Mississippi Medicaid HCBS Waivers: The E&D Waiver

Mississippi Medicaid does pay for care at home and in the community, and its main pathway for aged and disabled adults is the Elderly and Disabled (E&D) Waiver. These Mississippi Medicaid HCBS waivers, where HCBS is short for home and community-based services, are built for people who, but for that help, would otherwise need the level of care a nursing facility provides.1 Instead of moving into an institution, an eligible person can stay in their own home and receive services like personal care, home-delivered meals, and adult day care paid by Medicaid.

In This Guide

• What Are Mississippi Medicaid HCBS Waivers?
• The E&D Waiver and Mississippi's Other HCBS Programs
• Who Qualifies for Mississippi Medicaid HCBS Waivers?
• What the E&D Waiver Pays For
• How Enrollment and Case Management Work
• How to Apply

What Are Mississippi Medicaid HCBS Waivers?

Home and community-based services (HCBS) waivers are a way for a state to use Medicaid dollars on care delivered in your home or community rather than inside a nursing facility. The federal authority behind them is Section 1915(c) of the Social Security Act, which lets a state ask the federal government to "waive" some standard Medicaid rules so it can offer this kind of care. You will often see them written as 1915(c) waivers.2,1

The core idea is a trade. To use one of these waivers, a person has to need a nursing facility level of care, which is the same medical threshold that would qualify them for a nursing home. The waiver then pays for services that let them stay at home instead.2 That is why eligibility looks at both sides of the coin: the medical need that would otherwise send someone to an institution, and the income and asset rules that Medicaid applies to long-term care.

Mississippi runs its version of this through the Mississippi Division of Medicaid, and its flagship program for older adults and adults with disabilities is the E&D Waiver.1 The rest of this guide focuses on that program, with a quick note on the state's parallel waivers for other populations.

The E&D Waiver and Mississippi's Other HCBS Programs

The Division of Medicaid administers and operates the Elderly and Disabled (E&D) Waiver itself, as an alternative to placement in a nursing facility, and CMS lists it as waiver 0272.R07.00.1 CMS describes it as serving people 65 or older, and people with physical disabilities ages 21 to 64, who meet a nursing facility level of care.1 Where you live matters too: under Mississippi's rules, an E&D participant cannot live in a nursing facility or in a licensed or unlicensed personal care home.1

Mississippi also runs other HCBS waivers for different groups. Alongside the E&D Waiver, the CMS factsheet for Mississippi lists four more: the Assisted Living Waiver, the Independent Living Waiver, the Traumatic Brain Injury and Spinal Cord Injury Waiver, and the ID/DD Waiver for people with autism, intellectual disabilities or developmental disabilities.1 Each of those is built around a particular setting or population, so the E&D Waiver is the one most families arrive at when they are trying to keep an aging parent or a disabled adult at home.

Who Qualifies for Mississippi Medicaid HCBS Waivers?

Qualifying for the E&D Waiver means clearing two separate tests: a medical (functional) test and a financial test. You have to pass both.

The Medical Test: A Nursing Facility Level of Care

On the medical side, an applicant must be age 21 or older and need a nursing facility level of care, as determined by a comprehensive long-term services and supports (LTSS) assessment.1 In plain terms, that means your care needs are serious enough that, but for the waiver's services, you would require the kind of help a nursing facility provides. Each applicant is evaluated individually against that standard, and federal rules require a reevaluation at least once a year.2

The Financial Test: Income and Assets

On the financial side, there are two ways to qualify. You can qualify as a Supplemental Security Income (SSI) recipient, or as an aged, blind or disabled person who meets all of Mississippi's institutional eligibility rules.1 For 2026, those rules work out like this:

• In 2026, Mississippi Medicaid's monthly income limit for the E&D Waiver is $2,982, which is 300% of the SSI federal benefit rate (CMS puts the 2026 SSI individual rate at $994). Mississippi compares your total income to that cap.1 Because the cap is built on the SSI rate for one eligible individual ($994, against $1,491 for an eligible individual with an eligible spouse), it is measured against the applicant's own income: a married applicant should not add both spouses' incomes together and compare the total to $2,982, and should let the Division of Medicaid determine eligibility.1
• For 2026, Mississippi Medicaid's countable resource (asset) limit for the E&D Waiver is $4,000 for an individual.1
• Not everything counts toward the $4,000. Mississippi excludes one home, one automobile regardless of value, household goods, burial spaces for family members, and up to $6,000 in burial funds held in a revocable arrangement, among other items.1
• Home equity has its own cap. Mississippi's limit rises each year with consumer prices, and CMS sets the 2026 minimum at $752,000. If your eligibility depends on the waiver and your home equity is over the limit, you cannot get full Medicaid services, though a Medicare Savings Program can still be approved. The cap does not apply when a spouse, a child under 21, or an adult blind or disabled child lives in the home, and it can be waived for undue hardship.1
• A five-year look-back applies to assets given away or sold for less than fair market value. If a penalty applies and your eligibility depends on the waiver, the application is denied, or the case is closed, for the penalty period.1

If you are married, Mississippi applies spousal impoverishment rules, and an HCBS waiver participant counts as the institutionalized spouse. The couple's countable resources are combined: the at-home spouse's share is the federal maximum, $162,660 in 2026, and the applicant's share is the $4,000 individual limit plus anything above the at-home spouse's maximum, which has to be spent down before the applicant qualifies. Both spouses cannot qualify for an HCBS waiver under these rules at once; each is evaluated separately.1

If your income is above the $2,982 limit, an HCBS waiver participant can still qualify through an Income Trust. To qualify, the applicant pays the Division of Medicaid the portion of income due under the trust's terms, and the trust can pay out to the person no more than $1 less than the current Medicaid income limit.1 Setting one up is worth talking through with an elder law attorney, since the mechanics have to be done correctly to work.

For the broader picture of how the state counts income and assets across all its Medicaid programs, see our guide to Mississippi Medicaid income and asset limits.

What the E&D Waiver Pays For

CMS lists these covered services under the E&D Waiver:1

• Adult day care
• Case management
• Personal care
• Home-delivered meals
• In-home respite
• Institutional respite care
• Extended home health services
• Community transition services
• Medication management
• Environmental safety services
• Physical therapy and speech therapy

Together these are what make staying at home workable: personal care for day-to-day help, respite to give a family caregiver a break, meals delivered to the door, and environmental safety services for the home itself.

How Enrollment and Case Management Work

Case management is one of the E&D Waiver's covered services, alongside the hands-on help listed above.1 Coverage starts only once two things are true: the waiver placement has been approved, and you have been found eligible under Mississippi's institutional rules. It begins on whichever of those happens later.1

A 1915(c) waiver can cap how many people it serves in each waiver year, so slot availability can change from year to year, and any waiting-list or enrollment timing depends on how the program is running when you apply.2 Because that status shifts, ask the Mississippi Division of Medicaid where enrollment stands for your situation rather than relying on secondhand information.

How to Apply

If you are not already on Medicaid, you file an Aged, Blind and Disabled Medicaid application with the Mississippi Division of Medicaid and contact the waiver program's initial point of contact for a clinical evaluation.1 If you ask for it, coverage can also reach back to the third month before the month you applied, for any month in which you were eligible and received covered Medicaid services.1

Federal Medicaid rules also give you more than one way to file an application. The state agency must accept applications online, by phone, by mail, and in person.3 So you are not locked into a single method; pick the channel that works best for you.

Once you apply, the state has a set window to make a decision. Under federal rules, a Medicaid eligibility determination may not take longer than 90 days for applicants who apply for Medicaid on the basis of disability, and 45 days for all other applicants, except in unusual circumstances.4 The agency may not use those limits as a waiting period or as a reason to deny you, and if it does run late, it must document the reasons for the delay in your case record.4 The longer window follows the basis you applied under, not whether a disability question happens to arise: someone applying on the basis of age is on the 45-day cap even though the E&D Waiver requires a nursing facility level-of-care assessment. Both numbers are ceilings on the agency rather than a promised decision date. Keeping copies of everything you submit and following up if you approach those limits will help keep your application moving.

If a nursing home rather than home care is what you are weighing, our guide to Mississippi Medicaid and nursing home care covers that side of long-term care.

Learn More

Find personalized help applying for Mississippi's E&D Waiver at brevy.com.

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.