Frequently Asked Questions:
Q: What is Medicaid?
A: Medicaid is a medical assistance program. Services like doctor visits, medications, hospital services, and therapies are covered under the State Plan. There are different rules for what is covered for people of different ages. Until the age of 21, almost any medically necessary support can be covered. “Adult” Medicaid is much more limited. The Georgia Department of Community Health (DCH) runs the Medicaid programs in our state.
Q: How do I get Medicaid?
A: Eligibility can be based on income or other needs. Children with developmental disabilities get Medicaid when they get SSI benefits or through the Katie Beckett / Deeming waiver program if family income is above SSI limits. After reaching 18 years of age, applicants may apply for SSI benefits without regard to family income and will automatically be approved for Medicaid State Plan services.
Q: What is a Medicaid waiver?
A: Sometimes what is covered under the State Plan isn’t enough, so states create waiver programs to give people access to services in addition to what’s covered under the State Plan. A federal agency has to approve these waivers and then money can be used to pay for things not otherwise covered (like dental care, transportation, special equipment, or behavioral, vocational and other services intended to promote independence).
Q: What are NOW and COMP waivers?
A: These are Home and Community-Based Services (HCBS) waivers designed by the state of Georgia to provide services to people with intellectual or developmental disabilities who without these supports might wind up in an institution. Basically, NOW is for people who don’t need 24 hour care and COMP is for people with more intensive needs.
Q: How do I know if I can get a waiver?
A: The Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) is responsible for NOW and COMP waivers and has field offices to handle Intake and Evaluation for people who are looking for services.
Q: What is the process for getting the NOW or COMP waiver?
A: After contacting Intake and Evaluation at the regional field office, you will complete an application. (Provide as much information as you can but you can ask the field office for help.) Then DBHDD professionals will conduct a series of evaluations. If you are found to be eligible, you will receive a letter of determination. If funding is available you will be assigned a support coordinator and a budget will be developed. You will choose a service provider; in some cases it is possible to direct your own services. Services will begin and will be evaluated at least annually.
Q: How quickly will I get a waiver once I’m eligible?
A: NOW and COMP have a long waiting list for services because there is more need than funding. Waiver services are supposed to be provided to those “most in need” first, so it is important to help the regional field office understand how critical your need is. While you are on the waiting list the regional field office will contact you annually for updates.
Q: Does Georgia Options work with people who don’t have a Medicaid Waiver?
A: Yes, Georgia Options will work with people on individual service arrangements.