The Model Waiver Program is designed to avoid costly long-term hospitalization of children and youth with complex medical needs and disabilities by providing medically necessary supportive services in the home, funded by Maryland Medicaid. Participants receive Medicaid eligibility and benefits based on their own income and assets without respect to parental income.
Population Served and Eligibility
Children and youth with complex medical needs who are at risk of long-term hospitalization/institutionalization without appropriate care at home and who:
- Are under the age of 22 at the time of referral
- Are not eligible for any other Medicaid funded programs
Medical eligibility is based on information completed by the referring physician. Financial eligibility is determined through the Medicaid application process. The application is based on the child`s income and assets compared to expanded SSI limits. Children who have access to private health insurance benefits may still be eligible for the program. Children who are currently Medicaid eligible, but who will imminently lose that eligibility due to financial reasons, may be able to access the program, assuming that other eligibility criteria is met. To maintain eligibility in the waiver the participant’s community-based medical services must be cost neutral. That is, the cost of the community-based services must not exceed the cost of institutional care.
The Coordinating Center provides care coordination services for the Model Waiver Program. In addition, participating individuals are eligible to receive all Medicaid covered services, as well as nursing assistance and prescribed services delineated in the Plan of Care.
Referral and Application Process
The Coordinating Center assists with the intake and eligibility process for the Model Waiver Program. Currently there is a prioritized waiting list and applications are processed in the order they are received. For more information, contact The Coordinating Center and ask to be connected to the Model Waiver Intake Department: 410-987-1048.