ASSISTIVE TECHNOLOGY (PENDING)
A PRESCRIPTION IS REQUIRED
Assistive technology is specialized medical equipment, supplies, devices, controls, and appliances, not available under the State Plan for Medical Assistance, which enable individuals to increase their abilities to perform activities of daily living (ADLs), or to perceive, control, or communicate with the environment in which they live, or which are necessary for life support, including the ancillary supplies and equipment necessary to the proper functioning of such technology. In order to qualify for these services, the individual shall have a demonstrated need for equipment or modification for remedial or direct medical benefit primarily in the individual’s home, vehicle, community activity setting, or day program to specifically improve the individual’s personal functioning.
AT shall be covered in the least expensive, most cost-effective manner. Equipment or supplies already covered by the State Plan may not be purchased under the waiver.
The Support Coordinator is required to ascertain whether an item is covered through the State Plan before requesting it through the waiver.
- Building Independence – which includes supports for adults (18+) who live independently in their own homes. Supports are complemented by non-waiver funded rent subsidies and/or other types of support. Children on the DS Waiver will transition to the Family and Individual Supports
- Family and Individual – which includes supports for children and adults living with their families, friends, or in their own homes.
- Community Living – which includes up to 24/7 residential services and additional supports for adults and children with exceptional medical and/or behavioral support needs. This is the only waiver that provides the sponsored residential and group home residential services options.
Up to $5000 annually
Detailed information about the program can be found at:
- Making Strides of Virginia provides environmental modification through the DD Waiver and CCC Plus Waiver-
- Case Manager goes into WAMS and launches a blank Service Authorization (SA)
- Case Manager contacts Making Strides to alert them that there is a SA open
- Phone Number (804) 203-1991
- SA is completed by therapist and sent back to case manager with request for hours need & required documents (treatment plan).
- Case manager reviews the SA and sends for approval
- Approval is seen in WAMS and service can be provided
Insurances Accepted: (Please check back frequently as we are continuously adding insurance companies)
- United Healthcare (UHC)
- VA Community Care
- Patient Centered Community Care (PCCC)
- Veterans Choice Program (VCP)
- CCC Plus Managed Care Program – Basic Concept of CCC Plus: CCC Plus is managed care, which means that instead of medical and other service providers contracting with Medicaid directly and billing Medicaid directly, each provider will have to go through one of six managed care organizations (MCOs) to enroll, get service authorization, and bill. These MCOs are usually for-profit insurance companies. The move toward managed care is part of a large and growing national trend to contain costs for Medicaid.
- The 6 MCO’s administering the CCC Plus Waiver are:
- United Healthcare
- Anthem Health Keepers Plus
- Optima Health
- Magellan Complete Care of VA (Pending)
- AETNA Better Health of VA (OUT OF NETWORK)
- Virginia Premier (OUT OF NETWORK)
Detailed information about the program can be found at: https://thearcofnova.org/content/uploads/sites/6/2018/08/Commonwealth-Coordinated-Care-Handout-8.7.18.pdf