Federally approved Elderly Waiver Plan, Minn. Stat. Chapter 256S

Elderly Waiver (EW): Program that funds home and community-based services for people age 65 and older who are eligible for Medical Assistance (MA) and require the level of care provided in a nursing home but choose to live in the community.

Minnesota Senior Care Plus (MSC+): A mandatory managed care program for people age 65 and older. This program does not coordinate Medicare services, but the person may have Medicare plans.

Minnesota Senior Health Options (MSHO): A voluntary managed care program for people age 65 and older who are also enrolled in Medicare Parts A and B. This program combines MA and all Medicare A and B benefits, drugs and other services into one coordinated plan.

Special Needs BasicCare (SNBC): A voluntary managed care program for people ages 18-64 with a certified disability.

For more information about managed care programs, refer to CBSM – Minnesota MA managed care programs.

EW promotes community living and independence with services and supports that address each person’s individual needs and choices. EW offers services that go beyond what is available through MA.

To be eligible for EW, a person must meet all the following criteria:

65th birthday

If the person is enrolled in SNBC, they will disenroll at the end of the month they turn 65. The person cannot start EW until they disenroll from SNBC at the end of their birthday month.

Exception: If the person’s birthday is the first day of the month, the person will disenroll from SNBC on the first day of their birthday month.

The following services are covered under EW. For a service-specific policy page, select a service from the list:

EW does not cover services that are available through another funding source (e.g., Medicare, MA state plan services, long-term care insurance).

Note: Older Americans Act (OAA) funding is not considered “another funding source” for this purpose because people on EW are not legally entitled to receive OAA-funded services. DHS does not require that OAA programs fund benefits that are available to a person through EW. The lead agency should authorize the service or amount of service the person needs within the limits of EW. If a person needs additional services beyond what can be authorized under EW, OAA programs may be an option for the person. For more information, refer to ACL – OAA payer of last resort.

When a person on EW needs skilled nursing visits, the county/tribal nation case manager must authorize the service on the waiver service authorization. For more information, refer to CBSM – Skilled nursing visit (SNV).

A person who is on EW may receive waiver services and MA services funded through a managed care organization (MCO). This can be through Minnesota Senior Care Plus (MSC+) or Minnesota Senior Health Options (MSHO).