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Medicaid §1915(i) HCBS State Plan Option

Medicaid state plan option allowing states to provide home and community-based services to people who meet state-defined needs-based criteria. States define target populations, covered services, and optional self-direction through a CMS-approved state plan amendment.

Medicaid 1915(i) is a State Plan Home and Community-Based Services authority. States that adopt it can define HCBS benefits for specific populations within federal guidelines, using state-defined needs-based criteria rather than a 1915(c)-style institutional level of care. Medicaid.gov examples include long-term services such as respite, case management, supported employment, and environmental modifications in home and community-based settings. States may target populations, define covered HCBS including CMS-approved other services, and choose whether any or all HCBS are self-directed. A state Medicaid agency must submit a state plan amendment to CMS for review and approval. Current states, service menus, family-caregiver payment options, and financial thresholds vary by approved state plan.

Questions to ask the program

These are questions to ask the program, not a verdict on your eligibility. Confirm the current rules directly with the program.

  • What are the current income and asset limits, and whose income counts?
  • Is there a caregiver-specific department, coordinator, or support line? Ask for it by name. — Many agencies have one that isn’t advertised on the website.
  • What documents do you need from us to start an application?
  • Is there a waitlist right now, and how long is it?

Services

Medicaid 1915(i) is a State Plan Home and Community-Based Services authority. States that adopt it can define HCBS benefits for specific populations within federal guidelines, using state-defined needs-based criteria rather than a 1915(c)-style institutional level of care. Medicaid.gov examples include long-term services such as respite, case management, supported employment, and environmental modifications in home and community-based settings. States may target populations, define covered HCBS including CMS-approved other services, and choose whether any or all HCBS are self-directed. A state Medicaid agency must submit a state plan amendment to CMS for review and approval. Current states, service menus, family-caregiver payment options, and financial thresholds vary by approved state plan.

How to apply

Use the official program page for application details: official program page.