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AGED AND DISABLED WAIVER FORMS INSTRUCTIONS Form Name: Aged and Disabled Waiver (ADD) Medical Necessity Evaluation Request (Policy Sections 501.9.2 and 501.9.3) Purpose: To request a medical evaluation

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How to fill out dhhrwvgovbmsprogramsaged and disabled waiver

01

Contact the DHHR office to inquire about the Aged and Disabled Waiver program.

02

Complete the application form with accurate information about the individual in need of services.

03

Submit the necessary documentation such as proof of income, citizenship status, and medical records.

04

Wait for the DHHR to review the application and schedule an assessment to determine eligibility.

05

If approved, work with a case manager to develop a care plan and begin receiving services through the waiver program.

Who needs dhhrwvgovbmsprogramsaged and disabled waiver?

01

Individuals who are aged 65 and older or have a disability that requires long-term care services and support.

02

Those who are financially eligible and in need of assistance with activities of daily living.

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What is dhhrwvgovbmsprogramsaged and disabled waiver?

The dhhrwvgovbmsprogramsaged and disabled waiver is a program that provides support and services to elderly and disabled individuals to help them remain living in their communities.

Who is required to file dhhrwvgovbmsprogramsaged and disabled waiver?

Individuals who meet the eligibility criteria for the program are required to file dhhrwvgovbmsprogramsaged and disabled waiver.

How to fill out dhhrwvgovbmsprogramsaged and disabled waiver?

To fill out the dhhrwvgovbmsprogramsaged and disabled waiver, individuals must provide personal information, medical history, and documentation of need for services.

What is the purpose of dhhrwvgovbmsprogramsaged and disabled waiver?

The purpose of the dhhrwvgovbmsprogramsaged and disabled waiver is to help elderly and disabled individuals receive necessary support services in their communities.

What information must be reported on dhhrwvgovbmsprogramsaged and disabled waiver?

Information such as personal details, medical needs, and requested services must be reported on the dhhrwvgovbmsprogramsaged and disabled waiver.

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