1915(i) Waiver: Medicaid Home and Community-Based Services

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The 1915(i) waiver offers free Medicaid services to support your independence at home or in the community. These services started July 1, 2023.

1915(i) services are for people with serious mental illness, severe substance use disorders, traumatic brain injuries or intellectual/developmental disabilities.

1915(i) can help you or a loved one live at home, find a job, learn skills to participate in the community, recover from substance use disorder and more.

If you’re on the waitlist for the NC Innovations Waiver or TBI Waiver, you can get these services without losing your spot.

If you get similar services through the “1915(b)(3) waiver” program, they are now moving to the 1915(i) waiver. To keep getting those services after June 30, 2024, you might need to do an assessment. Contact your LME/MCO health plan, like Alliance, Partners, Trillium or Vaya Total Care, to make sure your services continue.

Download a printable flyer about 1915(i) Medicaid home and community-based services.

Services

When you apply for 1915(i), you will be matched to the right services based on your needs and goals.

1. Respite Care

Gives caregivers a break, while knowing that their loved one is cared for. Care for the member could be provided in or out of the home.

  • Overnight care
  • Weekend care
  • Emergency care

This service helps caregivers caring for people with:

  • Serious emotional disturbance (SED), substance use disorder (SUD); ages 3-20
  • Intellectual and developmental disabilities (I/DD), traumatic brain injury (TBI); ages 3 or older

2. Community Transition

Get up to $5,000 in credit to help you move from an institution or approved setting to your own home. Approved settings can be a state-operated health care facility, a foster or group home, a psychiatric residential treatment facility, a community intermediate care facility (ICF-IID) and more.

  • Security deposit for an apartment or house
  • Essential home furnishings, like furniture, kitchen utensils and linens
  • Moving expenses
  • Set-up fees for utilities (like phone, internet, gas)

This service helps people with intellectual and developmental disabilities (I/DD), traumatic brain injury (TBI), substance use disorder (SUD), serious mental illness (SMI), severe and persistent mental illness (SPMI); it is available for people of all ages.

3. Supported Employment / Individual Placement and Support Services

Learn skills to find, get and keep a job that’s right for you.

  • Career planning and discovery
  • Résumé assistance
  • Job interview practice
  • Support with assigned job tasks
  • Transportation services

The “Supported Employment” service helps people with intellectual and developmental disabilities (I/DD), traumatic brain injury (TBI); ages 16 or older

The “Individual Placement and Support Services” service helps people with severe and persistent mental illness (SPMI), serious mental illness (SMI), serious emotional disturbance (SED); ages 16 or older

4. Community Living and Support

Learn skills to help you live independently at home and participate in the community.

  • Manage eating, bathing, dressing, personal care, hygiene and other daily activities
  • Life skills such as shopping and banking
  • Extra support for health and safety

This service helps people with intellectual and developmental disabilities (I/DD), traumatic brain injury (TBI); it is available for people of all ages.

5. Individual and Transitional Support

Get personalized support for your recovery from mental health issues or substance use disorders.

  • Participate and guide your recovery process
  • Access transportation
  • Find housing
  • Manage your finances
  • Continue your education

This service helps people with:

  • substance use disorder (SUD); ages 16 or older
  • serious mental illness (SMI), severe and persistent mental illness (SPMI); ages 18 or older
  • serious emotional disturbance (SED); ages 16-21

If you get these services through the “1915(b)(3) waiver” program, they are now moving to the 1915(i) waiver. To keep getting those services after June 30, 2024, you might need to do an assessment. Contact your LME/MCO health plan, like Alliance, Partners, Trillium or Vaya Total Care, to make sure your services continue.

Eligibility

You must have an NC Medicaid health plan managed by an LME/MCO (Alliance, Partners, Trillium, Vaya Total Care) like:

  • NC Medicaid Direct
  • Tailored Plans
  • EBCI Tribal Option
  • The Children & Families Specialty Plan (upon launch)

These groups are not eligible for 1915(i):

  • Standard Plan members (WellCare, UnitedHealthcare Community Plan, HealthyBlue, AmeriHealth Caritas, Carolina Complete Health)
  • NC Innovations Waiver enrollees*
  • TBI Waiver enrollees*

*If you’re on the waitlist for the Innovations Waiver or the TBI Waiver, you can get 1915(i) services while you’re waiting. You will not lose your spot.

Not sure which health plan you have? Check your health plan ID card or call the NC Medicaid Enrollment Broker at 1-833-870- 5500.

Don’t have NC Medicaid? Apply for NC Medicaid before applying for 1915(i) waiver services.

 

How to apply

To get started, call your health plan and tell them you want 1915(i) services. (Or tell your care coordinator or Tailored Care Manager, if you have one.)

Your health plan will help you through each step of the application process.

Here are the steps in the application process, so you know what to expect:

  1. Call your health plan, care coordinator or Tailored Care Manager to start the process.
  2. You’ll complete an assessment and wait for it to be processed.
  3. You’ll create a plan for services (called an Individual Support Plan or Care Plan).
  4. Once the care plan is processed, services will start.

If you get similar services through the “1915(b)(3) waiver” program, they are now moving to the 1915(i) waiver. To keep getting those services after June 30, 2024, you might need to do an assessment. Contact your LME/MCO health plan, like Alliance, Partners, Trillium or Vaya Total Care, to make sure your services continue.

 

Need help?

Call your health plan:

Don’t know who to call? Your health plan company (LME/MCO) is assigned based on the county that administers your NC Medicaid. Use this directory to find your LME/MCO. Or, call the number that’s on your health plan ID card.