Form preview

Get the free Application for a §1915(c) Home and Community-Based Services Waiver

Get Form
This document is an application for the 1915(c) Home and Community-Based Services Waiver program in Kansas, detailing the purpose, services, and administrative structure of the Autism Waiver designed
We are not affiliated with any brand or entity on this form

Get, Create, Make and Sign application for a 1915c

Edit
Edit your application for a 1915c form online
Type text, complete fillable fields, insert images, highlight or blackout data for discretion, add comments, and more.
Add
Add your legally-binding signature
Draw or type your signature, upload a signature image, or capture it with your digital camera.
Share
Share your form instantly
Email, fax, or share your application for a 1915c form via URL. You can also download, print, or export forms to your preferred cloud storage service.

How to edit application for a 1915c online

9.5
Ease of Setup
pdfFiller User Ratings on G2
9.0
Ease of Use
pdfFiller User Ratings on G2
Here are the steps you need to follow to get started with our professional PDF editor:
1
Log in to your account. Click on Start Free Trial and register a profile if you don't have one yet.
2
Prepare a file. Use the Add New button. Then upload your file to the system from your device, importing it from internal mail, the cloud, or by adding its URL.
3
Edit application for a 1915c. Rearrange and rotate pages, add and edit text, and use additional tools. To save changes and return to your Dashboard, click Done. The Documents tab allows you to merge, divide, lock, or unlock files.
4
Save your file. Choose it from the list of records. Then, shift the pointer to the right toolbar and select one of the several exporting methods: save it in multiple formats, download it as a PDF, email it, or save it to the cloud.

Uncompromising security for your PDF editing and eSignature needs

Your private information is safe with pdfFiller. We employ end-to-end encryption, secure cloud storage, and advanced access control to protect your documents and maintain regulatory compliance.
GDPR
AICPA SOC 2
PCI
HIPAA
CCPA
FDA

How to fill out application for a 1915c

Illustration

How to fill out Application for a §1915(c) Home and Community-Based Services Waiver

01
Gather necessary documentation, including proof of income, residency, and medical evaluations.
02
Complete the application form, ensuring all personal information is filled in accurately.
03
Specify the services you are applying for under the waiver.
04
Provide any supporting documentation required by your state’s Medicaid agency.
05
Review the application for completeness and accuracy.
06
Submit the application to your local Medicaid office or designated agency.
07
Keep a copy of the application for your records and follow up with the agency to check the status.

Who needs Application for a §1915(c) Home and Community-Based Services Waiver?

01
Individuals with disabilities or chronic conditions who require long-term care services and support in their homes or communities.
02
Families seeking alternatives to institutional care for their loved ones.
03
Individuals eligible for Medicaid who meet specific criteria outlined by their state.
Fill form : Try Risk Free
Users Most Likely To Recommend - Summer 2025
Grid Leader in Small-Business - Summer 2025
High Performer - Summer 2025
Regional Leader - Summer 2025
Easiest To Do Business With - Summer 2025
Best Meets Requirements- Summer 2025
Rate the form
4.4
Satisfied
28 Votes

People Also Ask about

States can operate as many HCBS Waivers as they want — currently, about 257 HCBS Waiver programs are active nationwide.
A family of two seeking to qualify for government subsidies under the 2025 Obamacare health insurance must have an income between $20,440 and $81,760.
1915(i) State Plan HCBS Overview 1915(i) provides states with the option to cover HCBS through their Medicaid state plans rather than through a 1915(c) waiver. 1915(i) requires participants to meet a state-defined needs-based criteria, not an institutional level of care as required under a 1915(c) waiver.
The Medicaid Home- and Community-Based Services (HCBS) waiver program was authorized under Section 1915(c) of the Social Security Act. Through this program, states can help provide different services that allow those who need care to receive services in their homes or communities.
There are two financial eligibility requirements for Home and Community Based Services (HCBS) Waivers – an asset limit and an income limit. In most states in 2025, the individual asset limit for HCBS Waivers is $2,000 and the individual income limit is $2,901/month.
There are two financial eligibility requirements for Home and Community Based Services (HCBS) Waivers – an asset limit and an income limit. In most states in 2025, the individual asset limit for HCBS Waivers is $2,000 and the individual income limit is $2,901/month.
The OPWDD Home and Community-Based Services (HCBS) Waiver operated by the Office for People With Developmental Disabilities (OPWDD) is a program of supports and services that enables adults and children with developmental disabilities to live in the community as an alternative to Intermediate Care Facilities (ICFs).

For pdfFiller’s FAQs

Below is a list of the most common customer questions. If you can’t find an answer to your question, please don’t hesitate to reach out to us.

The Application for a §1915(c) Home and Community-Based Services Waiver is a formal request submitted to the Centers for Medicare and Medicaid Services (CMS) for approval to provide long-term care services and supports in community settings, rather than in institutional settings.
State Medicaid agencies are required to file the Application for a §1915(c) Home and Community-Based Services Waiver in order to obtain federal funding and authority to offer home and community-based services to eligible individuals.
To fill out the Application for a §1915(c) Home and Community-Based Services Waiver, state agencies must complete specific forms provided by CMS, detailing the proposed services, target population, and operational plans. It may also require consultation with stakeholders and public input.
The purpose of the Application for a §1915(c) Home and Community-Based Services Waiver is to enable states to provide Medicaid-funded services that support individuals with disabilities or chronic conditions in living independently within their communities.
The Application must report information such as the target population, the range of services to be provided, service delivery methods, participant rights, and quality assurance measures, as well as budget and financial projections.
Fill out your application for a 1915c online with pdfFiller!

pdfFiller is an end-to-end solution for managing, creating, and editing documents and forms in the cloud. Save time and hassle by preparing your tax forms online.

Get started now
Form preview
If you believe that this page should be taken down, please follow our DMCA take down process here .
This form may include fields for payment information. Data entered in these fields is not covered by PCI DSS compliance.