Care Coordination

Care Coordination, Model Waiver

The Maryland Medicaid Model Waiver is a program that provides medically necessary home care services for children and young adults with complex medical needs. The program is designed as an alternative to costly institutionalization.

What does the program pay for?
It pays for medically necessary services that are covered under Maryland Medicaid. Such services can include

Durable medical equipment (large items like wheelchairs)
Disposable medical and supplies
Nursing assistance, including private duty nursing
Physician visits, including specialty physician visits
Therapies including speech, occupational and physical therapies
Nutritional services
Care coordination, which is provided by The Center.

Who should apply?
Families with children and young adults under the age of 22 who have significant health care needs that would require long term hospitalization should apply. Families whose insurance is exhausted or inadequate to meet the needs of the child at home may also want to apply.

What about families with insurance?
This program may help families with insurance in certain circumstances. Insurance may be used along with Medicaid coverage, remembering that Medicaid the payer of last resort.

What are the eligibility criteria?
There are three levels of eligibility: Medical, Financial and Cost Effective.

The child’s physician completes a medical eligibility review form that is used to determine the severity of the medical need
Families complete a Medicaid application and provide other related information needed to determine financial eligibility. One of the reasons this program is a waiver is that family/parental income is not counted toward financial eligibility. Only the child’s income is counted toward eligibility.
The Center must be able to determine that the cost of care at home would be less (or the same as) than the projected cost of long term hospital care. In addition it must be demonstrated that Maryland Medicaid would be liable for paying for a long-term hospitalization.

To make a referral to the program, contact the Intake Coordinator, Briget Barr, at 410-987-1048 ext. 127 or email her at bbarr@coordinatingcenter.org. You may also use the dedicated referral fax line at 410-729-4529.

For more information about the waiver, Contact Us or
email Betsy Bernstein at bbernstein@coordinatingcenter.org.

Providers who are interested in providing services under this program should contact Maryland Medicaid Provider Relations at 410-767-5340







		Care Coordination, Model Waiver The Maryland Medicaid Model Waiver is a program that provides medically necessary home care services for children and young adults with complex medical needs. The program is designed as an alternative to costly institutionalization. What does the program pay for? It pays for medically necessary services that are covered under Maryland Medicaid. Such services can include Durable medical equipment (large items like wheelchairs) Disposable medical and supplies Nursing assistance, including private duty nursing Physician visits, including specialty physician visits Therapies including speech, occupational and physical therapies Nutritional services Care coordination, which is provided by The Center. Who should apply? Families with children and young adults under the age of 22 who have significant health care needs that would require long term hospitalization should apply. Families whose insurance is exhausted or inadequate to meet the needs of the child at home may also want to apply. What about families with insurance? This program may help families with insurance in certain circumstances. Insurance may be used along with Medicaid coverage, remembering that Medicaid the payer of last resort. What are the eligibility criteria? There are three levels of eligibility: Medical, Financial and Cost Effective. The child’s physician completes a medical eligibility review form that is used to determine the severity of the medical need Families complete a Medicaid application and provide other related information needed to determine financial eligibility. One of the reasons this program is a waiver is that family/parental income is not counted toward financial eligibility. Only the child’s income is counted toward eligibility. The Center must be able to determine that the cost of care at home would be less (or the same as) than the projected cost of long term hospital care. In addition it must be demonstrated that Maryland Medicaid would be liable for paying for a long-term hospitalization. To make a referral to the program, contact the Intake Coordinator, Briget Barr, at 410-987-1048 ext. 127 or email her at bbarr@coordinatingcenter.org. You may also use the dedicated referral fax line at 410-729-4529. For more information about the waiver, Contact Us or email Betsy Bernstein at bbernstein@coordinatingcenter.org. Providers who are interested in providing services under this program should contact Maryland Medicaid Provider Relations at 410-767-5340