In order to “waive off” institutionalization, each Medicaid Waiver has access to a specific “cost limit” (maximum) that is connected to the price of a specific institutionalization – either:
- Nursing Home annual cost
- Intermediate Care Facility for Intellectual Disability cost
- Psychiatric facility cost
| Texas Medicaid Waiver Cost Limit Comparisons | |||||
| Program: | Limit based on: | Max per year per person: | |||
| HCS Waiver | 200% Institutional cost | Pervasive Plus (9) $305,877 | Pervasive (6) $168,615
Extensive (8) $167,468 Limited (5) $167,468 Intermittent (1) $167,468 |
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| Star+Plus Waiver | 200% Institutional cost | Without vent: $142,022 | With vent <24 hr day: $178,551
With 24-hr/day vent: $233,337 |
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| CLASS Waiver | 200% Institutional cost | $114,736.07 Link to source. |
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| DBMD Waiver | 200% Institutional cost | $114,736.07 | |||
| MDCP Waiver | 50% Institutional cost | Without vent: $35,505 | With vent <24 hr day: $44,638 | Tracheostomy: $49,202
With 24-hr/day vent: $58,334 |
|
| YES Waiver | $35,000 | ||||
| TxHmL Waiver | $17,000 | ||||
Texas Medicaid Waivers Explained 
I am just now trying to understand it. Thank you
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