Minnesota Medicaid waiver guide
Learn how Minnesota 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 See something out of date?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.
Minnesota runs four disability waivers, and which one fits you depends less on your diagnosis than on the level of care you are assessed as needing. The Developmental Disabilities Waiver is for people who need an ICF/DD level of care; the Community Access for Disability Inclusion (CADI) Waiver is for people who would otherwise need a nursing facility level of care. You apply through your county agency or tribal nation — Minnesota calls these lead agencies — not to the state directly. One requirement catches families off guard: the DD Waiver requires daily interventions, daily service needs, and a 24-hour plan of care.
Search by state, city, or ZIP code to compare provider profiles, services, contact details, and verified status.
Children and adults with a developmental disability or related condition needing an ICF/DD level of care
Children and adults who would otherwise need a nursing facility level of care — must be under 65 when the waiver opens
People with an acquired or traumatic brain injury
People who are chronically ill and would otherwise need hospital-level care
For the DD Waiver you must have a developmental disability or related condition, need an ICF/DD level of care, be eligible for Medical Assistance, be certified disabled by Social Security or through Minnesota's State Medical Review Team (SMRT), make an informed choice for community services, require daily interventions and a 24-hour plan of care, and have assessed needs for habilitation and for supports beyond what Medical Assistance state plan services cover. CADI has a different level-of-care standard — nursing facility rather than ICF/DD — and requires you to be under 65 when the waiver is opened.
For the DD Waiver, you must be determined to have a developmental disability or a related condition, and to require the level of care provided in an intermediate care facility for persons with developmental disabilities (ICF/DD).
You must be certified disabled by the Social Security Administration or through Minnesota's State Medical Review Team process. If you have never applied to Social Security, SMRT is the alternative route and is worth asking about directly.
The DD Waiver requires daily interventions, daily service needs, and a 24-hour plan of care specified in the support plan, plus an assessed need for habilitation. This is a stricter standard than many families expect.
You must have an assessed need for supports and services over and above what is available through Medical Assistance state plan services, and choose community services instead of institutional care.
Minnesota does not run a single open-ended queue. The number of people who can be served through the DD Waiver varies depending on the federally approved waiver plan and state legislative funding levels, and lead agencies manage allocations locally. Both the DD and CADI waivers have published waiting list guidance that your lead agency works from.
You apply through the county agency or tribal nation where you live, not to the state. They conduct the screening that determines which waiver, if any, fits.
Open linkYou must be certified disabled by Social Security or through the State Medical Review Team. If you are not already receiving Social Security disability benefits, ask your lead agency about the SMRT route rather than assuming you are ineligible.
The screening determines whether you meet an ICF/DD level of care (DD Waiver) or a nursing facility level of care (CADI). Which standard you meet decides which waiver you are considered for.
For the DD Waiver, your support plan must specify daily interventions, daily service needs, and a 24-hour plan of care, plus an assessed habilitation need. Make sure the assessment captures the full picture of a day, not just peak moments.
After eligibility, the lead agency evaluates whether services are necessary for health, welfare, and safety; whether all options were assessed; whether cost is reasonable and customary; whether another funding source — state plan services, private insurance, Medicare, education, or Vocational Rehabilitation — covers it; and whether services build or maintain skills.
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.
Minnesota offers consumer-directed community supports (CDCS), which give participants a budget to design and manage their own services, including hiring their own staff. Ask your lead agency case manager about CDCS by name — it is an option within the waivers rather than a separate program.
Approved waiver services are paid through Medical Assistance, Minnesota's Medicaid program. Once enrolled, there is generally little or no direct cost for covered services.
Lead agencies must check whether a service is covered by Medical Assistance state plan services, private health coverage, Medicare, education, or Vocational Rehabilitation before the waiver pays. Being redirected to one of those is the expected order of operations, not a denial.
The number of people served through the DD Waiver depends on the federally approved plan and state legislative funding. Access can shift year to year in ways that have nothing to do with your individual eligibility.
Minnesota's early intervention system serves infants and toddlers with delays, separately from the waivers.
School districts provide special education under an IEP. Waiver services are separate — and note that the lead agency will check whether education funding covers a service before the waiver does.
Certification by Social Security or SMRT is a prerequisite. Families who have never applied for Social Security benefits should ask about SMRT well before they need waiver services.
The CADI Waiver requires you to be under 65 when the waiver is opened. If CADI is the right fit, opening it before that birthday matters.
If eligibility or a waiver service is denied, reduced, or ended, you have the right to appeal and to request a state fair hearing within the deadline printed on your notice. The Minnesota Disability Law Center, part of Mid-Minnesota Legal Aid, is the federally designated protection and advocacy agency and serves people with disabilities in every Minnesota county regardless of income.
Protection & Advocacy agency for Minnesota
1-800-292-4150Visit siteWhere you apply — screening, waiting lists, and case management
Visit siteWaiver program information and fact sheets
Visit siteFree legal help regardless of income — intake 612-334-5970 or 800-292-4150
1-800-292-4150Visit siteThe alternative route to disability certification if you are not SSA-certified
Visit siteLocal help & referrals — dial 211
Visit siteIt depends on the level of care you are assessed as needing, not on your diagnosis alone. The DD Waiver requires an ICF/DD level of care. CADI requires a nursing facility level of care and that you be under 65 when the waiver opens. The Brain Injury and Community Alternative Care waivers serve other specific populations.
For the DD Waiver, you must require daily interventions and daily service needs, with a 24-hour plan of care specified in your support plan. It is a stricter standard than many families expect, so make sure the assessment documents a full day rather than only the hardest moments.
Yes, potentially. You must be certified disabled either by the Social Security Administration or through Minnesota's State Medical Review Team. SMRT exists precisely for people who are not SSA-certified — ask your lead agency about it by name.
Lead agencies must check whether a service is covered by Medical Assistance state plan services, private insurance, Medicare, education, or Vocational Rehabilitation before waiver funds pay for it. Being routed to another source first is the normal order of operations.
Yes. Minnesota offers Consumer-Directed Community Supports (CDCS), which give you a budget to design your own service package and hire your own staff. Ask your case manager about CDCS specifically — it is an option within the waivers.
For the DD Waiver you must have a developmental disability or related condition, need an ICF/DD level of care, be eligible for Medical Assistance, be certified disabled by Social Security or through Minnesota's State Medical Review Team (SMRT), make an informed choice for community services, require daily interventions and a 24-hour plan of care, and have assessed needs for habilitation and for supports beyond what Medical Assistance state plan services cover. CADI has a different level-of-care standard — nursing facility rather than ICF/DD — and requires you to be under 65 when the waiver is opened.
contact your county or tribal lead agency, get disability certification in place, complete the screening and level of care assessment, document daily needs and the 24-hour plan, then enroll and choose providers. Start with Minnesota Department of Human 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.
Minnesota does not run a single open-ended queue. The number of people who can be served through the DD Waiver varies depending on the federally approved waiver plan and state legislative funding levels, and lead agencies manage allocations locally. Both the DD and CADI waivers have published waiting list guidance that your lead agency works from.
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.
Full eligibility criteria, how to apply through your lead agency, and what the lead agency evaluates next.
MinnesotaThe nursing-facility-level-of-care alternative, including the under-65 rule.
MinnesotaProgram overviews, fact sheets, and the county and tribal directory.
MinnesotaFree legal help for people with disabilities in every county, regardless of income.
MinnesotaFind waiver providers and services in Minnesota on Waiverly.
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