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Or is it a case by case basis?

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Well, I'm not sure what a medicaid waiver is. If it relates to the aged and you're talking about Medicaid picking up the tab for a nursing home, your answer is very complex. First of all, there must be a medical need for placement in custodial care. Unsafe to live alone would probably qualify.

Then, they must be flat broke. In other words, they must have spent all of their own funds before Medicaid will start paying the bill. They'll turn over all their monthly income and be allowed to keep, I think it's, $30 a month for pocket change. They'll cash in all their whole life insurance policies, sell their home, spend their savings, etc., etc.

It's a wonderful program, We don't float our oldsters out on icebergs. But one must spend all of their own money in order to qualify.

Call your local Council on Aging (or whatever it's called in your area). They'll send someone out to interview this person and his/her family and give you the nitty gritty.
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ZIg - Are you asking about a "diversion of funding" type of waiver? Like Medicaid in most states for the elderly is primarily for skilled nursing care in a NH or other long-term stay facility. Most states have "waiver" programs which divert funding for NH to community based services or for AL (assisted living), which can be a huge cost savings than the cost of a NH. But just what is provided and also to what degree vendors or non-NH facilities will participate in waivers will be dependent on your state. Medicaid - although it is a joint federal & state program - is administered or managed by each state in their own unique way. So there is no one single answer like there would be for Medicare (totally federal).

Most AL's do not take waivers or if they do it will be for a very very small # of beds and they are usually filled from waiting lists of current private pay residents. Now there are a lot of community based care that is Medicaid diversion paid for programs like for home health care maybe 2 - 4 times a week type of services. But you still have to meet the financial & medical criteria before Medicaid will pay.
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