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 Aug 2, 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, an adult day center, an adult foster care home, or an assisted living setting. The word "waiver" points to the federal authority behind these programs: section 1915(c) of the Social Security Act. Minnesota's Elderly Waiver is authorized under section 1915(c) and runs through Medical Assistance, overseen by DHS.Centers for Medicare & Medicaid Services. (n.d.). Minnesota Waiver Factsheet - Medicaid.gov (MN Elderly Waiver 0025.R09.00). medicaid.gov. Retrieved Aug 2, 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 who is 65 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 Aug 2, 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 an Elderly Waiver application starts with the county or tribal nation where you live.Centers for Medicare & Medicaid Services. (n.d.). Minnesota Waiver Factsheet - Medicaid.gov (MN Elderly Waiver 0025.R09.00). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MN 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 Aug 2, 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, which you schedule through the county or tribal nation where you live. 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.Centers for Medicare & Medicaid Services. (n.d.). Minnesota Waiver Factsheet - Medicaid.gov (MN Elderly Waiver 0025.R09.00). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MN That cost-effectiveness test is not a formality. Someone who meets the age, Medical Assistance and level-of-care tests can still fall outside the Elderly Waiver if the services they need would cost more at home than in a nursing facility.State of Minnesota. (n.d.). Elderly Waiver - Minnesota DHS. mn.gov. Retrieved Sep 4, 2026, from https://mn.gov/dhs/disability-aging/home-and-community-services/programs-and-services/elderly-waiver/index.jsp
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 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. 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 Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MN Don't read that $3,000 as a disqualification just because you own a home. DHS describes assets as things like cars, bank accounts, your home and financial investments, but says that in most cases your home and one car do not count against the asset limit.State of Minnesota. (n.d.). Elderly Waiver - Minnesota DHS. mn.gov. Retrieved Sep 4, 2026, from https://mn.gov/dhs/disability-aging/home-and-community-services/programs-and-services/elderly-waiver/index.jsp Confirm what counts in your own situation with DHS or your county; our Minnesota Medicaid eligibility and income limits guide covers Medical Assistance's financial rules 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 Aug 2, 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 services with an individual budget and hire the people you chooseCenters for Medicare & Medicaid Services. (1915). Medicaid.gov - Minnesota 1915(c) waiver descriptions (CDCS listed as an approved service under each waiver). medicaid.gov. Retrieved Sep 6, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MN
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 matters if assisted living is the setting your family is weighing. Second, Consumer Directed Community Supports gives you a self-directed route: you manage your services with an individual budget and hire the people you choose, including family, friends or neighbors, and in return you act as the employer of your workers with help from a financial management services provider.Centers for Medicare & Medicaid Services. (1915). Medicaid.gov - Minnesota 1915(c) waiver descriptions (CDCS listed as an approved service under each waiver). medicaid.gov. Retrieved Sep 6, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MN
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 Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MN DHS also points families to Minnesota Aging Pathways at 800-333-2433 to connect with other local services and programs.Centers for Medicare & Medicaid Services. (n.d.). Minnesota Waiver Factsheet - Medicaid.gov (MN Elderly Waiver 0025.R09.00). medicaid.gov. Retrieved Aug 2, 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.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 Which addresses and phone lines Minnesota actually runs are set by the state's own instructions, and our how to apply for Minnesota Medicaid guide has those 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 90 days for applicants who apply for Medicaid on the basis of disability, and no more than 45 days for all other applicants. Those limits can be exceeded only in unusual circumstances, for example when the applicant or an examining physician delays or fails to take a required step, or when an administrative or other emergency beyond the agency's control gets in the way.U.S. Government Publishing Office. (2026). 42 CFR 435.912(c)(3) — Timely determination of eligibility (eCFR current text, as revised eff. July 31, 2026). ecfr.gov. Retrieved Aug 7, 2026, from https://www.ecfr.gov/current/title-42/section-435.912 The longer window turns on the basis you applied under, not on whether a disability determination happens to come up in your case, so an Elderly Waiver applicant applying on the basis of age is on the 45-day cap even though the waiver requires a level-of-care assessment. Those are outer limits, not a decision you are promised on the last day, and the agency may not use them as a waiting period before deciding or as a reason to deny you.U.S. Government Publishing Office. (2026). 42 CFR 435.912(c)(3) — Timely determination of eligibility (eCFR current text, as revised eff. July 31, 2026). ecfr.gov. Retrieved Aug 7, 2026, from https://www.ecfr.gov/current/title-42/section-435.912
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 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 Aug 2, 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).Centers for Medicare & Medicaid Services. (n.d.). Minnesota Waiver Factsheet - Medicaid.gov (MN Elderly Waiver 0025.R09.00). medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MN CDCS lets you manage your services with an individual budget and hire the people you choose. In return you develop a community support plan and act as the employer of your workers, with help from a financial management services provider.Centers for Medicare & Medicaid Services. (1915). Medicaid.gov - Minnesota 1915(c) waiver descriptions (CDCS listed as an approved service under each waiver). medicaid.gov. Retrieved Sep 6, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/MN Relatives, including adult children, may be paid under CDCS if they meet all of DHS's criteria, such as not being otherwise responsible to provide the care and being qualified for the service. A spouse can be paid only for CDCS personal assistance, for up to 60 hours in a seven-day period.dhs.state.mn.us. (n.d.). Community-Based Services Manual (CBSM) - Paying relatives and legally responsible individuals (Minnesota DHS, dhs.state.mn.us; page updated 5/8/23). Retrieved Oct 14, 2026, from https://www.dhs.state.mn.us/main/idcplg?IdcService=GET_DYNAMIC_CONVERSION&RevisionSelectionMethod=LatestReleased&dDocName=dhs16_184033 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 Aug 2, 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 Aug 2, 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.
Learn More
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.
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