Medicaid & Waiver Program Tools

Applying for Medicaid and waiver programs in New York can feel overwhelming. Families often don’t know where to start, what forms they need, or how to confirm eligibility. At Individual Home Care Professionals (IHCP), we designed this Medicaid & Waiver Program Tools resource hub to simplify the process. Here, you’ll find essential tools, guides, and links to help you take confident steps forward.

1. Medicaid Eligibility Screener

One of the most common questions we hear is: “Do I even qualify for Medicaid or a waiver program?” Eligibility depends on many factors including income, resources, age, and medical need.

To make it easier, we’ve created a quick Medicaid Eligibility Screener Quiz. In just a few minutes, you can get a preliminary sense of whether you or your loved one may qualify. This tool is not a replacement for official review, but it’s an excellent starting point.

Take the quiz here: Medicaid Eligibility Screener

Why use this tool?

• Saves time before gathering paperwork

• Reduces confusion about income/resource thresholds

• Points you in the right direction (Medicaid, TBI waiver, NHTD waiver, OPWDD services, etc.)

For those who want official confirmation, we also link directly to the NY.gov Medicaid eligibility tool, which allows you to input your information into the state’s system.

2. Waiver Program Comparison Chart

New York offers three major waiver programs that support community-based care:

• TBI (Traumatic Brain Injury)

• NHTD (Nursing Home Transition & Diversion)

• OPWDD (Office for People With Developmental Disabilities)

Each program has different eligibility rules, services, and target populations. Families are often unsure which is the best fit.

Our Waiver Program Comparison Chart breaks down the differences in eligibility, services, and goals side by side, so you can quickly see which applies to your situation. Whether your loved one is recovering from a brain injury, transitioning from nursing home care, or living with a developmental disability, the chart helps you find clarity.

Key highlights include:

• Eligibility criteria (diagnosis, age, Medicaid status)

• Services offered (personal care, respite, habilitation, community supports)

• Goals of each program (rehabilitation, diversion from nursing homes, lifelong developmental disability supports)

This chart is updated to reflect current New York program rules and can serve as a family-friendly reference guide when meeting with care coordinators or Medicaid planners.

3. Downloadable Forms Library

One of the biggest barriers in the Medicaid/waiver process is paperwork. Missing a single form can delay your application. That’s why we’ve assembled a Downloadable Forms Library of the most commonly requested documents.

Forms you’ll find in this library:

• Medicaid Application (DOH-4220)
  The standard application for Medicaid in New York.

• Physician’s Orders
  Medical certification that verifies diagnosis and care needs (often required for TBI and OPWDD).

• Plan of Care Templates
  Helps you outline the services your loved one needs at home, a requirement for many waivers.

• Freedom of Choice Forms
  Needed for waiver enrollment (TBI/NHTD).

• Supplemental Documentation Templates
  Includes sample income statements, no-income declarations, and resource disclosure forms.

All forms are sourced directly from NY.gov or New York State program agencies, ensuring accuracy. Families can download, print, and complete them at their own pace, reducing stress and avoiding back-and-forth delays.

How to Use These Tools Together

1. Start with the Quiz – Take the Eligibility Screener to see if Medicaid or waivers may be a fit.

2. Review the Chart – Compare TBI, NHTD, and OPWDD to narrow down which program is most relevant.

3. Download Your Forms – Access the forms you’ll likely need for your application.

4. Organize and Prepare – Keep your forms, IDs, and supporting documents in one place.

5. Get Expert Help – IHCP can guide you step by step to avoid mistakes and accelerate approval.

Why These Tools Matter

• Clarity: Families often feel lost. These tools provide straightforward guidance.

• Time Savings: By gathering forms and eligibility information up front, you’ll save weeks of delays.

• Confidence: With a roadmap in hand, you can approach the Medicaid process knowing you’re prepared.

• Support: IHCP offers one-on-one guidance. You don’t have to do this alone.

At Individual Home Care Professionals, we believe navigating Medicaid and waiver programs should not be overwhelming. That’s why we built this resource page—to provide practical tools, clear guidance, and the confidence to take the next step in securing care for your loved one.

Use these tools, download the forms, and when you’re ready, reach out to us. Together, we’ll make sure you have everything you need to apply successfully.