Beneficiary Eligibility

Beneficiary Eligibility A. In order to qualify as a beneficiary of the Elderly & Disabled (E&D) Waiver Program, individuals must meet the following criteria: 1. Must be twenty-one (21) years of age or older. 2. Must require nursing facility level of care as determined by a comprehensive long-term services and supports (LTSS) assessment. 3. Must meet the criteria in one (1) of the following Categories of Eligibility (COE): a) Supplemental Security Income (SSI) eligible under 20 C.F.R. § 416.202, or b) An aged, blind or disabled individual who meets all factors of institutional eligibility. If income exceeds the current institutional limit, the individual must pay the Division of Medicaid the portion of their income that is due under the terms of an Income Trust to qualify. B. Beneficiaries enrolled in the E&D Waiver cannot reside in a nursing facility or licensed or unlicensed personal care home. C. In the event of imminent danger to the beneficiary, caregiver or service provider, the beneficiary may be discharged from the waiver immediately.