Minnesota Elderly Waiver (EW): Eligibility, Benefits & How to Apply

Last reviewed: · Senova editorial team

Quick answer: The Minnesota Elderly Waiver (EW) lets people 65 and older who qualify for Medical Assistance (Medicaid) live at home or in a community setting instead of a nursing facility — with Medicaid paying for in-home help, adult day care, home modifications, personal emergency response systems, and other supports the regular Medicaid program doesn't fully cover. This 2026 guide explains who qualifies, what's covered, how much costs are, and exactly how to apply in Minnesota.

If you've been told that the only way to get help paying for your mother's daily care is to "spend down" everything she owns and move her into a nursing facility — you've been told something that isn't fully true in Minnesota.

The Elderly Waiver (EW) is a Medical Assistance program designed for one specific situation: an older adult who would qualify for nursing-home-level Medicaid care but wants to stay at home or in a community setting. The state of Minnesota will pay for the home-based help that makes that possible. For a lot of Minnesota families, EW is the difference between a parent staying in the home where she raised her children and being moved into a facility she doesn't want to live in.

This guide explains how EW works, who qualifies, what it covers, and exactly what to do today.

What Is the Minnesota Elderly Waiver?

The Elderly Waiver is one of several Home and Community Based Services (HCBS) waivers that Minnesota Medical Assistance offers. A "waiver" simply means the state has gotten federal permission to waive the rule that says Medicaid only pays for nursing-facility care for older adults — and instead use those dollars to pay for community-based care.

That's a big deal, because:

• Nursing-facility care in Minnesota averages $8,000–$11,000 per month
• A robust in-home care package — daily aide visits, adult day care, a personal emergency response system, home modifications — usually costs less, while letting the person live where they want

If you can stay home safely with help, EW pays for that help.

Not sure if you or a loved one qualify? Senova's free eligibility checker walks you through the questions in about 3 minutes.

Who Qualifies for the Elderly Waiver?

To enroll in EW, an applicant must meet three sets of criteria.

1. Be 65 or older

EW is age-restricted. If the person is under 65, they may qualify for a different waiver — most commonly CADI (Community Access for Disability Inclusion) or AC (Alternative Care) — and we cover those in companion guides.

2. Qualify medically for nursing-facility-level care

This is determined through a MnCHOICES assessment — a free, in-person assessment by a county or tribal assessor. The assessor evaluates whether the person needs help with daily living activities (bathing, dressing, eating, transferring, toileting, medication management) at the level a nursing facility would provide.

You don't have to "look bad enough" on paper — the assessor's job is to capture the real picture. Be specific: how often does she fall? How many medications does she take? When did she last cook a meal safely? When did she last leave the house alone? Honest answers protect the applicant.

3. Qualify financially for Medical Assistance

Income limits (2026, single adult): Generally up to 100% of the Federal Poverty Level for the elderly/blind/disabled MA category — about $1,255/month in 2026. Higher with a spend-down or with the EW special income standard. Two-person household: roughly $1,704/month.

Asset limits: Single adult: $3,000 in countable assets. Married, with one spouse on EW: the well spouse (the "community spouse") can usually keep substantially more under spousal impoverishment rules (often $30,000–$150,000+ depending on the year and circumstance). The applicant's home is generally protected if a spouse, child under 21, or certain dependent relatives live there.

Important: Financial rules are nuanced. Many families think they don't qualify and they actually do, especially with proper planning. If income or assets are slightly above the limit, an elder-law attorney or a Senior LinkAge Line specialist (800-333-2433) can often help structure things legally so the applicant qualifies.

Try our eligibility checker for a quick read on whether you may qualify, then verify with a county worker.

What Does the Elderly Waiver Cover?

EW covers an extensive list of community-based services. Not every person gets every service — the care plan is built around what the assessment shows is needed.

Personal care and in-home support

• Personal Care Assistant (PCA) services — help with bathing, dressing, toileting, eating, mobility, medication reminders, in-home tasks
• Home health aide visits through a Medicare-certified agency
• Skilled nursing visits as ordered
• Homemaker services — meal prep, laundry, light cleaning related to the recipient's care

Day programs and respite

• Adult day services — see our adult day care guide for what to expect
• Respite care — short-term relief for the family caregiver (in-home or facility-based)
• Companion services — supervision and socialization

Community and home environment

• Home modifications — grab bars, ramps, walk-in shower, widened doorways, lift chairs — up to a cap that varies by year
• Specialized medical equipment & supplies — beyond what regular MA covers
• Personal Emergency Response System (PERS) — the "I've fallen and I can't get up" button, installed and monitored
• Transportation for medical and community participation (beyond what MA's standard transportation covers)
• Caregiver living expenses in some Customized Living settings (assisted living)

Other supports

• Case management by a county or tribal case manager who helps coordinate everything
• Chore services — heavier seasonal tasks the person can't safely do
• Consumer-directed community supports (CDCS) — a self-directed option where the family hires and manages caregivers directly (often a family member)
• Customized Living — pays for the services portion of an assisted living arrangement (the room-and-board portion is paid by the person from their income, usually)

The full menu and rules update each year. Minnesota DHS publishes the current EW services list at mn.gov/dhs.

How Much Does EW Cost the Family?

For most enrollees, EW services themselves have no monthly premium or copay. Where families do encounter costs:

• Income contribution toward Customized Living or Foster Care room-and-board — the person pays from their income (usually keeping a small personal needs allowance, with the remainder going toward room and board)
• Optional services the family adds outside the waiver (private companions, alternative therapies, etc.)
• A small Medical Assistance premium for some EW participants with higher income, under a sliding scale

Our cost calculator can give a rough estimate of out-of-pocket costs for your situation.

How to Apply — The Step-by-Step Path

This is where most families get stuck. The process has several moving parts, but the path is predictable. Here it is.

Step 1 — Apply for Medical Assistance (if not already enrolled)

• Online: mn.gov/dhs → "Apply for Health Care"
• By phone: Minnesota DHS — 651-431-2670 (Twin Cities) or 800-657-3739 (statewide)
• In person: Your county human services office
• Use the MNsure application for combined eligibility

Step 2 — Request a MnCHOICES assessment

After (or alongside) the MA application, contact your county human services office (or tribal nation) and request a MnCHOICES assessment. This is the medical-need evaluation that determines EW eligibility.

The assessment is free, takes 2–3 hours, and happens in the home. A care plan grows out of it.

Tips: - Schedule it for a time when the applicant is at their typical, not their best. Mornings are often better for an honest read. - Have a family member present who can fill in gaps (the applicant may not remember the last fall, the missed medications, the kitchen near-misses). - Write down a few real recent examples in advance: "On April 14, mom forgot she had taken her blood pressure pill and took it twice."

Step 3 — Choose a case manager and a lead agency

After the assessment, the county will assign or help select a case manager who builds the EW service plan with you. The lead agency coordinates the care plan, services, and providers.

Step 4 — Choose your providers

The case manager will help you choose providers for each authorized service (PCA agency, home health agency, adult day program, etc.). You have the right to choose any provider enrolled with Minnesota DHS.

Our directory at senova.info lists Minnesota-enrolled home health, adult day, and respite providers by city — verified, free, no signup required.

Step 5 — Care begins

Once the service plan is signed and providers are selected, services begin. The case manager monitors and adjusts the plan as needs change.

Typical timeline

• MA approval: 30–45 days from application (faster with completed documentation)
• MnCHOICES assessment: scheduled within 20 business days of request; sometimes faster for urgent situations
• EW eligibility decision: within 60 days of MnCHOICES assessment
• Services start: typically 1–2 weeks after the service plan is signed

Urgent situations (post-hospital discharge, sudden caregiver loss) can move faster — be specific and direct with the county about why timeline matters.

Frequently Asked Questions

Can my parent get EW if they have a home and savings? The home is generally protected if the applicant, spouse, child under 21, or certain dependent relatives live there. Asset limits apply to countable assets — not the home, one vehicle, prepaid burial, personal items. Many families think they're over the limit and aren't. Talk to a Senior LinkAge Line specialist before assuming.

Can EW pay a family member to be the caregiver? Yes, under Consumer-Directed Community Supports (CDCS), the participant can hire and pay family members (other than a spouse) to provide care. This is a major benefit families miss. It does require more paperwork and management.

How does EW interact with Medicare? EW participants who are also on Medicare keep their Medicare coverage. Medicare pays first for medical services it covers; EW pays for community-based supports Medicare does not cover.

Is there a waiting list for EW? Minnesota does not have a waiting list for EW as of 2026 — if you medically and financially qualify, you can enroll. (This is not the case in every state. Minnesota's policy choice here is unusually family-friendly.)

What's the difference between EW, AC, and CADI? - EW (Elderly Waiver): 65+, qualifies medically for nursing-facility care, qualifies financially for MA - AC (Alternative Care): 65+, qualifies medically for nursing-facility care, but income/assets too high for MA. A sliding-scale alternative. - CADI (Community Access for Disability Inclusion): under 65, qualifies medically for nursing-facility care, qualifies financially for MA

We cover each in dedicated guides on Senova.

What if my parent's needs change? The service plan is reassessed annually, or earlier if needs change. Tell the case manager about any new fall, new diagnosis, or new caregiver-availability change immediately.

Where to Start in Minnesota — Right Now

You don't need to figure this out alone, and you don't need to know which form to fill out first. The fastest path is one of these three:

1. Senior LinkAge Line — 800-333-2433. Free, state-supported phone help. They will walk you through MA, EW, CADI, AC, and connect you with a county worker. This is the call to make first if you don't know where to start.
2. Your county human services office — request a MnCHOICES assessment and an MA application packet
3. Senova's eligibility checker — 3 minutes, no signup, gives you a read on which programs may apply before you call the county

A Note From Senova

Minnesota built EW because the state decided that aging Minnesotans deserve the right to stay in their homes if they can be safe there. That's a value, not a paperwork program. If you or someone you love qualifies, please use it. We'll help you navigate it.

If you have a question this guide didn't answer, our care team replies within one business day at help@senova.info. A real person. No phone tree.

This guide is for general information and does not constitute legal, medical, or financial advice. Income limits, asset rules, and waiver policies change. Verify current numbers and eligibility with Minnesota DHS (mn.gov/dhs), your county human services office, or a Minnesota elder-law attorney before making decisions.

Related guides on Senova: - How to Pay for Hospice With Medicaid in Minnesota - Adult Day Care vs. In-Home Care (forthcoming) - CADI Waiver Explained (forthcoming) - Senova Eligibility Checker - Senova Cost Calculator - Find Home Health Care in Saint Paul - Find Home Health Care in Minnesota

Reviewed by the Senova editorial team. Medical disclaimer: General guidance, not medical advice. Verify current eligibility and benefits with Minnesota DHS (mn.gov/dhs) or your licensed provider before making decisions.