Home modifications are physical adaptations to a home that are necessary to ensure the health, welfare and safety of the individual. Waiver funding covers only basic modifications determined to be medically necessary for the waiver individual and is not available for items that exceed basic medical need. Requests to upgrade products or to use materials exceeding the individual’s basic needs will not be approved.
Due to the state’s responsibility to ensure each modification is the most cost effective to meet the individual’s basic needs for accessibility within the home, it is not acceptable to submit bids attempting to combine waiver funding for basic modifications with private funding to cover the higher costs of the desired upgrades.
If an individual or family requests an upgrade, such as tile floor when basic vinyl is the lowest cost product to meet the need, then the individual or family must assume financial responsibility for the entire modification. Basic modifications covered under the home modification benefit will match existing architecture and aesthetics as much as possible.
Read the full announcement here: https://www.in.gov/medicaid/providers/files/bulletins/BT202651.pdf
Comments