Federal, exists in every state
Medicaid home-care programs (waivers)
Approved services at home, such as nursing or personal care, depending on the program and the child’s assessed needs.
What it is
Approved services at home, such as nursing or personal care, depending on the program and the child’s assessed needs.
ALTCS can cover nursing, personal care, homemaker help and habilitation at home. Ordinary AHCCCS coverage also has a route for medically needed home nursing. The care team assesses the tasks and hours; this questionnaire cannot decide them.
Eligibility rules
- ALTCS uses Arizona’s section 1115 demonstration, approved through September 30, 2027.
- For an unmarried child under 18 in a qualifying setting, ALTCS can assess the child’s money separately from parents. Its medical test still applies.
What you get
- Approved home services for children who meet a program’s criteria.
Coverage details
- AHCCCS can cover medically necessary home-health nursing and aide services without ALTCS. Under-21 EPSDT review also covers qualifying medically necessary private-duty nursing. ALTCS adds approved long-term services, including homemaker and habilitation care; those are not automatically ordinary AHCCCS benefits.
If you decide to apply
- Ask the discharge planner or health-plan care manager to review the tasks your child needs at home.
- Bring care notes, the treatment schedule and the clinician’s description of nursing needs.
Discharge planner or care manager
After you apply
- The discharge planner can identify the health-plan or ALTCS route for the needed service.
Good to know
A note of the tasks you do at home and how long they take helps any assessment; it is not a requirement.
Other details
- An application, approval of hours and an available worker are separate matters.
- Parent pay has separate routes: ALTCS Parents as Paid Caregivers and qualifying licensed-parent home-health employment. Being the parent or receiving a nursing approval does not automatically establish employment or pay; overlapping services cannot be billed twice.
Related Arizona cards: Long-term care coverage; nursing and aide hours; paid parent caregiving.
Official sources
“Would an assessment for nursing or other help at home fit our child’s needs, and who would arrange it?”
Why I’m asking: I want to understand what support could make care at home manageable.
More background and detailed requirements
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
Register the child on the list, keep the task log, and answer the assessment call when it comes.
Your social worker
Names the waiver that takes medically fragile children in this state and helps with the registration form.
The care team
Documents the nursing-level tasks and the risk if care stops.
- Who decides
- The state waiver agency after a level-of-care assessment
- Ask your social worker
- “Which home-care program fits my child, and can we register today? Can Medicaid start home-nursing hours while we wait?”
How to apply
First step: Ask the discharge team which state home-care service or waiver fits your child's assessed needs, and how to apply.
- Register on the list this week.
- Ask the Medicaid plan for EPSDT nursing hours while you wait.
- Keep a two-week task log for the assessment.
Where it starts: State application or interest list. Assessment when a slot opens
What to gather
- A two-week log of daily tasks: what, how often, how long
- Doctor's letter naming nursing, equipment or safety needs
- Medicaid ID if the child has one
How long: Application steps, assessment timing and waiting-list availability depend on the specific state program. Ask for its current process.
What a yes looks like
A service plan with approved hours and a case manager's name.
What a no looks like, and the next move
“Does not meet level of care” or “no slot”: ask for Medicaid's rule that a child under 21 gets what is medically needed nursing through the Medicaid plan instead, and stay on the list.
Watch out
- If a suitable waiver has a waiting list, ask how and when to register and how priority is determined.
- For a child already on Medicaid, Medicaid's rule that a child under 21 gets what is medically needed home nursing can start long before a waiver slot opens. Ask for both.
- The assessment considers the child's actual care needs under the specific program's rules. No diagnosis or item of equipment guarantees approval.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 7, 2026.
What it is worth
Nursing hours, respite, personal care, equipment, home changes and a case manager. The value is the approved hours.
Covers: Case management · Respite · Personal care · Nursing (some waivers) · Adaptive equipment · Home and vehicle modifications · Caregiver training
What it costs the family: Medicaid-delivered. Patient liability depends on the state.
The eligibility facts, as published
- State specific
- yes
- Institutional level of care
- yes
- Target population
- medically fragile or technology-dependent children in most states
Decisions this site cannot make: Level of care · Service-plan necessity · Financial eligibility (child-only in institutional-deeming waivers)
Expect friction on: Interest lists · Provider shortages · Reassessment
The trap: Ask which waiver, if any, serves your child's needs and whether it has a waiting list. Request covered Medicaid services separately while any waiver application is reviewed.
What changes by state: Which waiver takes medically fragile children, the list length (Texas runs years), and whether parents' income is ignored.
Where I read this
- Home and Community-Based Services 1915(c) — Centers for Medicare & Medicaid Services, read August 27, 2026
- Full List of Medicaid Waivers and Programs — Kids’ Waivers, read August 27, 2026
- Early and Periodic Screening, Diagnostic, and Treatment — Centers for Medicare & Medicaid Services, read August 27, 2026