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Get the free Home and Community-Based Services (HCBS) Waiver.

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HOME AND COMMUNITY BASED (HUBS) WAIVER REQUEST (for current Medicaid recipients only!) APPLICANT INFORMATION First Name, Middle Name, Last Name Home AddressPhone NumberCityStateBirth Date CodeCountySocial
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How to fill out home and community-based services

01
Begin by gathering all necessary information such as personal identification, medical history, and current health needs.
02
Contact the relevant home and community-based services agency or organization to inquire about their application process.
03
Fill out the application form completely and accurately, ensuring all required fields are answered.
04
Provide any supporting documentation required, such as medical records or letters from healthcare providers.
05
Submit the completed application either online, by mail, or in person as directed by the agency.
06
Follow up with the agency to ensure your application is received and processed in a timely manner.
07
Attend any assessments or interviews scheduled by the agency to determine your eligibility for home and community-based services.
08
Once approved, work with the agency to develop a care plan that meets your individual needs and preferences.

Who needs home and community-based services?

01
Individuals with disabilities who require assistance with daily living activities.
02
Elderly individuals who need support to remain independent in their homes.
03
Individuals recovering from surgery or illness who require temporary assistance with medical care.
04
People with chronic health conditions who need ongoing support to manage their symptoms and maintain their quality of life.
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Home and community-based services are programs that provide assistance and support to individuals in their own homes or community settings, rather than in institutions.
Individuals or agencies providing home and community-based services are required to file.
Home and community-based services can be filled out through the appropriate forms provided by the specific program or agency offering the services.
The purpose of home and community-based services is to help individuals live independently and access the support they need to remain in their homes and communities.
Information such as the type of services provided, the number of hours of care, and any outcomes or changes in the individual's health or well-being must be reported on home and community-based services.
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