Medicaid Waivers: Staying Home Instead of a Nursing Home
Watch on YouTube Medicaid Home and Community-Based Services (HCBS) waivers let states pay for personal care aides, adult day programs, home-delivered meals, and other services that keep people out of nursing homes. This episode explains Section 1915(c) and Section 1115 waivers, who qualifies, what they cover, and how to navigate the waiting list crisis that affects approximately seven hundred ten thousand people nationwide as of two thousand twenty-four. Watch the next video in the playlist for the Medicaid work requirements episode. Always verify with your state Medicaid agency or Area Agency on Aging.
▶ Watch next: Medicaid Work Requirements: What the New Law Means for You https://www.youtube.com/watch?v=dydv_14EdmA
📺 Full playlist: Medicaid (US - 2026) https://www.youtube.com/playlist?list=PLlIAFxS29649JfKT2uWUj5JKZqmduWdyo
Chapters
Nursing homes are expensive, and most people do not want to live in one. Medicaid waivers — particularly Section 1915(c) Home and Community-Based Services (HCBS) waivers — let states pay for care that keeps people in their own homes or in community settings instead of institutions. Services can include personal care aides, adult day programs, home-delivered meals, assistive technology, home modifications, respite care for family caregivers, and more. The problem? Demand crushes supply. As of 2024, roughly 710 thousand people were on HCBS waiting lists nationwide. Some states have waits of three to five years. Section 1115 waivers give states even broader flexibility to redesign their Medicaid programs. This episode explains both waiver types, what they cover, and how to get on a waiting list.
Key Topics
- What HCBS waivers are: Medicaid pays for home and community-based care instead of institutional (nursing home) care
- Section 1915(c) waivers: the most common HCBS authority — covers personal care, adult day care, respite, home modifications, assistive technology
- Section 1115 demonstration waivers: broader authority for states to experiment (managed long-term care, behavioral health carve-outs, expanded eligibility)
- The waiting list crisis: approximately 710 thousand people on HCBS waiting lists nationwide as of 2024, with waits of three to five years in some states
- Who qualifies for HCBS waivers: generally must meet nursing-home level of care AND Medicaid financial eligibility
- The American Rescue Plan HCBS boost: temporary 10% FMAP increase (expired March 2025) helped states expand slots and raise caregiver wages
- How to apply: contact your state Medicaid agency or Area Agency on Aging to get on the waiver waiting list