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Home | For Disability Services | Alternatives to Nursing Homes | Additional Medicaid Waiver Eligibility Requirements

Additional Medicaid Waiver Eligibility Requirements

To be eligible for either the OBRA Waiver, the Independence Waiver or the COMMCARE Waiver, individuals must:

• Possess income and resources within limits established in the Medicaid Waiver programs.
• Have a disability that is likely to continue indefinitely and results in three or more substantial functional limitations in major life activities.
• Be a citizen of the United States or immigrant lawfully admitted for permanent residence.
• Be a resident of Pennsylvania

Additional requirements to participate in the OBRA Waiver:

• Must have an other related condition that occurred before the age of 22 and be age 18 or over.
• Cannot have mental retardation or a major mental disorder as a primary diagnosis.
• Requires services at the level of an intermediate care facility for persons with an other related condition (ICF-ORC).

Additional requirements to participate in the Independence Waiver:

• Must be age 18 and over with a physical disability.
• Cannot have mental retardation or a major mental disorder as a primary diagnosis or be ventilator dependent.
• Must be clinically eligible for a nursing facility.

Additional requirements to participate in the COMMCARE Waiver:

• Must be age 21 and over with a traumatic brain injury.
• Cannot be ventilator dependent.
• Requires a special rehabilitation facility (SRF) level of care.

Intake Process

An intake coordinator at the local enrollment agency can start the process and guide individuals throughout each step.