Illinois Medicaid Waivers: A Complete Guide for Home Care Agencies
If you run a home care or home health agency in Illinois, Medicaid waivers are one of your biggest revenue opportunities — and one of the most confusing systems to navigate. Each waiver targets a different population, comes with its own enrollment process, and reimburses different services. This guide breaks down every active Illinois HCBS waiver so you know exactly who qualifies, what you can bill for, and how to get enrolled.
What Are HCBS Waivers?
Under federal law, states can use Medicaid dollars to pay for care delivered at home instead of in a nursing facility or hospital. Illinois operates several of these Home and Community-Based Services waivers, each designed for a specific population. To qualify for any of them, a client must be a Medicaid-eligible Illinois resident who meets nursing-facility level of care. Beyond that, each waiver has its own age requirements, disability criteria, and covered services — which is exactly what the rest of this guide covers.
Persons Who Are Elderly Waiver (Community Care Program)
Administered through the Illinois Department on Aging, this waiver helps adults 60 and older remain safely at home. It’s one of the most widely used waivers in Illinois and a major source of clients for home care agencies.
Who Qualifies: Adults age 60 or older (with priority for those 65+) who are Medicaid eligible, at risk of nursing facility placement per a Determination of Need (DON) assessment, and safe to remain in the community with planned services.
Services Covered: In-Home Homemaker Services (personal care, cleaning, meal prep, and errands), Adult Day Services, Personal Emergency Response Systems (PERS), and Automated Medication Dispensers.
How to Enroll: To become an approved CCP provider, start at the Illinois Department on Aging’s Apply to be a Provider page, then submit your certification packet — a Legal Entity Application and Service Specific Application — through the CCP Online Application portal.
Persons with Disabilities (PD) Waiver
This waiver helps non-elderly adults with severe physical disabilities live independently and avoid nursing facility placement. It is administered by DHS – Division of Rehabilitation Services (DHS-DRS).
Who Qualifies: Adults ages 15 to 59 with a severe physical disability expected to last at least 12 months, who are Medicaid eligible (or enrolled in the Health Benefits for Workers with Disabilities program) and at risk of nursing facility placement per a DON assessment.
Services Covered: Homemaker Services, Home Health Aide, Individual Provider (consumer-directed care), OT/PT/Speech Therapy, In-Home Shift Nursing, Respite, Adult Day Services, PERS, Home-Delivered Meals, Environmental Accessibility Adaptations, and Specialized Medical Equipment.
How to Enroll: Agencies must enroll as an approved provider through DHS-DRS and complete Medicaid enrollment through the IMPACT Provider Enrollment system. Review agency-specific requirements at the IDHS Becoming a Provider page, then contact your local DRS/HSP office to begin the enrollment process.
Persons with Brain Injury (BI) Waiver
This waiver provides specialized services — including cognitive rehabilitation and vocational supports — to individuals whose limitations stem from an acquired brain injury. It is administered by DHS-DRS.
Who Qualifies: Individuals of any age with an acquired brain injury documented by a physician or neurologist (including TBI, stroke, aneurysm, anoxia, brain infection, toxic encephalopathy, or neoplasm) who are Medicaid eligible and at risk of nursing facility placement.
Services Covered: Homemaker, Home Health Aide, Individual Provider, In-Home Shift/Intermittent Nursing, OT/PT/Speech Therapy, Cognitive Behavioral Therapies (unique to this waiver), Day Habilitation, Supported Employment, Prevocational Services, Respite, PERS, Home-Delivered Meals, Environmental Adaptations, and Specialized Equipment.
How to Enroll: Provider enrollment runs through DHS-DRS and requires Medicaid enrollment via IMPACT. This waiver is part of the Home Services Program — visit the HSP provider information page for agency-specific requirements and contact your local DRS office to initiate enrollment.
Persons with HIV or AIDS Waiver
This waiver supports individuals of any age living with HIV or AIDS who are at risk of nursing facility placement. It is administered by DHS-DRS.
Who Qualifies: Individuals of any age diagnosed with HIV or AIDS who are Medicaid eligible, at risk of nursing facility placement, and safe to remain at home with planned services.
Services Covered: Homemaker, Home Health Aide, Individual Provider, In-Home Shift/Intermittent Nursing, OT/PT/Speech Therapy, Respite, Adult Day Services, PERS, Home-Delivered Meals, Environmental Adaptations, and Specialized Equipment.
How to Enroll: Enroll through DHS-DRS and complete Medicaid provider enrollment via IMPACT. Visit the HSP provider page for agency requirements, or email DHS.HSPWaiver@illinois.gov with questions.
Medically Fragile/Technology Dependent (MFTD) Children Waiver
Known as the DSCC Home Care Program, this waiver provides intensive in-home nursing and support to children who require life-sustaining medical technology. It is administered by the Division of Specialized Care for Children (DSCC) at UIC and is open to any family regardless of income.
Who Qualifies: Children under age 21 who require daily skilled nursing care and use medical technology such as ventilators, feeding tubes, tracheostomies, IV medications, or similar equipment, and who score at least 50 on the level of care tool. Children enrolled before age 21 may continue services after their birthday.
Services Covered: In-Home Shift Nursing (RN/LPN), CNA Services, Respite, Specialized Medical Equipment and Supplies, Environmental Adaptations, Family Training, and Nurse Training.
How to Enroll: Nursing agencies must apply directly through DSCC at the Nursing Agency Application page and submit required documentation to DSCCNurseEnroll@uic.edu. Agencies also need to enroll in IMPACT.
Adults with Developmental Disabilities (DD) Waiver
This waiver provides individualized supports to adults with intellectual or developmental disabilities, helping them live in the community instead of an ICF-I/DD facility. It is administered by DHS – Division of Developmental Disabilities (DHS-DDD).
Who Qualifies: Adults age 18 or older with an intellectual or developmental disability (including autism) who are Medicaid eligible, at risk of ICF-I/DD placement, and working with an Independent Service Coordination (ISC) agency.
Services Covered: Personal Support, Day Habilitation, Supported Employment, Prevocational Services, Respite, Behavioral Intervention and Treatment, OT/PT/Speech Therapy, Home Accessibility Modifications, Caregiver Training, Specialized Equipment, and Nursing Services.
How to Enroll: Begin at the Becoming a New DD Provider page on the DHS website, then complete Medicaid enrollment through IMPACT. Email DHS.DDDMedProv@illinois.gov once your IMPACT application is submitted.
Support Waiver for Children and Young Adults with Developmental Disabilities
This waiver supports children and young adults ages 3 to 21 with intellectual or developmental disabilities living at home. Families receive a monthly budget to select services from an approved menu, keeping care flexible and family-centered.
Who Qualifies: Children and young adults ages 3 through 21 who live at home with family, have a diagnosed intellectual or developmental disability, are Medicaid eligible and at risk of ICF-I/DD placement, and are working with an ISC agency.
Services Covered: Respite, Behavioral Intervention, OT/PT/Speech Therapy, Home Modifications, Caregiver Training, Specialized Equipment, and Day Habilitation.
How to Enroll: Start at the Becoming a New DD Provider page and complete IMPACT enrollment. Connect with local ISC agencies to get on their provider lists, as families select providers through their ISC-managed budgets.
Supportive Living Program (SLP)
The SLP provides services within a licensed Supportive Living Facility, similar to assisted living. Agencies that operate or partner with SLFs can deliver services under this waiver.
Who Qualifies: Adults age 65 or older, or adults ages 22 to 64 with a physical disability, who are at risk of nursing home placement, do not require 24-hour skilled nursing, and are not currently enrolled in another HCBS waiver.
Services Covered: 24-hour staffing, personal care, housekeeping, two meals per day, medication management, intermittent nursing, PERS, case management, and dementia care in designated settings.
How to Enroll: Agencies must be licensed as a Supportive Living Facility through HFS. Review the Illinois SLP program page for facility requirements and view the Operational SLP Provider Sites map to assess your market. All SLP providers must also enroll in IMPACT as a Medicaid provider. Contact HFS directly for facility licensure guidance.
Billable Add-On Services Available Across Multiple Waivers
Several services appear across multiple Illinois waivers and represent strong opportunities to expand revenue without adding entirely new program lines.
Home-Delivered Meals are covered under the Elderly, PD, BI, and HIV/AIDS waivers for clients who can feed themselves but cannot prepare food. To bill, your agency must be enrolled as a Medicaid provider, document the client’s inability to prepare meals in the care plan, and ensure meals meet nutritional standards. Meals are billed per meal delivered and do not require a physician order.
Personal Emergency Response Systems (PERS) are covered under virtually every Illinois HCBS waiver. Agencies that provide and monitor PERS devices can bill for installation, monthly monitoring, and equipment maintenance. You must be an enrolled PERS provider with HFS, and the client must have a documented health or safety need such as a fall risk, cardiac condition, or seizure history.
Transportation is billable under several waivers for rides to adult day programs and medical appointments. This requires enrollment as a transportation provider (or a partnership with an enrolled NEMT vendor), documentation of medical necessity, and transportation listed in the plan of care.
How to Enroll as an Illinois HCBS Provider
Regardless of which waiver you’re targeting, the enrollment path follows a similar framework:
- Obtain your NPI — Keep your National Provider Identifier current.
- Enroll with HFS via the Illinois MMIS at hfs.illinois.gov.
- Register with the operating agency — DHS-DRS for the PD, BI, and HIV/AIDS waivers; DHS-DDD for DD waivers; Department on Aging for the Elderly waiver; and DSCC for MFTD.
- Complete required training for providers and direct care staff.
- Obtain IDPH licensure — Home health agencies must also meet Medicare Conditions of Participation for skilled services.
- Build relationships with Care Coordinators — ISC agencies, CCUs, and MCO care coordinators are your primary referral sources.
Need Help Navigating Illinois Waivers?
Understanding Illinois Medicaid waivers is complex — but you don’t have to navigate it alone. GEOH works with Illinois home care agencies every day to help them get enrolled, stay compliant, and protect their revenue. Chat with a GEOH specialist today to talk through which waiver programs make sense for your agency and how to get started.