What Is a Medicaid Waiver?


Quick Answer

Medicaid defines Medicaid waivers as programs that allow states to test methods for offering health care services. These methods can be newly created or modifications of programs already in place. Waivers can only apply toward Medicaid health care services and Children's Health Insurance Program services. Medicaid waivers can also be used to develop methods to pay for new or modified programs.

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Full Answer

There are four types of Medicaid waivers available. These types are: section 1115, research and demonstration projects; section 1915(b), managed-care waivers; section 1915(c), home- and community-based services waivers; and concurrent section 1915(b) and 1915(c) waivers. The section 1115 projects allow states to test different ways to deliver and pay for both Medicaid and Children's Health Insurance Program services. Section 1915(b) allows states to apply for waivers to limit consumer choice of providers or to provide managed-care systems. Section 1915(c) gives states the ability to apply for waivers that allow them to offer long-term care in patient homes or in local communities instead of in more traditional health care institutions. Concurrent sections 1915(b) and 1915(c) provide a way for states to use both sections at once for elderly and disabled patients. With the concurrent programs, states can offer complete health care solutions that include specific providers for initial care, followed by a transition to home or community long-term health services.

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