Understanding Waivered Medicaid Services in Minnesota

Minnesota’s Medicaid program—known locally as Medical Assistance (MA)—offers several waivered options that provide essential services to enable individuals to remain in community settings rather than residing in institutions. These Home and Community-Based Services (HCBS) waivers are designed to support people with chronic illnesses, disabilities, or age-related needs by offering personalized care in familiar environments.

There are six waiver programs:

• Brain Injury (BI) Waiver: For individuals with traumatic or acquired brain injuries requiring nursing‑facility-level care, but living in the community.

• Community Alternative Care (CAC) Waiver: For chronically ill or medically fragile individuals who would otherwise need hospital-level care.

• Community Access for Disability Inclusion (CADI) Waiver: Helps individuals with disabilities requiring nursing facility-level support to live in community settings.

• Developmental Disabilities (DD) Waiver: Supports those with developmental disabilities who would otherwise need Intermediate Care Facility services.

• Elderly Waiver (EW): Tailored to Minnesotans aged 65+ who require nursing home-level care, enabling them to remain in their homes through services such as home modifications, personal care, and adult-day services.

• Alternative Care (AC): Though not always listed among disability-specific waivers, AC serves older adults at risk of institutionalization with low income and assets—similar in function to the Elderly Waiver.

A popular choice for Minnesotans to elect for their waiver is the Consumer-Directed Community Supports (CDCS) option, allowing recipients to design and manage their own care—hiring trusted caregivers, including family members, and even managing payroll through financial management services.

The services covered under these waivers are comprehensive, ranging from case management, homemaker support, respite care, and adult day services to specialized equipment, transportation, home or vehicle modifications, therapy, and employment-related supports.

However, access isn’t always immediate. Approximately 3,600 people are currently on waiting lists, while around 15,000 are receiving waiver services in Minnesota. As a temporary measure, the Consumer Support Grant program provides state-funded home care alternatives for those awaiting waiver eligibility.

Eligibility requires a clinical assessment commonly via the MnCHOICES tool—to determine functional eligibility and identify specific needed services. A beneficiary must also be financially eligible for Medical Assistance to qualify for a waiver.

As Minnesota works toward making its system more navigable and empowering, initiatives like Waiver Reimagine aim to simplify program access, increase flexibility, and enhance participant control.

Contact the Bravura Group Elder Law team to discuss your questions about eligibility, access, and coverage for waivered services. Our team includes 3 Elder Law attorneys and a dedicated paralegal with significant experience managing government benefits applications.