Delaware Medicaid waiver guide
Learn how Delaware Medicaid waiver services work, which state agency to start with, how the application process usually begins, and where to search for home and community-based services.
Last reviewed July 2026. See something out of date? Use the “Suggest an edit” button to let us know.
Delaware serves people with intellectual and developmental disabilities through the Division of Developmental Disabilities Services (DDDS), part of the Department of Health and Social Services. Its Medicaid home and community-based program is the Lifespan Waiver. The single most useful thing to understand about Delaware is that these are two separate applications: being found eligible for DDDS is not the same as being enrolled in the Lifespan Waiver. Families regularly assume the first step finished the job. Waiver enrollment is a second process you pursue with a DDDS case manager after eligibility is established.
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People eligible for DDDS who need home and community-based supports to live independently
DDDS eligibility is set by Title 16, Section 2100 of the Delaware Administrative Code. It requires a diagnosis of an intellectual developmental disability — which in Delaware includes brain injury — or autism spectrum disorder, or Prader-Willi Syndrome, assigned during the developmental period. Delaware uses age 22 rather than 18 as its cutoff: the standardized psychological testing or assessment used to establish eligibility must have been completed before age 22. DDDS makes an eligibility determination within 30 days of a complete application.
An intellectual developmental disability — Delaware explicitly includes brain injury here — or autism spectrum disorder, or Prader-Willi Syndrome. The brain injury inclusion is broader than many states, so it is worth asking about even if you have been turned down elsewhere.
The condition must have been assigned during the developmental period, per Title 16, Section 2100 of the Delaware Administrative Code.
The standardized psychological testing or assessment used to determine eligibility must have been completed before age 22 — not 18, as in many states. If testing exists from the college years, it may still count.
DDDS eligibility is about disability. To fund services through the Lifespan Waiver you must also meet Delaware Medicaid rules and the waiver's level of care.
Being found eligible for DDDS does not by itself enroll you in the Lifespan Waiver. Waiver enrollment depends on available capacity and is pursued with your case manager as a separate step. Delaware does not publish a standing public waitlist count the way some states do, so the practical move is to ask your case manager directly where you stand and what would change your priority.
Apply online for electronic submission to the Applicant Services office, or print the paper application and send it by email or fax, or bring it to a DDDS office. This establishes DDDS eligibility only.
Open linkStandardized psychological testing or assessment completed before age 22 is required. Delaware's age-22 cutoff is more generous than most states' age-18 rule, so gather records from the late teens and early twenties too.
DDDS makes an eligibility determination within 30 days of a complete application and sends a letter with the decision and next steps. If your application is incomplete the clock does not start — check that everything was received.
An application to DDDS is not an application for waiver services. Once eligible, you work with your DDDS case manager to apply for the HCBS Lifespan Waiver. Ask explicitly for this to be started; do not assume eligibility triggered it.
Open linkOnce enrolled, your case manager helps develop your person-centered plan and select providers, or set up self-direction.
Exact covered services depend on the waiver, assessed need, Medicaid rules, funding, and state program requirements. Confirm services, availability, and payment acceptance with the state, support coordinator, and provider.
Delaware's Lifespan Waiver includes self-directed options that let participants and families take a role in hiring, training, and managing their own support staff rather than relying only on agency providers. Ask your case manager which services can be self-directed under your plan.
Approved Lifespan Waiver services are paid through Delaware Medicaid. Once enrolled, there is generally little or no direct cost for covered services.
The waiver covers assistive technology only if it is not otherwise covered by State Plan Medicaid. Expect to be asked to try the State Plan route first — that is normal, not a denial.
In residential settings the waiver pays for services, not room and board, which is typically covered by the person's own income such as SSI.
Delaware's early intervention program serves infants and toddlers with delays, separately from DDDS waiver services.
School districts provide special education under an IEP. Keep every evaluation the school performs — Delaware's eligibility rests on standardized testing, and these records are the usual source.
Delaware allows testing completed any time before age 22 to establish eligibility. If a young adult was never formally tested, there is still time — this is a wider window than most states allow.
Adult supports run through the Lifespan Waiver. If someone acquires a qualifying brain injury during the developmental period, Delaware's definition may cover them where other states' would not.
If DDDS eligibility or a Lifespan Waiver service is denied, reduced, or ended, you have the right to appeal and to request a Medicaid fair hearing within the deadline printed on your notice. Disability Rights Delaware, housed within the Community Legal Aid Society, is the state's federally mandated protection and advocacy agency and provides free legal help.
Protection & Advocacy agency for Delaware
302-575-0690Visit siteEligibility, intake, and case management — 866-552-5758 Option 2
302-744-9700Visit siteWhere the eligibility application goes
Visit siteFree disability rights and appeals help — CLASI toll-free 800-292-7980
302-575-0690Visit siteGeneral DHSS information
302-255-9040Visit siteLocal help & referrals — dial 211
Visit siteNo, and this is the most common misunderstanding in Delaware. An application to DDDS is not an application for waiver services. Once you are DDDS-eligible you pursue Lifespan Waiver enrollment as a separate process with your case manager. Ask for it explicitly.
Age 22. The standardized psychological testing or assessment used to determine eligibility must have been completed before age 22. That is a wider window than most states, so testing from the late teens or early twenties may still qualify.
Delaware's definition of intellectual developmental disability explicitly includes brain injury, assigned during the developmental period. That is broader than many states, so it is worth applying even if another state turned you down.
DDDS makes a determination within 30 days of a complete application and mails you a letter with the decision and next steps. If you have not heard back, confirm the application was actually complete — an incomplete file does not start the clock.
The Lifespan Waiver covers assistive technology only when it is not otherwise covered by State Plan Medicaid. Being routed to the State Plan first is the expected order of operations, not a rejection.
DDDS eligibility is set by Title 16, Section 2100 of the Delaware Administrative Code. It requires a diagnosis of an intellectual developmental disability — which in Delaware includes brain injury — or autism spectrum disorder, or Prader-Willi Syndrome, assigned during the developmental period. Delaware uses age 22 rather than 18 as its cutoff: the standardized psychological testing or assessment used to establish eligibility must have been completed before age 22. DDDS makes an eligibility determination within 30 days of a complete application.
submit the ddds eligibility application, include psychological testing from before age 22, wait for the 30-day determination, then apply for the lifespan waiver — this is a separate step, then enroll and choose providers. Start with Delaware Division of Developmental Disabilities Services.
Covered services vary by waiver and assessed need, and commonly include in-home supports, respite, supported employment, day services, behavior support, residential supports. Confirm specifics with the state and provider.
Being found eligible for DDDS does not by itself enroll you in the Lifespan Waiver. Waiver enrollment depends on available capacity and is pursued with your case manager as a separate step. Delaware does not publish a standing public waitlist count the way some states do, so the practical move is to ask your case manager directly where you stand and what would change your priority.
Approved waiver services are generally covered by Medicaid at little or no direct cost once enrolled, though some enrollees may owe a monthly patient responsibility based on income.
How to apply for DDDS eligibility, online or on paper, and where applications go.
DelawareDelaware's HCBS waiver supporting community living.
DelawareDDDS programs, contacts, and provider information.
DelawareFree protection and advocacy legal services, including appeals help.
DelawareFind waiver providers and services in Delaware on Waiverly.
Want to deliver these services instead? How to become a waiver provider in Delaware
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