Federal, exists in every state
Medicaid home-care programs (waivers)
Home-care waivers can pay for approved services that help a child live safely at home.
What it is
Home-care waivers can pay for approved services that help a child live safely at home.
Waivers have their own care tests, financial rules and available places. NH Medicaid also covers approved home nursing through its health plans. A waiver application and a request for covered nursing are separate steps.
Eligibility rules
- NH has four home- and community-based waivers with different age, disability and level-of-care tests. Cancer does not establish a developmental disability, but an older teen may need a separate adult-waiver assessment.
- NH’s Developmental Disabilities waiver is for qualifying autism, intellectual disability or developmental disability at any age and an ICF/IID level of care; In Home Supports uses those categories for ages 0–21. Acquired Brain Disorder is for qualifying brain injury from age 22 and nursing-facility-level care, so it is not a pediatric brain-injury waiver. Choices for Independence serves people 65 or older and adults ages 18–64 with physical or other disabilities who meet nursing-facility-level care. Thus an 18-year-old with cancer-related physical disability may deserve a CFI assessment, but neither a cancer diagnosis nor the website’s care description establishes eligibility. Each waiver also has its own Medicaid financial, service-plan and enrollment-place rules; DHHS or the designated assessment agency must explain the current application and waiting-list process. HCCSD is a different section 1902(e)(3) eligibility option, and ordinary medically necessary Medicaid nursing should be considered separately from a waiver place.
What you get
- Approved nursing, caregiver breaks or other home services under a program’s own rules.
What coverage includes
- Ordinary Medicaid nursing is a separate covered-service request, through the child’s plan or the DHHS fee-for-service route as applicable; a waiver waiting list does not settle that request.
- A waiver may use the child’s finances rather than parents’ income; the particular waiver decides.
If you decide to apply
- Ask the discharge planner which home-care service or waiver fits your child’s daily needs.
- Bring a note of the care tasks, how often they happen and how long they take.
Discharge planner or NH Medicaid care manager
After you apply
- Ask for the written care assessment, requested services and decision.
Good to know
A waiting list for a waiver does not replace a request for covered Medicaid services.
Other details
- Finding a nurse is separate from getting nursing hours approved.
Official sources
“Which home-care service fits our child, and can covered nursing be considered while any waiver application is reviewed?”
Why I’m asking: We want to be ready if home care needs change.
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