Eligibility for NC Innovations Waiver

Versión en español

The following are general guidelines to help you decide if you should apply. Other eligibility requirements will need to be met.

The NC Innovations waiver is for North Carolinians of all ages who:

  1. Have an intellectual or developmental disability or a related condition.
    This may include autism, cerebral palsy, Down syndrome, epilepsy, fetal alcohol spectrum disorder, traumatic brain injury (if the injury occurred before age 22) and more.
  2. And need a lot of support, now and in the future.
    For instance, your loved one may need help to take care of themselves, like bathing or dressing. Or they may need help to live on their own, like cooking or working. (The technical requirement is “meeting ICF-IID level of care,” which means they have needs similar to people in an intermediate care facility. You do not need to know if you meet this to apply.)

Not sure if your loved one is eligible? We encourage you to apply anyway to secure your spot. It is best to get on the waitlist early, especially if services may be needed in the future.

Notes on who can apply:

  • Anyone can apply regardless of age, insurance or income.
  • Even if you have private insurance, you may still apply.
  • You do not have to have NC Medicaid to apply.

Ready for the next step?

The best way to find out if you are eligible is to apply.  

How to Apply

Need help?

For questions about the NC Innovations Waiver:
Call the Local Management Entity/Managed Care Organization (LME/MCO) that serves your county. These organizations manage the NC Innovations waiver.

Not sure who to call? Use the LME/MCO directory or call the Division of Mental Health, Developmental Disabilities and Substance Use Services Customer Service Team at 1-855-262-1946. Hours of operation: 8 a.m. to 5 p.m., Monday through Friday.

If your LME/MCO has not been able to solve your problem, or if you need help understanding NC Medicaid: Call the NC Medicaid Ombudsman at 1-877-201-3750. Hours of operation: 8 a.m. to 5 p.m., Monday through Friday.

Off