Florida Medicaid’s Covered Services and HCBS Waivers
Model
The purpose of the Medicaid Model Waiver is to provide services to eligible children 20 years of age or younger who are medically complex/medically fragile or diagnosed with degenerative spinocerebellar disease. The Model Waiver is designed to delay or prevent institutionalization and allow waiver recipients to maintain stable health while receiving services at home and in the community.
Medicaid reimburses for the following waiver services:
- Assistive Technology and Service Evaluation
- Environmental Accessibility Adaptations
- Respite
- Transition Case Management
The Model Waiver is a fee-for-service program and is not offered by health plans serving Medicaid enrollees.
Eligibility
Medicaid recipients who meet the following criteria are eligible to enroll in the Model Waiver:
- 20 years of age or younger
- Living at home, or is medically fragile and has resided in a skilled nursing facility for at least 60 consecutive days prior to entrance on the waiver
- Diagnosis of a degenerative spinocerebellar disorder which is generally identified in the 330-337 range of ICD9-CM diagnostic classifications, or is Medically Fragile as defined in F.A. C. 59G-1.010
- Meet the disability criteria for Social Security Disability
- A level of care determination of “at risk for hospital placement”, or must meet skilled nursing facility level of care determined by CMAT, and reside in a nursing facility for a minimum of 60 days
- Able to live safely at home
Resource Information
More information on the Model Waiver is available on the Home and Community Based Services Waivers: Model Waiver webpage.
