Understanding Medicaid Home and Community Services: A Primer, 2010 Edition. Chapter 4. Options for Designing Service Coverage: General Considerations


To remain in their homes and communities, many people with disabilities and chronic conditions need long-term care services and supports, ranging from personal assistance to more specialized services, as well as assistive technology and environmental modifications. Federal Medicaid law and policy give states great latitude to offer individuals a wide range of home and community services through a state’s regular Medicaid program. States can also offer a comprehensive range of services by operating one or several home and community-based services (HCBS) waiver programs. This chapter discusses Medicaid coverage options, including important issues states need to consider in selecting the particular combination of home and community services and benefits that best suits their needs.1

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