Medicaid §1915(i) HCBS State Plan Option¶
Medicaid state plan benefit allowing states to provide home and community-based services — including respite care and caregiver supports — to individuals with needs-based criteria below institutional level of care, with no waiting lists permitted. Unlike 1915(c) waivers, 1915(i) is a state plan entitlement: if a state adopts it and a person meets the criteria, services cannot be waitlisted. Often serves behavioral health, early dementia, and developmental disability populations.
States that adopt 1915(i) can offer HCBS services including: respite care, personal care, adult day health, home modifications, caregiver training/education, and self-directed services where family members (including in some states legally responsible relatives) can be hired as paid caregivers. Key advantage over 1915(c): no waitlists — if eligibility criteria are met and the state has an active 1915(i) benefit, services must be provided. Criteria are needs-based but below the institutional level of care required for 1915(c). Often covers behavioral health populations, early dementia, and people with moderate functional limitations who do not yet need nursing home level care. Contact your state Medicaid office to determine if 1915(i) is offered and what services are covered.
Some details for this program are still being verified. Check the official source for the most current information.
Services¶
States that adopt 1915(i) can offer HCBS services including: respite care, personal care, adult day health, home modifications, caregiver training/education, and self-directed services where family members (including in some states legally responsible relatives) can be hired as paid caregivers. Key advantage over 1915(c): no waitlists — if eligibility criteria are met and the state has an active 1915(i) benefit, services must be provided. Criteria are needs-based but below the institutional level of care required for 1915(c). Often covers behavioral health populations, early dementia, and people with moderate functional limitations who do not yet need nursing home level care. Contact your state Medicaid office to determine if 1915(i) is offered and what services are covered.
How to apply¶
Apply online or find more information at the official program page.