Eligibility and Enrollment

Are the eligibility requirements changing for the current waivers?

Eligibility for the current waivers is not changing. Iowa HHS is proposing to add autism and developmental disabilities as qualifying diagnoses for the existing Health and Disability (HD) waiver. 

This change is included as part of the September 2026 waiver amendments. The Centers for Medicare & Medicaid Services (CMS) must approve it before it can take effect.  

If CMS approves the change, people with autism or a developmental disability could apply for the HD waiver and be added to the waitlist beginning January 1, 2027. 

This means they would not need to wait for the future Children and Youth Waiver or Adults with Disabilities Waiver to apply for waiver services. 

When a waiver slot becomes available, they must meet all Medicaid financial and level-of-care eligibility requirements, before they can enroll and receive waiver services.

What is happening with the Children and Youth Waiver and Adults with Disabilities Waiver? 

The new waivers will launch in the future, but Iowa HHS has not determined the date. 

Iowa’s current seven waivers will stay in place while Iowa HHS continues planning the broader waiver redesign and how members will transition to the new waivers.  

Who will the Children and Youth Waiver and Adults with Disabilities Waiver serve?

The Children and Youth Waiver will support children and young adults from birth through age 20. It is designed to meet needs in early childhood, during school years, and as youth prepare for adulthood. These services are meant to add to, not replace, the care children should receive through Iowa Care for Kids, also known as Early and Periodic Screening, Diagnostic, and Treatment (EPSDT).

The Adults with Disabilities Waiver will serve people starting at age 21. It will include supports people may need as they move through adulthood and into older age.

The new HOME Waivers will include the current groups served through the Intellectual Disability Waiver, Health and Disability Waiver, Brain Injury Waiver, Physical Disability Waiver, HIV/AIDS Waiver, and Children's Mental Health Waiver. 

The new HOME Waivers will also cover people with developmental disabilities and autism. On the Adults with Disabilities Waiver, autism will be a separate eligibility category from developmental disabilities so people diagnosed with autism after age 21 can also qualify.

What requirements will I need to meet to qualify for the Children and Youth Waiver and Adults with Disabilities Waiver?

To qualify for a HOME Waiver, you will need to meet:

• Medicaid financial eligibility requirements 
• The age and qualifying disability or health condition requirements for the waiver 
• Level-of-care requirements, determined through an assessment 

The eligibility rules are a little different for the Children and Youth Waiver and the Adults with Disabilities Waiver. For the Adults with Disabilities Waiver, you must have an approved disability determination. Learn more about Iowa’s Disability Determination Process.

Iowa HHS eligibility staff make the final eligibility decision. If you have a case manager, they can help explain the process and help you gather the information you need, but they do not decide if you qualify. 

Disability Determination

A disability determination is an official decision from the Social Security Administration (SSA) or Iowa HHS that you meet the rules for having a disability.

To qualify for the Adults with Disabilities Waiver or join its waitlist, you must have an approved disability determination.

Many adults already on Iowa’s waivers or waiver waitlists have a disability determination on file. If you do, you usually will not need to complete a new one.

Learn more about Iowa’s Disability Determination Process.

If you do not have a disability determination, you can apply through SSA. If you do not qualify for Social Security benefits or do not want to apply through SSA, talk with your HHS eligibility worker about Iowa HHS’s Disability Determination Process.

If you are moving from the Children and Youth Waiver to the Adults with Disabilities Waiver, start checking your disability status between ages 18 and 20. Your case manager can help.

A disability determination is only one part of waiver eligibility. You must also meet the waiver’s financial and level of care requirements and have a qualifying condition.

If you receive Social Security benefits, you already have a disability determination. 

If you do not receive Social Security benefits, you can: 

• Ask your HHS eligibility worker or Eligibility Benefits Specialist to check. 
• Talk to your case manager to help you identify the right HHS contact. 

If Iowa HHS confirms that an approved disability determination is already on file, you will not need to take action unless Iowa HHS requests additional or updated information. People who receive Social Security disability benefits as children will need to complete an age-18 disability review to continue receiving benefits as an adult. 

Can I apply for the Children and Youth Waiver and Adults with Disabilities Waiver now?

No. The Children and Youth Waiver and Adults with Disabilities Waiver have not launched yet and Iowa HHS has not determined when they will start. 

For now, you should apply for one of Iowa’s current HCBS waivers if you need waiver services.

If I am currently on a waiver, will I need to submit an application for the Children and Youth Waiver or Adults with Disabilities Waiver?

When the new HOME Waivers launch, Iowa HHS plans to move members enrolled in the six current disability-based waivers to a new waiver based on their age: 

• Members from birth through age 20 will move to the Children and Youth Waiver.  
• Members age 21 and older will move to the Adults with Disabilities Waiver.  
• Members enrolled in the Elderly Waiver will stay on that waiver.  

You will not need to submit a new application. 

Iowa HHS plans to update members’ enrollment automatically, as long as you still meet Medicaid, disability or clinical, and level-of-care eligibility rules. 

Iowa HHS will use information it already has when possible. If they need more information, Iowa HHS or your case manager will contact you. 

Some members may need to complete a disability determination, including some young adults moving to the Adults with Disabilities Waiver.  

Iowa HHS also has made plans to prevent gaps in waiver services and case management as members move to the new waivers. 

For example, Iowa HHS expects that your person-centered service plan and scheduled review date will carry forward to the new waivers. 

For now: 

• Keep using the services in your approved plan.  
• Complete Medicaid renewals and scheduled waiver assessments.  
• Keep your address, phone number, and other contact information current.  
• Tell your case manager if your needs or circumstances change.  

Read notices from Iowa HHS, your managed care organization, and your case manager.

The Elderly Waiver will stay separate. 

Members enrolled on the Elderly Waiver will not move to the Adults with Disabilities Waiver when it launches. 

They will stay on the Elderly Waiver.