If you’re someone who is elderly or lives with a disability, you can be eligible for Medicaid coverage through the Aged and Disabled (A&D) Waiver if you meet the following criteria:
Once a client is approved on the A&D Waiver, a Medicaid Nurse Reviewer will make a referral for a Scale of Independent Behavior (SIB-R) assessment regarding the level of care required to help meet the person’s needs and care. This is only done by Liberty Healthcare. The client must be substantially limited in their ability to function in at least three (3) of the following major life activities;

1. Submit an Eligibility Application for Assistance with Idaho Department of Health and Welfare. An application can be found online here.
2. Demonstrate financial eligibility. If deemed ineligible, contact a Medicaid Planner found here for assistance or to set up a Miller Trust. Keep in mind that there may be a required share of cost depending on income as determined by Health and Welfare.
3. Get referred to the Bureau of Long Term Care for a Uniform Assesment Instrument (UAI) by a Medicaid Nurse Reviewer. The Nurse Reviewer will use the UAI to recommend a level of care, then send an L-CERT (a levels of care assessment) back to Self-Reliance for approval.
4. The Nurse Reviewer makes the referral to the SIB-R performed by Liberty Healthcare. Once the SIB-R is completed, move to the next step.
5. Meet with Residential Habilitation agencies to select one that will be a good fit.
6. Create a plan with your ResHab Agency and submit it to the Medicaid care manager who will review the plan within 14 days of submission. Upon approval, requested services can begin.
7. Choose your focus. The ResHab agency collaborates with the care team to tailor a program entirely around client needs and preferences. Those preferences are protected by Home and Community Based Services (HCBS) laws which empower clients or guardians to decide when, where, and which services are received.
8. Make changes as needed. Adjustments to the plan can be made throughout the year by contacting the Nurse Reviewer and submitting an addendum. Changes may involve selecting a different agency, modifying services, or adjusting service hours per week, ensuring flexibility and client-centered care.
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