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VA Medicaid Waivers|

In order to get the necessary services for your child, caregivers need to be advocates.  Waiver slots are limited in number and cannot serve all the people who could benefit from waiver-funded services.  If you feel your family member truly needs a waiver slot and is eligible for one, you must take action.

If a waiver slot is denied:

  • Double-check the eligibility criteria, including those for any waiting lists on the waiver in question.   For the MR/ID and Day Support Waivers, persons on the Urgent and Non-Urgent Waiting Lists have higher priority than those on the Planning Lists.
  • Talk with your case manager’s supervisor for a second opinion on the denial.

Request “reconsideration.”  The agency then has 10 days to reconsider the application and either approve it or present additional reasoning for upholding the denial.  If the agency fails to reconsider within 10 days or if the denial is upheld, you can appeal the decision.

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