Minnesota's Medicaid program does pay for care at home and in the community, and for adults 65 and older the main door is the Elderly Waiver. When families search for Minnesota Medicaid HCBS waivers, this is almost always the program they mean: a home and community-based services (HCBS) waiver, authorized under section 1915(c) of the Social Security Act and run through Medical Assistance, which is Minnesota's Medicaid program. It exists for one situation in particular: someone who needs the level of care a nursing home provides but would rather stay in their own home, an apartment, or an assisted living setting.Centers for Medicare & Medicaid Services. (n.d.). Minnesota Waiver Factsheet - Medicaid.gov (MN Elderly Waiver 0025.R09.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MN
In This Guide
- What Are Minnesota Medicaid HCBS Waivers?
- Inside the Elderly Waiver
- Do You Qualify for the Elderly Waiver?
- What Minnesota Medicaid HCBS Waivers Cover
- How to Apply for the Elderly Waiver
What Are Minnesota Medicaid HCBS Waivers?
Home and community-based services, usually shortened to HCBS, is the part of Medicaid that pays for long-term care delivered outside an institution: in your own home, a family member's home, an adult day center, or an assisted living building. The word "waiver" is where the name comes from. To fund care in these settings, a state asks the federal government to waive the usual rule that ties long-term-care dollars to a nursing facility, using the authority in section 1915(c) of the Social Security Act. Minnesota's law grants exactly that permission, directing the state to apply for a home and community-based services waiver for the elderly so that federal money can expand the services available to people who are eligible for Medical Assistance.Centers for Medicare & Medicaid Services. (n.d.). Minnesota Waiver Factsheet - Medicaid.gov (MN Elderly Waiver 0025.R09.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MN
Here is the part that trips people up. Minnesota does not run a program literally named "HCBS waivers." It runs specific 1915(c) waivers, and for older adults the one that matters is the Elderly Waiver. So when you read about Minnesota Medicaid HCBS waivers for a parent or spouse in their late sixties or older, the Elderly Waiver is the program to learn. The rest of this guide walks through how it works, who qualifies, what it pays for, and how to start.
Inside the Elderly Waiver
The Elderly Waiver is built around a single idea: a person can meet the level of care a nursing home provides and still choose to live in the community instead. Rather than paying for a nursing facility bed, Medical Assistance pays for the mix of in-home and community services that let that person stay put safely.Centers for Medicare & Medicaid Services. (n.d.). Minnesota Waiver Factsheet - Medicaid.gov (MN Elderly Waiver 0025.R09.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MN
The Minnesota Department of Human Services oversees the waiver, but the day-to-day work happens closer to home. Counties, tribal entities, and managed care organizations administer the program, which is why your first phone call goes to a local office rather than to a statewide hotline. Here is the shape of the program at a glance.
| Feature | Detail |
|---|---|
| Program type | 1915(c) home and community-based services waiver |
| Runs under | Medical Assistance (Minnesota Medicaid), overseen by DHS |
| Who it serves | Adults 65 or older at a nursing-home level of care |
| How need is measured | A MnCHOICES assessment |
| Administered by | Counties, tribal entities, and managed care organizations |
| 2026 asset limit | $3,000 for one person; $6,000 for a couple |
| 2026 income standard | $2,982 per month (Special Income Standard) |
Every figure in that table comes from Minnesota's own Medical Assistance rules and the Elderly Waiver's federal waiver description.Centers for Medicare & Medicaid Services. (n.d.). Minnesota Waiver Factsheet - Medicaid.gov (MN Elderly Waiver 0025.R09.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MN
Do You Qualify for the Elderly Waiver?
Eligibility has two halves, and you need both. The first is functional: can you show a nursing-home level of need? The second is financial: do you fit within Medical Assistance limits? Take them one at a time.
The care test
To qualify functionally, a person must be age 65 or older and meet the level of care provided in a nursing home, as determined by a MnCHOICES assessment. A MnCHOICES assessment is an in-person evaluation, arranged through your county or tribal nation, that looks at how much help you need with daily activities and health needs. There is one more condition built into the waiver: the services you would receive have to cost less than what nursing-home care would cost. That cost-effectiveness check is part of how the state confirms the waiver is the right fit.Centers for Medicare & Medicaid Services. (n.d.). Minnesota Waiver Factsheet - Medicaid.gov (MN Elderly Waiver 0025.R09.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MN
The money test
Financially, Elderly Waiver enrollees qualify through Medical Assistance for people who are age 65 or older, blind, or have a disability, a track the state calls MA-ABD. Two numbers do most of the work here. In 2026, the countable-asset limit is $3,000 for a household of one and $6,000 for a household of two, plus $200 for each additional household member. That is more generous than the $2,000 default many states use. On the income side, the Elderly Waiver uses a Special Income Standard of $2,982 per month, effective for 2026.Centers for Medicare & Medicaid Services. (n.d.). Minnesota Waiver Factsheet - Medicaid.gov (MN Elderly Waiver 0025.R09.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MN How specific assets are counted or excluded is handled under Medical Assistance rules, which our Minnesota Medicaid eligibility and income limits guide covers in more depth.
If a nursing facility turns out to be the better setting after all, the financial rules work differently there. Our Minnesota Medicaid long-term care and nursing home guide walks through that path.
What Minnesota Medicaid HCBS Waivers Cover
The Elderly Waiver pays for a broad set of in-home and community services, and the point of the list is flexibility: your care plan draws from these based on what the MnCHOICES assessment shows you need. Covered services include:Centers for Medicare & Medicaid Services. (n.d.). Minnesota Waiver Factsheet - Medicaid.gov (MN Elderly Waiver 0025.R09.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MN
- Adult day services
- Case management
- Homemaker and chore services
- Home-delivered meals
- Respite, so a family caregiver can take a break
- Adult foster care
- Customized living services, delivered in an assisted living setting
- Environmental accessibility adaptations, meaning home modifications such as grab bars or a wheelchair ramp
- Extended state plan personal care assistance
- Extended home care nursing
- Consumer Directed Community Supports (CDCS), a self-directed option that lets you manage your own budget and hire your own workers
Two things are worth pulling out of that list. First, customized living services mean the Elderly Waiver can help pay for the care piece of assisted living, which is often the setting families are weighing. Second, Consumer Directed Community Supports gives you a self-directed route: instead of having services arranged for you, you receive a budget and take on more of the hiring and scheduling yourself.
How to Apply for the Elderly Waiver
Because counties, tribal entities, and managed care organizations run the Elderly Waiver, the first step is local. To get started, contact the county or tribal nation where you live and ask to schedule a MnCHOICES assessment. That assessment is the gateway: it establishes the nursing-home level of care the waiver requires and starts building your care plan.Centers for Medicare & Medicaid Services. (n.d.). Minnesota Waiver Factsheet - Medicaid.gov (MN Elderly Waiver 0025.R09.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MN
You also need Medical Assistance itself, since the Elderly Waiver rides on top of it. Federal rules require the state to accept a Medicaid application through several channels, so you can apply online, by phone, by mail, or in person at a local office.U.S. Government Publishing Office. (n.d.). 42 CFR 435.907 — Application (eCFR, current). ecfr.gov. Retrieved Jul 13, 2026, from https://www.ecfr.gov/current/title-42/section-435.907 Our how to apply for Minnesota Medicaid guide has the state-specific details.
Once your application is in, the wait for a decision is not open-ended. Federal Medicaid rules cap how long the state may take to decide: no more than 45 days for most applicants, and no more than 90 days when eligibility rests on a disability determination.U.S. Government Publishing Office. (2024). 42 CFR 435.912 Timely determination and redetermination of eligibility (2024 ed.) — govinfo.gov. govinfo.gov. Retrieved Jun 25, 2026, from https://www.govinfo.gov/content/pkg/CFR-2024-title42-vol4/pdf/CFR-2024-title42-vol4-sec435-912.pdf Those are the outer limits, and many decisions come faster.
Frequently Asked Questions
What is the difference between the Elderly Waiver and going into a nursing home?
Both serve people who need a nursing-home level of care, so the difference is not how much help you need. It is where you receive that care, and how the state pays for it. The Elderly Waiver funds services in the community rather than a nursing facility, and it carries a cost-effectiveness condition the institutional path does not: the services it provides have to cost less than nursing-home care would.Centers for Medicare & Medicaid Services. (n.d.). Minnesota Waiver Factsheet - Medicaid.gov (MN Elderly Waiver 0025.R09.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MN You qualify by meeting the same level-of-care standard a nursing home would, then choose the community setting instead.
Can I choose and direct my own caregivers?
Yes, through an option called Consumer Directed Community Supports (CDCS). Rather than having all of your services arranged for you, CDCS gives you a budget you help manage, so you can hire and schedule your own workers within the plan.Centers for Medicare & Medicaid Services. (n.d.). Minnesota Waiver Factsheet - Medicaid.gov (MN Elderly Waiver 0025.R09.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MN It is one of the covered services under the Elderly Waiver, and your case manager can explain whether it fits your situation.
Does the state or the county run the Elderly Waiver?
Both play a role. The Minnesota Department of Human Services (DHS) oversees the Elderly Waiver at the state level, but counties, tribal entities, and managed care organizations administer it on the ground.Centers for Medicare & Medicaid Services. (n.d.). Minnesota Waiver Factsheet - Medicaid.gov (MN Elderly Waiver 0025.R09.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MN That is why your application and your MnCHOICES assessment run through your local county or tribal nation rather than a single statewide office.
Does the Elderly Waiver help pay for assisted living?
It can. One of the waiver's covered services is customized living, which is care delivered in an assisted living setting, so the Elderly Waiver can help pay for the care portion of assisted living for someone who qualifies.Centers for Medicare & Medicaid Services. (n.d.). Minnesota Waiver Factsheet - Medicaid.gov (MN Elderly Waiver 0025.R09.00). medicaid.gov. Retrieved Jul 17, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MN Which services apply is set by your MnCHOICES assessment and the care plan built from it.
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The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.