New Mexico Medicaid Home and Community-Based Waivers

Managed Care 1915(b) and/or Home and Community-Based 1915(c) Waivers for Respite Support

Medicaid is a program in every state that pays for medical assistance for certain individuals and families with low incomes and resources. It is the largest source of funding for medical and health-related services for America’s poorest people. Because Medicaid is funded jointly by the federal and state governments, the services paid for vary from state to state. In addition to medical services, Medicaid will pay for home and community-based services (HCBS) through the state plan as well as through Medicaid waivers that offer services as a lower-cost alternative to treatment in a medical or long-term care facility, such as a nursing home. Respite is usually paid for through one or more of the following types of waivers: research and demonstration (1115), managed care (1915b) and HCBS (1915c) waiver programs. This state’s Medicaid waivers that include respite are: 

 New Mexico’s Home and Community-Based 1915(c) waivers are being incorporated into the 1115 Demonstration: “NM Centennial Care 2.0 waiver” and are now operated as Managed Long-term Services and Supports. For members qualifying for basic Medicaid, all of the waiver services offered by the Home and Community-Based 1915(c) waivers including respite care are to be provided in the MLTSS delivery system. Members qualifying as part of the 217-like group (individuals who need HCBS to avert institutional placement, who would be eligible for Medicaid under another eligibility group if they were in an institution, and who receive waiver services) will receive respite and other LTSS through the 1915(c) waivers listed below.