered assistive technology or adaptive technology (like large digital displays or easy-use light fixtures) are also defined as home modifications by Medicaid. Examples of Medicaid-defined home modifications include the following:
- Accessory apartments: additions to the home that provide a safe living space for the disabled person or their caregiver
- Larger digital displays: make important readouts like clocks, climate controls, and computer monitors easier to see for someone who is vision-impaired
- Easy-use fixtures: oversized light switches, levers instead of knobs on faucets, etc.
- Grab bars or handrails: usually in the bathroom, hallway, or stairs
- Brighter lighting
- Roll-out shelving for easy access to food, clothes, and other stored items
- Push-button automatic door openers
- Security systems for remote monitoring
- Personal Emergency Response Systems (PERS) in case of an accident (a.k.a. Medical Alerts)
- Flooring upgrades, like replacing carpet with smooth surfaces for a wheelchair
- Stair lifts to get up and down stairs while seated in an electric chair
- Traction strips in the bathroom or wherever a slick floor might be dangerous (like on stairs)
- Transfer chairs or benches for getting into a wheelchair or the tub/shower
- Walk-in tub/shower that is wheelchair accessible with a seat
- Wheelchair ramps
- Widening doorways and/or hallways
What Defines a Home According to Medicaid?
A beneficiary’s single-family house may be the most common place for Medicaid-funded home modifications, but it’s not the only one. If the beneficiary lives in the home of a family member or a loved one, Medicaid may cover home modifications in those settings, depending on the state and the program. And the home of the beneficiary or their loved one could be a condo, a mobile home, a house boat, or a unit in a multi-family house or an apartment building. However, it’s important to check with the owner of the property before making any physical changes if the home is rented.
Difference Between Labor and Materials
Depending on the state and particular Medicaid program, it might be necessary to distinguish between labor and materials when making home modifications. Materials are the equipment, like stair lifts or grab bars, that are installed in the home. Labor is the work to install it. It is possible that your state’s Medicaid Long Term Care program covers the cost of materials, but not labor.
Materials would be classified officially as durable medical equipment, or DME, which is usually covered by the Medicaid programs described on this page, especially Home and Community Based Services (HCBS) waivers.
While Medicaid might not cover costs for installing home modifications, this doesn’t mean you need to pay out-of-pocket for installation. Many communities have local organizations that provide the labor to install home modifications for free. Medicaid programs are for low-income individuals, and sometimes contractors offer reduced rates, or in some cases even free labor for those considered financially needy. To connect with programs that help find volunteers or reduced rates for labor to install home modifications, click here.
Types of Medicaid That Pay for Home Modifications
Home modifications are just the type of cost-saving services Medicaid is evolving to cover. The aim of many Medicaid programs is to keep someone in their own home for as long as possible, because nursing homes are expensive and Medicaid pays 100% of the cost for qualified individuals. Sometimes, a change as simple as installing a stair lift or wheelchair ramp can make the difference between staying at home or needing to move into a nursing home.
Home and Community Based Services Waivers
One of the most common ways for Medicaid to pay for home modifications is through a Home and Community Based Services (HCBS) Waiver. Exactly what type of home modifications an HCBS Waiver will cover depends on the state where you live and the HCBS Waiver (some states have more than one). Some states and Waivers distinguish between assistive technology, like brighter lighting, and actual physical modifications, like wheelchair ramps. Some states and Waivers might cover the cost of equipment and materials, but not the labor to install it. Some might not pay for home modifications that increase the size or value of the home. Some might cover modifications if the beneficiary lives in the home of a family member or a loved one, some might not.
While the rules and scope of HCBS Waivers depend on the state and the program, all HCBS Waivers are designed to delay nursing home placement. This is a win-win situation since most seniors would prefer to live in their own home for as long as possible, and it’s in the state’s best interest to provide the most cost-effective care. Home modifications can help achieve both of those goals.
Aged, Blind and Disabled Medicaid
Home modifications may also be covered through Aged, Blind and Disabled (ABD) Medicaid. ABD Medicaid can sometimes be referred to as state Medicaid or regular Medicaid for seniors, but it should not be confused with the regular Medicaid that is available for low-income people of all ages.
Seniors only need to be age 65 or older to qualify for ABD Medicaid. However, applicants will be evaluated by the state, and if they need long-term care services and supports to live independently in the community, including home modifications, ABD Medicaid may cover those modifications. The coverage depends on the needs and circumstances of the individual, the ABD Medicaid coverage in their state of residence, as well as the type and cost of the necessary home modifications.
ABD Medicaid is an entitlement, which means that anyone who meets the requirements is guaranteed by law to receive the benefits without any wait, including long term care benefits. This is different from Home and Community Based Service (HCBS) Waivers. Instead, HCBS Waivers have a limited number of enrollment spots, and once those spots are full, additional applicants are placed on a waitlist before receiving benefits. So, being an entitlement is a plus for ABD Medicaid. A plus for HCBS Waivers is that, in general, they have less strict financial eligibility criteria than ABD Medicaid.
Consumer Directed Care
Even if home modifications are not specifically listed as benefits for Home and Community Based Services (HCBS) Waivers, ABD Medicaid, or any other Medicaid program in your state, it may still be possible to pay for home modifications with Medicaid funds via Consumer Directed Care. With Consumer Directed Care, Medicaid beneficiaries are given a predetermined budget and can spend that on approved healthcare services and supports, which may include home modifications.
For example, a Medicaid beneficiary is enrolled in an HCBS Waiver that doesn’t list home modifications as a benefit, but it does have a Consumer Directed Care option. That beneficiary can pay for home modifications with their Consumer Directed Care budget, as long as it’s approved by their state Medicaid agency.
Managed Care
Some states deliver Medicaid Long Term Care services and supports through a Managed Care Organization. Managed care programs offer benefits similar to Home and Community Based Services (HCBS) Waivers, including labor and materials for home modifications, provided through Managed Care Organizations (MCOs) that have formed a relationship with Medicaid to make delivery of benefits more efficient. Medicaid Managed Care programs have replaced HCBS Waivers in some states, like Florida, where the former HCBS Waiver benefits are now delivered through the Statewide Medicaid Managed Care (SMMC) Program.
Money Follows the Person
Sometimes, an individual will spend time in a nursing home, but then wish to return to living in their own home, or somewhere else in the community. They may have suffered an injury or needed to recover from surgery, or maybe they have come to realize full-time nursing home care is not necessary. Money Follows the Person (MFP) is a Medicaid program that will help cover expenses related to moving out of a nursing home and into the community. That help might include paying for home modifications that would allow the Medicaid beneficiary to live independently in their home in the community as opposed to the nursing home.
MFP can also cover transition costs like paying for movers, rental deposits, utility set-up fees, and basic furnishings. MFP is currently available in 37 states and Washington, D.C. In some states it is simply called Money Follows the Person, but it has alternative names in other states. In West Virginia, for example, it is called Take Me Home, and in Maine it is called Homeward Bound.
Finding Medicaid Programs that Pay for Home Modifications
Medicaid is different in every state, but they all have some form of Long Term Care program and almost all of them have a benefit to cover home modifications. The eligibility criteria is different in every state, meaning it varies what level of functional and financial need qualifies a person to receive Medicaid benefits. The amount of financial help will also vary, as some programs offer coverage for materials and labor both, while others do not. Likewise, some states offer Consumer Directed Care (see above) and others do not.
What follows is a state-specific list of Medicaid programs that cover home modifications for people who are elderly or infirm, and would need to move into a nursing home if not for long term care services and supports, including home modifications.
Medicaid Programs that Cover Home Modifications & Assistive Technology by State – Updated May 2023 | |
Alabama | – State of Alabama Independent Living (SAIL) Waiver: Benefits for this HCBS Waiver include an assistive technology needs evaluation, as well as necessary home modification equipment, installation, and repairs. For more information and an application, click here.
– Elderly & Disabled (E&D) Waiver: Benefits for this waiver include assistive technology, durable medical equipment and home modifications. For more information and an application, click here. – Alabama Community Transition (ACT) Waiver: For people who wish to move from a nursing home back into their own home, ACT covers assistive technology and home modifications up to $5,000. More information at this link. |
Alaska
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– Alaskans Living Independently (ALI) Waiver: Benefits for this HCBS Waiver include home modifications and specialized medical equipment. Contact the Alaska Department of Health and Human Services for more information or to apply.
– Alaska Adults with Physical and Developmental Disabilities (APDD) Waiver: For adults of any age with intellectual or developmental disabilities, APDD helps cover costs including home modifications and specialized medical equipment. Contact the Alaska Department of Health and Human Services to apply. |
Arizona
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– Arizona Long Term Care Services (ALTCS): This program provides long term care benefits, including home modifications and durable medical equipment, to Arizona Medicaid recipients who live in the community through the Arizona Health Care Cost Containment System (AHCCCS). For more information including how to apply, click here.
– Arizona Self-Directed Attendant Care (SDAC): This “cash and counseling” program allows the recipient to manage their own benefits, and will cover the costs of remaining independent at home, including home modifications. For more, click here. |
California
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– Multipurpose Senior Services Program (MSSP) Waiver: Available in 45 California counties, benefits of the MSSP Waiver include home modifications, assistive technology, and non-medical home equipment. For more, click here.
– Home and Community-Based Alternatives (HCBA) Waiver: Intended for Medi-Cal recipients who are medically fragile or technology dependent, benefits if the HCBA Waiver include assistive technology and home modifications. For more information and how to apply, click here. |
Colorado
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– Elderly, Blind & Disabled (EBD) Waiver: Home modifications for safety and accessibility are among the long term care benefits for this HCBS Waiver. For more on the EBD Waiver, including how to apply, click here. |
Connecticut
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– Community First Choice (CFC) Option: Home modifications and assistive technologies are listed as benefits of this program, which is delivered through ABD Medicaid, known as Husky C in Connecticut, which means there is no waitlist. For more on Connecticut’s CFC Option, click here.
– Connecticut Home Care Program for Elders (CHCPE): This program covers minor home modifications via an HCBS Waiver, the Connecticut Home and Community Based Service Waiver for the Elderly, and through ABD Medicaid via the Home and Community Based Services Benefit. For more on CHCPE, click here. |
Delaware
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– Diamond State Health Plan Plus: This Medicaid managed care program will cover home modifications through its Long Term Care Community Services program, which is an entitlement. For more on the Diamond State Health Plan Plus, click here. |
District of Columbia
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– Elderly and Persons with Disabilities Waiver: Home modifications are listed among the benefits for this HCBS Waiver, which also refers to those modifications as, “environmental accessibility adaptations. For more on the EPD Waiver, click here. |
Florida | – Statewide Medicaid Managed Care Long-Term Care (SMMC LTC): This program provides all of the in-home long term care benefits to Florida Medicaid recipients, including home modifications. SMMC is divided into 11 regions with various managed care programs providing benefits, so coverage will vary. For more on Florida’s Statewide Medicaid Managed Care Long-Term Care program, click here. |
Idaho
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– Aged & Disabled (AD) waiver: This HCBS Waiver covers home modifications, but calls them “environmental accessibility adaptions,” along with other long term care services and supports like home-delivered meals and Personal Emergency Response Systems (PERS). For more on Idaho Medicaid, click here. |
Indiana
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– Aged and Disabled (A&D) Medicaid Waiver: In addition to home modifications, this HCBS Waiver will cover home modification assessments. Indiana’s A&D Waiver also covers vehicle modifications. For more on Indiana’s A&D Waiver, click here. |
Iowa
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– Iowa Medicaid Home and Community Based Services (HCBS) Elderly Waiver: Iowa’s HCBS Waiver can directly cover home modifications, and beneficiaries can also pay for all of the modification or part of them, like a specific piece of equipment or a hand-picked contractor, using the Consumer Choices Option. To check your Iowa Medicaid eligibility or apply, click here. |
Kansas
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– Frail Elderly (FE) Waiver: Assistive Technology, which can include home modifications as well as durable medical equipment, is one of the benefits Kansas Medicaid, which is called KanCare, lists for this HCBS Waiver. For more on Kansas’s FE Waiver, click here. |
Kentucky
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– Home and Community Based Waiver: Kentucky Medicaid will cover “environmental and minor home adaptation” using its HCB Waiver, which will also cover home delivered meals and attendant care. For more on Kentucky’s HCB Waiver, click here. |
Louisiana
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– Community Choices Waiver: Home modifications to aid in self care, as well as assistive technologies, are covered by the Louisiana’s CCW Waiver. For more on Louisiana’s Community Choices Waiver, click here. |
Maine
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– Medicaid Waiver for Elderly and Adults with Physical Disabilities: Maine Medicaid, which is called MaineCare, will cover home modification, assistive technology, and fall prevention goods using this HCBS Waiver. For more, click here. |
Maryland
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– Home and Community Based Options (HCBO) Waiver: Also called the Community Options Waiver, HCBO Waiver benefits include environmental assessments and accessibility adaptations (meaning home assessments and modifications), as well as assistive technology. For more on Maryland’s HCBO Waiver, click here.
– Community First Choice: This program is an entitlement, which means qualified applicants are guaranteed by law to receive benefits, which include accessibility adaptations (also known as home modifications) and assistive technology. For more on Maryland’s CFC Program, click here. |
Massachusetts
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– Frail Elder Waiver (FEW): In-home evaluations by an occupational therapist, and the corresponding home modifications, are covered by this Massachusetts Medicaid (MassHealth) HCBS Waiver, which also covers home based wandering response systems and home meal delivery. For more on FEW, click here.
– Moving Forward Plan (MFP) Waiver: This HCBS Waiver will provide home accessibility adaptations (meaning home modifications) in a number of different settings, including a provider-operated residence. For more on MFP Waivers, click here. |
Michigan
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– MI Choice Waiver: Benefits for this HCBS Waiver include environmental accessibility adaptations, meaning home modifications. For more on the MI Choice Waiver, click here.
– Michigan (MI) Health Link: Covers home modifications and other medical and non-medical long term care benefits for Michigan seniors who qualify for both Medicaid and Medicaid, which is also known as “dual eligible.” MI Health Link is available in 25 counties across the state and delivers its benefits through Integrated Care Organizations (ICOs) that have their own network of care providers. For more on MI Health Link, click here. |
Minnesota
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– Elderly Waiver (EW): Medical Assistance (the name for Medicaid in Minnesota) will cover home modifications through this HCBS Waiver. It also includes an option for consumer direction, which means EW beneficiaries can have more of a say in the labor and material involved in the modifications. For more on Minnesota’s Elderly Waiver, click here.
– Consumer Support Grants: This state-funded program is an alternative to Medicaid and provides recipients a monthly budget they can use on healthcare expenses, including home modifications. For more on Minnesota’s Consumer Support Grant Program, click here. |
Mississippi
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– Independent Living (IL) Waiver: Benefits include home modifications and specialized medical equipment, as well as transition assistance for seniors leaving nursing homes and returning to the community. For more on Mississippi’s Independent Living Waiver, click here. |
Montana
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– Big Sky Waiver (BSW): Home modifications for safety and accessibility, as well as specialized medical equipment and vehicle modifications, are available BSW benefits. This HSBC Waiver allows for some consumer direction, meaning the beneficiary has more say in choosing the materials and labor needed for the home modifications. For more on Montana’s BSW, click here. |
Nebraska
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– Aged and Disabled (AD) Waiver: This HCBS Waiver will cover home modifications, vehicle modifications, and other long term care benefits, as well as transition assistance for seniors leaving nursing homes and returning to the community. For more on Nebraska’s AD Waiver, click here. |
Nevada
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– Waiver for Persons with Physical Disabilities: Environmental accessibility adaptations (meaning home modifications), as well as specialized medical equipment, Personal Emergency Response Systems, and other long term care services, are among the benefits of this HCBS Waiver. For more on Nevada’s Waiver for Persons with Physical Disabilities, click here. |
New Hampshire
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– Choices For Independence: This HCBS Waiver allows beneficiaries to self-direct its home modification benefit, meaning they have greater say in the labor and materials used in the modifications. For more on New Hampshire’s Choices for Independence, click here. |
New Jersey
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– Managed Long Term Services and Supports (MLTSS): This entitlement program (benefits guaranteed with no waiting for qualified applicants) will cover home modifications, as well as vehicle modifications, Personal Emergency Response Systems, and other long term care benefits. For more on MLTSS in New Jersey, click here. |
New Mexico
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– Centennial Care Community Benefit: Benefits include home modifications, which can be self-directed, meaning the beneficiary has greater say in the materials and labor used for the modifications. This program has a limited number of yearly enrollment spots. For more on Centennial Care, click here. |
New York
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– Managed Long Term Care (MLTC) Program: Home modifications are among the long term care benefits of this entitlement program (no waitlist for benefits for qualified applicants). For more on New York’s MLTC Program, click here.
– Community First Choice (CFC) Option: Part of ABD Medicaid in New York (also called state plan or Regular Medicaid), the CFC Option will cover home modifications for safety and accessibility, as well as assistive technology and other long term care benefits. For more on the CFC Option in New York, click here. |
North Carolina
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– Community Alternatives Program for Disabled Adults (CAP/DA): Home accessibility and adaptation, as well as assistive technology, are among the long term care benefits for this HCBS Waiver. For more on CAP/DA, click here. |
North Dakota
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– Home and Community Based Services (HCBS) Waiver: Home modifications, assistive technology, and specialized medical equipment are included in the long term care benefits for this HCBS Waiver, which is also called the Aged and Disabled Waiver. For more, click here. |
Ohio
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– MyCare Ohio Plan: Home modifications, as well as assistive technology, are among the long term care benefits for this managed care plan that covers Ohio residents who are enrolled in both Medicaid and Medicare (also known as “dual eligible”). MyCare Ohio is also known as the Integrated Care Delivery System (ICDS), and it is available in 29 Ohio counties. For more on MyCare Ohio, click here.
– PASSPORT Waiver: This HCBS Waiver offers home modifications, as well as home maintenance and repairs, as one of its long term care benefits. Personal Emergency Response Systems (PERS) and meal delivery are also available benefits. For more on Ohio’s PASSPORT Waiver, click here. |
Oklahoma
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– ADvantage Waiver: Home modifications, as well as specialized medical equipment and home-delivered meals, are among the long term care benefits for this HCBS Waiver. For more information on the ADvantage Waiver, click here. |
Oregon
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– K Plan: Also known as the Community First Choice (CFC) Option, this entitlement program (meaning eligible applicants are guaranteed to receive benefits without any wait) covers home modifications and assistive technology. For more on Oregon’s K Plan, click here. |
Pennsylvania
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– Community HealthChoices (CHC): Home modifications, as well as assistive technology and vehicle modifications, are covered under this HCBS Waiver program. In Pennsylvania, Medicaid is called Medical Assistance. For more on Community HealthChoices, click here. |
Rhode Island
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– Long-Term Services and Supports (LTSS): This Rhode Island Medicaid program covers home modifications and assistive technology. LTSS is not an entitlement program, meaning there are a limited number of enrollment spots, and once those spots are full additional applicants will be placed on a waitlist. For more on LTSS in Rhode Island, click here. |
South Carolina
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– Community Choices Waiver: Among the long term care benefits for this HCBS Waiver is environmental modification, which includes minor physical adaptation to the home as well as pest control services. For more information on South Carolina’s Community Choices Waiver, click here. For an application, click here. |
South Dakota
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– Home and Community-Based Options and Person-Centered Excellence (HOPE) Waiver: Long term care benefits for the HOPE Waiver include home modifications, specialized medical equipment, and Personal Emergency Response Systems. For more on South Dakota’s HOPE Waiver, click here. |
Tennessee
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– CHOICES: Home modifications and assistive technology are among the long term care benefits for this program, which is more formally called the CHOICES in Long-Term Services & Supports Program. For CHOICES beneficiaries who still live in the community, program benefits are not an entitlement. For more on CHOICES, click here. |
Texas
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– STAR+PLUS: Texas Medicaid’s STAR+PLUS HCBS Waiver covers home modifications and adaptive aids (meaning assistive technology). Texas residents enrolled in STAR+PLUS receive their healthcare and long term term care benefits via a single Medicaid plan through one of the managed care organizations available in their area. For more on STAR+PLUS, click here. |
Utah
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– Aging Waiver: Home modifications (referred to as environmental accessibility adaptations in this program), assistive technology and specialized medical equipment are covered by the Aging Waiver, along with other long term care benefits. This HCBS Waiver is more formally called the Utah Waiver for Individuals Age 65 or Older. For more on Utah’s Aging Waiver, click here.
– New Choices Waiver (NCW): This waiver program helps cover transitional expenses for Medicaid beneficiaries who are moving out of nursing homes, assisted living residence, medical institutions (not an institution for mental disease) or small health care facilities (3 or fewer residents) and back into the community. Those transition expenses can include home modifications for a private home in the community to make it accessible for the Medicaid beneficiary. For more on the New Choices Waiver, click here. |
Vermont
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– Choices For Care (CFC): This Medicaid program is divided into two Groups: Moderate Needs and High Needs. Home modifications and assistive devices are among the long term care benefits for the High Needs Group beneficiaries. Moderate Needs group beneficiaries can use a flexible budget provided by Medicaid to pay for home modifications. For more, click here. |
Virginia
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– Commonwealth Coordinated Care Plus Waiver (CCC+): Home modifications (called environmental modifications by this program) and assistive technology are covered by the CCC+ Waiver, which merges the state’s previous waiver programs for disabled and aged older adults (Assisted Technology and the Elderly or Disabled with Consumer Direction). For more, click here. |
Washington
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– Community Options Program Entry System (COPES): This HCBS Waiver covers home modifications and durable medical equipment and supplies, along with other long term care services and supports for Washington Medicaid (which is called Apple Health) beneficiaries across the state. For more in COPES, click here.
– New Freedom (NF) Waiver: This HCBS Waiver only covers Washington Medicaid (Apple Health) beneficiaries who live in King and Pierce counties. This program gives participants a monthly budget, and they can spend it on approved long term care services and supports, which includes home modifications, assistive technology, Personal Emergency Response Systems and vehicle modifications. For more on Washington’s NF Waiver, click here. – Medicaid Alternative Care (MAC) Program: This program is different because it is designed to support unpaid caregivers of Washington Medicaid (Apple Health) beneficiaries. Benefits include a home safety evaluation and minor home modifications that will help the Apple Health beneficiary remain living in the community, and will also make the caregiver’s job easier. This is an Aged, Blind and Disabled (ABD) Medicaid program, so it’s an entitlement, which means all eligible applicants are guaranteed by law to receive benefits without wait. For more, click here. |
Wisconsin
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– Include, Respect, I Self-Direct (IRIS) Medicaid waiver: This HCBS Waiver provides Wisconsin Medicaid beneficiaries with an individualized budget they can spend on approved long term care services and supports, which includes home modifications, assistive technology, Personal Emergency Response Systems and vehicle modifications. For more on IRIS, click here.
– Family Care: Family Care: Home modifications, assistive technology and Personal Emergency Response Systems are among the long term care benefits for this HCBS Waiver program, which is available across the state. For more on Family Care, click here. – Family Care Partnership: This HCBS Waiver program combines medical, vision, dental and non-medical long term care supports into one plan for Wisconsin Medicaid beneficiaries in certain counties. This includes dual-eligible beneficiaries and their Medicare benefits. Home modifications, assistive technology and Personal Emergency Response Systems are among the long term care benefits for the program. For more on Family Care Partnership, click here. |
Eligibility Requirements for Medicaid Home Modifications
The eligibility criteria for home modifications depends on the specific Medicaid program under which the benefit is offered. In addition, eligibility is state-specific, and application specific. To learn the specific eligibility criteria for any Medicaid program, use our Medicaid Eligibility Requirements Finder.
For home modifications specifically, in additional to being financially and medically eligible for the Medicaid program through which home modifications are offered, there will be an additional requirement that the individual must have a specific need for the modification that is being requested. In many cases, Medicaid-funded, home modifications are approved on a case-by-case basis.
If you are over your financial eligibility limits, or have questions about home modifications or other Medicaid Long Term Care benefits, contact a professional for some personalized advice.