Wyoming Community Choices Waiver: Eligibility and Benefits

The Community Choices Waiver (CCW) is Wyoming's primary Medicaid program for keeping people out of nursing homes. If your parent qualifies medically for nursing-facility-level care but prefers to stay home or move to assisted living, the CCW can fund the care services that make either option possible.

Understanding what the waiver covers — and what it explicitly cannot cover — prevents the most common planning mistake families make.

Who Qualifies

CCW eligibility requires meeting three gates simultaneously:

1. Age or Disability

Adults aged 65 and older qualify. Adults aged 19-64 qualify if they have a documented disability.

2. Financial Eligibility (Medicaid)

Your parent must meet Wyoming Medicaid's long-term care financial limits:

• Income: Gross monthly income at or below $2,982 (300% of the 2026 Federal Benefit Rate)
• Assets: Countable resources must not exceed $2,000 for an individual or $3,000 for a married couple when both spouses apply

Countable resources include bank accounts, retirement accounts (IRAs, 401ks), CDs, stocks, bonds, and non-primary real estate. The primary home is exempt if a spouse, child under 21, or blind/disabled child lives there. If no qualified person lives in the home, it's exempt only if equity is below $752,000 and the applicant signs an "intent to return" statement.

If your parent's income exceeds $2,982, they're not automatically disqualified — but they must establish a Miller Trust (Qualified Income Trust) to redirect the excess. Wyoming is an income-cap state with no medically needy spend-down pathway, so the Miller Trust is the only route past the income limit.

3. Clinical Eligibility (LT101 Assessment)

Your parent must score at least 13 points on the LT101 Level of Care Assessment, confirming they need nursing-facility-level care. A registered nurse from the County Public Health Nursing Agency conducts this evaluation, assessing mobility, bathing, dressing, cognitive function, and medical complexity.

The LT101 can only be scheduled after a Medicaid application is pending in the Wyoming Eligibility System. Timeline: up to 10 days for application verification, then 3 business days for state referral, then 7 business days for the nurse to complete the assessment.

What the Waiver Covers

CCW provides a comprehensive suite of in-home and community-based services:

• Personal care (bathing, dressing, grooming, toileting)
• Skilled nursing
• Home-delivered meals
• Non-medical transportation
• Adult day care
• Respite care (temporary relief for family caregivers)
• Personal Emergency Response Systems
• Environmental modifications (home accessibility adaptations)

Participant-Directed Care

A distinctive CCW feature: your parent (or their legal representative) can act as the employer — hiring, training, and managing their own direct support workers. This option allows adult children to be hired and paid an hourly wage for caregiving.

However, three categories of people are legally prohibited from serving as paid caregivers under this option:

• Spouses
• Legal guardians
• Anyone holding a financial power of attorney for the participant

The Room and Board Limitation

This is where most families get tripped up. The CCW can fund care services in an assisted living facility — but federal law prohibits the waiver from covering room and board.

In practical terms: if your parent moves to an assisted living facility at $5,400/month, the waiver might cover the care-services portion of the bill (personal care, medication setup, nursing oversight), but the monthly rent — room, meals, utilities — comes out of your parent's pocket.

The exact split depends on how the facility structures its billing. Some facilities separate care services from room and board cleanly; others bundle everything into a single monthly rate, making it harder to identify what the waiver actually covers.

This means CCW reduces the cost of assisted living but doesn't eliminate it. Your family needs a plan for the ongoing room and board expense.

How to Apply

1. File a Medicaid application through the Wyoming Eligibility System (wesystem.wyo.gov) or call the LTC Eligibility Unit at 1-855-203-2936. Specify that you're applying for the Community Choices Waiver.
2. Trigger the LT101 assessment — once the application is in the system, the CCW case manager or nursing facility submits the LT101 request.
3. Complete the assessment — coordinate with the assigned County Public Health Nurse.
4. If approved, a CCW Case Manager drafts a customized plan of care, identifies service providers, and implements the waiver services.

For step-by-step CCW application guidance including Miller Trust setup instructions and asset planning strategies, see the Choosing Care in Wyoming guide.

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