Medicaid Stairlift Waivers: Does Your State Cover It? (2026)

HCBS stands for Home and Community-Based Services. Under Section 1915(c) of the Social Security Act, every state Medicaid program can request a federal waiver that lets it pay for services and equipment that keep a beneficiary in their own home instead of in a nursing facility. Stairlifts fall under a specific HCBS line item usually called Environmental Accessibility Adaptations (sometimes Environmental Modifications or Home Modifications, depending on the state).

Three gates control access in every state:

1. Financial eligibility. You must qualify for Medicaid. For most states this means income under roughly 300% of the SSI Federal Benefit Rate (approximately $2,901/month for a single person in 2026) and countable assets under $2,000 ($3,000 married). Your home, one car, and personal effects are typically excluded.
2. Medical eligibility: nursing-facility level of care. A state-contracted case manager performs an in-home functional assessment. You must be assessed as needing the level of care that would otherwise require placement in a skilled nursing facility. Difficulty climbing stairs combined with two or more ADL limitations (bathing, dressing, toileting, transferring, feeding) typically qualifies.
3. Care plan inclusion. Your case manager writes a Plan of Care. The stairlift must be listed with a medical justification, usually backed by a physician letter or PT/OT evaluation. The state or managed care organization approves the dollar amount, and a credentialed provider installs the stairlift and bills Medicaid directly. The family never writes a check.

Start-to-finish timelines run 30 to 90 days in most states. Straight-rail stairlifts ($3,500 to $5,500 installed) are covered in full by nearly every waiver. Curved-rail stairlifts ($9,500 to $16,000 installed) are covered in states with higher caps or no-cap waivers. States with lower caps may cover partial costs and ask the family to pay the difference.

The vast majority of US states operate at least one Medicaid HCBS waiver that explicitly lists stairlifts or environmental accessibility adaptations as a covered service. Three states — Wyoming, South Dakota, and Idaho — restrict their environmental modification benefits to items like grab bars, ramps, and doorway widening, effectively excluding stairlifts from coverage. In those states, the VA HISA grant, the IRS medical expense deduction, and installer financing are the primary funding paths.

Among the 47 states that do cover stairlifts, the variation is enormous. New York's NHTD Waiver has a $15,000 environmental modification cap — enough to fund most curved-rail installs outright. Minnesota's Elderly Waiver caps at $20,000 lifetime. Washington's COPES Waiver and Oregon's K Plan have no fixed stairlift cap at all. On the other end, Kentucky's HCB Waiver caps at $5,000 per waiver year, and Iowa's Elderly Waiver caps at $6,000 lifetime — enough for a straight rail but tight for a curved install.

What follows is every state organized by region, with the waiver name, administering agency, phone number, typical stairlift cap, and any state-specific details that matter. We have installed under Medicaid funding in 34 of these states and are credentialed providers in all of them.

Connecticut

Waiver: Connecticut Home Care Program for Elders (CHCPE) + Personal Care Assistance (PCA) Waiver.
Agency: Connecticut Department of Social Services, Division of Aging Services.
Phone: 1-800-445-5394.
Cap: Varies by care plan; CHCPE has both a Medicaid tier and a state-funded tier for families above Medicaid income limits.
Quirk: Connecticut is one of the few states where middle-income seniors who exceed Medicaid limits can still qualify for environmental modification funding through the state-funded CHCPE tier. If your parent's income is slightly above the Medicaid threshold, Connecticut may still cover the install.

Delaware

Waiver: Diamond State Health Plan Plus HCBS Waiver.
Agency: Delaware Division of Medicaid and Medical Assistance (DMMA).
Phone: 1-800-372-2022.
Cap: Approved on medical necessity; no published fixed stairlift cap.
Quirk: Delaware runs all Medicaid long-term care through managed care. Your MCO care coordinator controls authorization.

Maine

Waiver: MaineCare Section 19 (Other Related Conditions), Section 18 and Section 20 (Older Adults) HCBS Waivers.
Agency: Maine DHHS, Office of Aging and Disability Services (OADS).
Phone: 1-800-262-2232 (OADS) or 1-800-977-6740 (MaineCare).
Cap: Varies by waiver and care plan.
Quirk: Maine contracts its functional assessments through Goold Health Systems as the statewide Assessing Services Agency. The ASA assessment determines your waiver eligibility and level of care — it is the single most important step in the process.

Maryland

Waiver: Community First Choice (CFC) Option — a 1915(k) state plan option, not a traditional 1915(c) waiver.
Agency: Maryland Department of Health, Office of Long Term Services and Supports.
Phone: 1-844-627-5465 (Maryland Access Point).
Cap: No fixed waiver slot cap; environmental modifications approved on medical necessity.
Quirk: Maryland's CFC is a state plan option rather than a waiver, which means there is no enrollment cap — anyone who meets the clinical and financial criteria gets in. This eliminates the waitlist problem that plagues traditional 1915(c) waivers in other states.

Massachusetts

Waiver: MassHealth Frail Elder Home and Community-Based Services Waiver.
Agency: Executive Office of Elder Affairs (EOEA) and MassHealth, administered through 25 Aging Services Access Points (ASAPs).
Phone: 1-800-243-4636 (MassOptions).
Cap: Approximately $10,000 per lifetime for environmental modifications.
Quirk: Massachusetts also runs the Home Modification Loan Program (HMLP) through the Mass Rehabilitation Commission — a zero-interest deferred loan up to $50,000 for households under 100% AMI. HMLP is a loan, not a grant, but the deferred version is not repaid until the home is sold. Phone: 617-204-3739.

New Hampshire

Waiver: Choices for Independence (CFI) HCBS Waiver.
Agency: NH Department of Health and Human Services, Bureau of Elderly and Adult Services.
Phone: 1-800-351-1888 (ServiceLink).
Cap: Up to $5,000 per waiver year for environmental modifications.
Quirk: New Hampshire runs ServiceLink Resource Centers in every county as the intake point. Call ServiceLink first, not the state office.

New Jersey

Waiver: Managed Long Term Services and Supports (MLTSS) — Medicaid managed care; plus JACC (Jersey Assistance for Community Caregiving) for non-Medicaid seniors.
Agency: NJ Division of Medical Assistance and Health Services (MLTSS); NJ Division of Aging Services (JACC).
Phone: 1-877-222-3737.
Cap: MLTSS has no fixed stairlift cap — approved on medical necessity through the MCO. JACC covers up to $4,600/year in home modifications for non-Medicaid seniors with income below 365% FPL.
Quirk: New Jersey has two parallel tracks. If you qualify for Medicaid, MLTSS is the route and there is no dollar cap. If you are above Medicaid but still lower income, JACC is one of the better state-funded alternatives in the country.

New York

Waiver: Nursing Home Transition and Diversion (NHTD) Waiver + Managed Long Term Care (MLTC) plans.
Agency: NY State Department of Health — Bureau of Community Integration and Alzheimer's Disease (NHTD); various MLTC plans including VNS Health, Elderplan, Fidelis, GuildNet (MLTC).
Phone: 1-518-474-5271 (NHTD) or 1-888-401-6582 (NY Medicaid Choice for MLTC enrollment).
Cap: NHTD has a $15,000 per-participant environmental modification cap — the highest traditional waiver cap in the Northeast and one of the highest in the country.
Quirk: New York is the single best state in the Northeast for Medicaid stairlift funding. The $15,000 NHTD cap covers almost any curved-rail install outright. The tradeoff: NHTD has the most paperwork-intensive application of any waiver we work with, and assessment timelines in the five boroughs run 60-90 days. Upstate is faster. MLTC plans cover stairlifts under the Community Benefit but with lower, plan-specific caps.

Pennsylvania

Waiver: Community HealthChoices (CHC) Medicaid Managed Long-Term Care.
Agency: PA Department of Human Services, Office of Long-Term Living, delivered through three MCOs: UPMC Community HealthChoices, PA Health & Wellness, Keystone First Community HealthChoices.
Phone: 1-800-757-5042.
Cap: $6,000 per rolling 12-month period, $10,000 lifetime cap on environmental modifications.
Quirk: Pennsylvania also runs the OPTIONS Program through the PA Department of Aging (1-800-753-8827) — a state-funded, sliding-scale program for seniors whose income is above Medicaid but still limited. OPTIONS funding varies by Area Agency on Aging region.

Rhode Island

Waiver: Rhode Island Medicaid Home and Community Care Co-Pay Program + HCBS Waiver.
Agency: RI Executive Office of Health and Human Services.
Phone: 1-401-462-5274.
Cap: Approved through care plan; typically $7,500-$10,000.
Quirk: Rhode Island is small enough that a single state intake line handles all HCBS waiver applications. Turnaround is among the fastest in the Northeast.

Vermont

Waiver: Choices for Care Medicaid Long-Term Services and Supports.
Agency: Vermont Department of Disabilities, Aging and Independent Living (DAIL).
Phone: 1-800-642-5119.
Cap: Approved through the individualized service plan; no published fixed cap.
Quirk: Vermont's Choices for Care program is an entitlement — if you meet the clinical and financial criteria, you are enrolled. No waitlist, no enrollment cap. This is unusual among state HCBS programs and eliminates one of the most common delays families encounter in other states.

Alabama

Waiver: Alabama Community Transition (ACT) Waiver + Elderly & Disabled (E&D) Waiver.
Agency: Alabama Medicaid Agency and Alabama Department of Senior Services (ADSS), administered through 13 regional Area Agencies on Aging.
Phone: 1-800-243-5463 (Alabama AgeLine).
Cap: Varies by care plan — no published fixed statewide cap.
Quirk: Alabama runs its E&D Waiver through the regional AAA network. The case manager in your county controls the authorization. Response times in rural Black Belt counties are slower than in Birmingham, Huntsville, or Mobile metro areas.

Arkansas

Waiver: ARChoices in Homecare HCBS Waiver.
Agency: Arkansas Department of Human Services, Division of Aging, Adult, and Behavioral Health Services.
Phone: 1-800-482-8988.
Cap: Typically $7,500 per modification, approved through the individualized care plan.
Quirk: Arkansas uses an independent assessment (ARIA) tool that generates the level-of-care determination. The assessment drives everything — the quality of documentation at the ARIA stage determines whether the modification gets authorized.

Florida

Waiver: Statewide Medicaid Managed Care Long-Term Care (SMMC-LTC).
Agency: Florida Agency for Health Care Administration (AHCA) and Department of Elder Affairs (DOEA), delivered through managed care organizations — Humana, Sunshine Health, Molina, UnitedHealthcare, Aetna, Simply Healthcare.
Phone: 1-800-963-5337 (Florida Elder Helpline).
Cap: Typically $7,500 per install, occasionally stretched with strong documentation.
Quirk: Florida is a managed-care state. Once approved for SMMC-LTC, you get assigned to one of six MCOs and your service coordinator works for that MCO. Which MCO you draw determines which stairlift provider is in-network. Start by calling the Elder Helpline to request a CARES (Comprehensive Assessment and Review for Long-Term Care Services) assessment. Some service regions have enrollment waiting lists.

Georgia

Waiver: Elderly and Disabled Waiver Program (EDWP).
Agency: Georgia Department of Community Health, Division of Medicaid.
Phone: 1-866-552-4464 (Georgia Aging & Disability Resource Connection).
Cap: Up to $10,000 lifetime environmental modification cap.
Quirk: Georgia has the 4th-largest veteran population in the country (690,000+), so many Georgia families qualify for both the EDWP waiver and the VA HISA grant simultaneously. We routinely file both in parallel — HISA covers the majority and the waiver covers the gap.

Kentucky

Waiver: Kentucky HCB Waiver (Home and Community Based Services).
Agency: Kentucky Cabinet for Health and Family Services, Department for Medicaid Services.
Phone: 1-844-784-5614 (Medicaid Waiver) or 1-800-372-2973 (CHFS).
Cap: Up to $5,000 per waiver year for environmental adaptations.
Quirk: Kentucky's $5,000/year cap is on the lower end nationally. It covers most straight-rail installs but will not fully cover a curved rail. The workaround: if the need extends across waiver years, a case manager can authorize the second phase in year two. We have done this on multiple Kentucky installs.

Louisiana

Waiver: Community Choices Waiver (CCW).
Agency: Louisiana Department of Health, Office of Aging and Adult Services (OAAS).
Phone: 1-866-758-5035.
Cap: Varies by plan of care — no published fixed statewide cap.
Quirk: Louisiana's CCW has historically maintained a waitlist. If you are placed on the waitlist, Louisiana Medicaid offers a Long Term Personal Care Services (LT-PCS) benefit that can bridge the gap for in-home support while you wait for CCW environmental modification authorization. Apply early — waitlists can run 6-12 months.

Mississippi

Waiver: Independent Living Waiver (ages 16-64) + Elderly & Disabled Waiver (65+).
Agency: Mississippi Division of Medicaid (DOM).
Phone: 1-800-421-2408.
Cap: Up to $10,000 per waiver year for environmental accessibility adaptations.
Quirk: Mississippi splits its HCBS coverage by age group. The Independent Living Waiver serves ages 16-64 with orthopedic or neurological impairments. The E&D Waiver covers 65+ through the Department of Human Services Area Agencies on Aging. Call DOM to determine which waiver fits.

North Carolina

Waiver: NC CAP/DA (Community Alternatives Program for Disabled Adults) + NC Innovations Waiver.
Agency: NC DHHS, Division of Health Benefits (CAP/DA); Division of Mental Health, DD & SAS (Innovations).
Phone: 1-855-652-5644.
Cap: CAP/DA: up to $28,000 lifetime cap on home modifications — one of the highest in the Southeast. Innovations: $17,000 lifetime.
Quirk: North Carolina's CAP/DA has an exceptionally generous $28,000 lifetime cap on home modifications, easily funding even the most complex multi-flight curved-rail installs. NC Innovations serves individuals with intellectual and developmental disabilities through the LME/MCO system.

South Carolina

Waiver: Community Choices Medicaid HCBS Waiver.
Agency: SC Department of Health and Human Services (SCDHHS), through the Community Long Term Care (CLTC) office.
Phone: 1-800-868-9095.
Cap: No fixed stairlift dollar cap — approved by case manager based on medical necessity.
Quirk: South Carolina's Community Choices Waiver has no published cap, which means it can cover the full cost of both straight and curved installs. The CLTC case manager's assessment drives the authorization entirely.

Tennessee

Waiver: TennCare CHOICES in Long-Term Services and Supports.
Agency: TennCare (Tennessee's Medicaid program), delivered through three MCOs: Amerigroup, BlueCare, UnitedHealthcare.
Phone: 1-877-224-0219.
Cap: Approved through individualized support plan — cap varies by MCO.
Quirk: Tennessee runs all Medicaid through TennCare managed care. Your MCO care coordinator controls the environmental modification authorization. All three MCOs cover stairlifts but with different internal processes.

Virginia

Waiver: Commonwealth Coordinated Care Plus (CCC Plus) Medicaid Waiver.
Agency: Virginia Department of Medical Assistance Services (DMAS), delivered through MCOs: Anthem HealthKeepers Plus, Molina, UnitedHealthcare, Sentara.
Phone: 1-804-786-6145.
Cap: Varies by MCO — typically $7,500-$10,000.
Quirk: Virginia also offers the Livable Home Tax Credit — up to $5,000 in state income tax credit for accessibility modifications including stairlifts. This stacks with the CCC Plus waiver for families who have out-of-pocket costs above the waiver cap. Virginia DHCD administers the tax credit.

West Virginia

Waiver: Aged and Disabled Medicaid Waiver.
Agency: West Virginia DHHR, Bureau for Medical Services.
Phone: 1-304-558-1700.
Cap: Approved on documented medical necessity — no published fixed cap.
Quirk: West Virginia has the highest disability rate in the country at 19.3% — nearly one in five residents. The waiver processes a high volume of environmental modifications relative to the state's population. Assessment timelines are reasonable.

Illinois

Waiver: Home Services Program (HSP) — Persons with Disabilities Waiver (ages 18-59) + Community Care Program (CCP, ages 60+).
Agency: Illinois Department of Human Services, Division of Rehabilitation Services (HSP); Illinois Department on Aging (CCP).
Phone: 1-800-843-6154 (IDHS Helpline).
Cap: Varies by assessment — no fixed statewide ceiling.
Quirk: Illinois splits by age: HSP covers adults 18-59 with significant disabilities through IDHS-DRS. The Community Care Program covers 60+ through the Department on Aging. Both include environmental modification benefits and both will cover stairlifts when the assessment supports it. Ask your DRS counselor or CCP case coordinator about the Environmental Accessibility Adaptation benefit.

Indiana

Waiver: Indiana Aged & Disabled (A&D) Waiver.
Agency: Indiana Family and Social Services Administration (FSSA), Division of Aging, administered through 16 Area Agencies on Aging.
Phone: 1-888-673-0002 (FSSA Division of Aging) or call 211.
Cap: Up to $15,000 lifetime environmental modification cap — one of the higher caps in the Midwest.
Quirk: Indiana's $15,000 cap comfortably covers curved-rail and outdoor installs plus the indoor straight rail. The AAA Options Counselor in your county performs the assessment.

Iowa

Waiver: Iowa Elderly Waiver (65+) + Health and Disability (HD) Waiver (18-64).
Agency: Iowa Department of Health and Human Services (Iowa HHS), Iowa Medicaid Enterprise.
Phone: 1-800-972-2017 (Iowa HHS) or 1-800-338-8366 (Iowa Medicaid Member Services).
Cap: Up to $6,000 per lifetime modification cap.
Quirk: Iowa's $6,000 lifetime cap is sufficient for a straight rail but will not fully fund most curved installs. Iowa runs separate waivers by age — the Elderly Waiver for 65+ and the Health and Disability Waiver for 18-64. Both include Home and Vehicle Modification benefits.

Kansas

Waiver: HCBS Frail Elderly (FE) Waiver (65+) + Physical Disability (PD) Waiver (16-64) + Technology Assisted (TA) Waiver.
Agency: Kansas Department for Aging and Disability Services (KDADS).
Phone: 1-800-432-3535 (KDADS) or 1-855-200-2372 (Kansas Aging and Disability Resource Center).
Cap: Determined by plan of care — no published statewide ceiling.
Quirk: Kansas splits waivers three ways by population. All three include environmental modification benefits. The ADRC is the single intake point regardless of which waiver you end up on.

Michigan

Waiver: MI Choice Waiver Program.
Agency: Michigan DHHS, administered through 16 Area Agencies on Aging.
Phone: 1-800-803-7174 (Michigan Aging & Adult Services Agency).
Cap: Typically $6,000 per plan year, stackable across years with approval.
Quirk: Michigan's MI Choice cap is $6,000 per plan year, but the Supports Coordinator at your AAA can authorize stacking across plan years for higher-cost installs. A $12,000 curved rail might be split across two plan years — year one covers the rail fabrication and initial install, year two covers the remaining balance. We have done this successfully on multiple Michigan installs.

Minnesota

Waiver: Minnesota Elderly Waiver (65+) + CADI Waiver (Community Access for Disability Inclusion, 18-64).
Agency: Minnesota Department of Human Services (DHS), administered through 87 county lead agencies.
Phone: 1-800-333-2433 (Senior LinkAge Line).
Cap: $20,000 lifetime for Environmental Accessibility Adaptations — the highest published waiver cap in the Midwest.
Quirk: Minnesota's $20,000 lifetime cap covers virtually any stairlift install outright, including multi-flight curved rails. The MnCHOICES assessment tool drives the eligibility determination. Call the Senior LinkAge Line to get routed to your county lead agency.

Missouri

Waiver: Missouri Aged and Disabled Waiver.
Agency: Missouri Department of Social Services, MO HealthNet Division.
Phone: 1-573-751-3425.
Cap: Approved on medical necessity — typically $7,500-$10,000.
Quirk: Missouri also runs the Division of Senior and Disability Services (DSDS) which coordinates HCBS assessments through regional offices.

Nebraska

Waiver: Nebraska Aged and Disabled HCBS Waiver.
Agency: Nebraska DHHS, Division of Medicaid and Long-Term Care.
Phone: 1-800-358-8802 (Nebraska DHHS).
Cap: Typically $7,500 per modification.
Quirk: Nebraska's rural geography means assessment timelines in western Nebraska counties run longer than in Omaha or Lincoln. Plan an extra 2-3 weeks for rural assessments.

North Dakota

Waiver: SPED (Service Payments for Elderly and Disabled) HCBS Waiver.
Agency: North Dakota Department of Health and Human Services, Aging Services Division.
Phone: 1-855-462-5465.
Cap: Approved through the person-centered service plan — typically $7,500-$10,000.
Quirk: North Dakota's small population means shorter waitlists and faster assessments than most states. Assessment to install can run as fast as 30 days.

Ohio

Waiver: PASSPORT (Pre-Admission Screening System Providing Options and Resources Today) + HOME Choice Program.
Agency: Ohio Department of Aging (PASSPORT); Ohio Department of Medicaid (HOME Choice).
Phone: 1-866-243-5678 (PASSPORT) or 1-888-221-1560 (HOME Choice).
Cap: $10,000 lifetime on environmental modifications.
Quirk: Ohio also runs the HOME Choice Program under the federal Money Follows the Person demonstration — specifically for people being discharged from a nursing facility back to their own home. If your parent is currently in a facility and wants to return home, HOME Choice adds transition funding on top of PASSPORT.

Wisconsin

Waiver: IRIS (Include, Respect, I Self-Direct) + Family Care Medicaid Long-Term Care.
Agency: Wisconsin DHS, Division of Medicaid Services, administered through Aging and Disability Resource Centers (ADRCs).
Phone: Your local ADRC — statewide locator at dhs.wisconsin.gov/adrc.
Cap: Approved through care plan — varies by MCO and IRIS budget.
Quirk: Wisconsin offers two parallel tracks: Family Care (managed care, MCO controls) and IRIS (self-directed, you control your budget). IRIS gives you more flexibility on provider choice. Both cover environmental modifications including stairlifts.

Arizona

Waiver: Arizona Long Term Care System (ALTCS) — Elderly & Physical Disability program.
Agency: Arizona Health Care Cost Containment System (AHCCCS), through MCOs: Mercy Care, UnitedHealthcare Community Plan, Banner - University Family Care.
Phone: 1-888-621-6880.
Cap: Approved on medical necessity through the MCO — no published fixed cap.
Quirk: Arizona runs its entire Medicaid program through AHCCCS, which is managed care. Your ALTCS MCO case manager controls the environmental modification authorization. Arizona has 712,000 veterans (10.5% of the adult population), so many families qualify for both ALTCS and VA HISA simultaneously.

Colorado

Waiver: Elderly, Blind and Disabled (EBD) 1915(c) HCBS Waiver.
Agency: Colorado Department of Health Care Policy & Financing (HCPF).
Phone: 1-303-866-2993.
Cap: $10,000 lifetime home modification cap.
Quirk: Colorado runs its assessments through Single Entry Point (SEP) agencies in each county. The SEP case manager is your intake point. Colorado Springs has one of the highest per-capita military populations in the country (Fort Carson, Air Force Academy, Peterson SFB, Schriever SFB), so HISA and EBD frequently stack in El Paso County.

New Mexico

Waiver: Mi Via Self-Directed Waiver + Centennial Care Community Benefit.
Agency: NM Human Services Department, Medical Assistance Division. Centennial Care delivered through MCOs: Blue Cross Blue Shield of NM, Presbyterian, Western Sky Community Care.
Phone: 1-866-551-1017 (Mi Via) or your MCO member line (Centennial Care).
Cap: Mi Via: up to $5,000 per plan year for environmental modifications. Centennial Care: varies by MCO.
Quirk: Mi Via is a self-directed waiver — you manage your own budget through a Support Broker rather than having an MCO case manager decide for you. This gives you more control over provider choice. Centennial Care is the standard managed-care HCBS route.

Oklahoma

Waiver: ADvantage Waiver — 1915(c) HCBS Medicaid Waiver.
Agency: Oklahoma Health Care Authority (OHCA).
Phone: 1-888-287-2443 (OHCA) or 1-800-435-4711 (Oklahoma Aging Services).
Cap: Typically $7,500 per modification under Environmental Accessibility Adaptations.
Quirk: Oklahoma's ADvantage Waiver explicitly lists stairlifts under Environmental Accessibility Adaptations along with ramps, grab bars, roll-in showers, doorway widening, and non-slip flooring.

Texas

Waiver: STAR+PLUS Home and Community-Based Services (HCBS).
Agency: Texas Health and Human Services Commission (HHSC), through contracted MCOs: Amerigroup, Molina, Superior, UnitedHealthcare, Cigna-HealthSpring.
Phone: 1-800-964-2777.
Cap: Approximately $7,500 to $10,000 depending on MCO and region.
Quirk: Texas has the second-largest veteran population in the country (1.4 million veterans). STAR+PLUS covers the Medicaid side, and VA HISA covers the veteran side — the two routinely stack. The MCO service coordinator has to approve the modification before installation. For general referrals, dial 2-1-1 anywhere in Texas.

Colorado

See Southwest section above.

Idaho

Status: LIMITED COVERAGE.
Waiver: Idaho Aged and Disabled HCBS Waiver.
Agency: Idaho Department of Health and Welfare.
Phone: 1-877-200-5441.
Cap: Environmental modifications are restricted primarily to grab bars, ramps, and doorway widening. Stairlifts are generally not included in the approved environmental modification list.
Alternative: VA HISA grant, IRS medical expense deduction, installer financing.

Montana

Waiver: Big Sky Waiver.
Agency: Montana DPHHS, Senior and Long Term Care Division, administered through 10 Area Agencies on Aging.
Phone: 1-800-332-2272.
Cap: $6,000 per plan year for environmental modifications.
Quirk: Montana's rural distances extend assessment timelines beyond the national average. Plan an extra 2-4 weeks for assessments in eastern Montana counties.

Nevada

Waiver: HCBW for the Frail Elderly (FE Waiver, 65+) + Physical Disability Waiver (18-64).
Agency: Nevada DHHS, Aging and Disability Services Division (ADSD).
Phone: 702-486-3545 (Las Vegas) or 775-687-0510 (Carson City).
Cap: $6,500 per waiver year for environmental modifications.
Quirk: Nevada splits by age — FE Waiver for 65+, Physical Disability Waiver for 18-64. Both include environmental modification coverage. Virtually all Nevada HCBS volume is in Clark County (Las Vegas) and Washoe County (Reno). Rural Nevada assessments take longer.

South Dakota

Status: LIMITED COVERAGE.
Waiver: South Dakota Home and Community-Based Options and Person-Centered Excellence (HOPE) Waiver.
Agency: South Dakota Department of Social Services.
Phone: 1-605-773-3165.
Cap: Environmental modifications under the HOPE Waiver are restricted to items like grab bars and ramps. Stairlifts are generally not listed as an approved modification.
Alternative: VA HISA grant, IRS medical expense deduction, installer financing.

Utah

Waiver: New Choices Waiver.
Agency: Utah DHHS, Division of Medicaid and Health Financing.
Phone: 1-800-662-9651.
Cap: Approved on documented medical necessity — no published fixed cap.
Quirk: Utah's New Choices Waiver originally focused on transitioning people from nursing facilities back to community settings. It has expanded to serve at-risk populations as well.

Wyoming

Status: LIMITED COVERAGE.
Waiver: Wyoming Community Choices Waiver.
Agency: Wyoming Department of Health, Aging Division.
Phone: 1-800-442-2766.
Cap: Environmental modifications are primarily limited to ramps, grab bars, and bathroom accessibility. Stairlifts are generally excluded from the approved modification list.
Alternative: VA HISA grant, IRS medical expense deduction, installer financing. Wyoming has a relatively high veteran population per capita, making HISA the primary funding route.

Alaska

Waiver: Alaska Adults with Physical Disabilities (APD) HCBS Waiver + Home and Community-Based Waiver for Older Alaskans.
Agency: Alaska Department of Health, Senior and Disabilities Services.
Phone: 1-800-478-9996.
Cap: Varies by care plan. Environmental modifications are approved on medical necessity.
Quirk: Alaska's extreme geography means assessment timelines in bush communities and remote areas can run 60-90+ days. Anchorage, Fairbanks, and Juneau are on standard timelines.

California

Waiver: Medi-Cal Home and Community-Based Alternatives (HCBA) Waiver + Multipurpose Senior Services Program (MSSP, for 65+).
Agency: California Department of Health Care Services (DHCS) for HCBA; California Department of Aging for MSSP.
Phone: 1-800-541-5555 (Medi-Cal).
Cap: Approximately $10,000 lifetime environmental modification ceiling under HCBA.
Quirk: California's HCBA Waiver is the broadest — it covers all ages with disabilities that qualify for nursing-home level of care. MSSP serves seniors 65+ with a narrower service menu but faster enrollment in some counties. HCBA has a limited number of enrollment slots statewide and maintains a waiting list. In-Home Supportive Services (IHSS) through your county social services department is a separate Medi-Cal program but often triggers the referral to HCBA.

Hawaii

Waiver: QUEST Integration 1115 Waiver (Going Home Plus).
Agency: Hawaii Department of Human Services, Med-QUEST Division, delivered through five health plans: AlohaCare, HMSA, Kaiser, Ohana, UnitedHealthcare.
Phone: 1-800-316-8005 (Med-QUEST).
Cap: Varies by health plan and care plan.
Quirk: Hawaii contracts all Medicaid HCBS services through managed care health plans. Your assigned health plan controls the authorization path. Island logistics add time — inter-island installs require coordinating equipment shipping.

Oregon

Waiver: Oregon Community First Choice (K Plan) — a 1915(k) state plan option.
Agency: Oregon DHS, Aging and People with Disabilities.
Phone: 1-800-282-8096.
Cap: No fixed stairlift cap — medical necessity driven.
Quirk: Oregon's K Plan is unusually generous. There is no fixed dollar cap on environmental modifications, meaning full-cost curved-rail installs are routinely approved based on medical necessity documentation. Oregon also runs Project Independence (OPI) through the Area Agencies on Aging for non-Medicaid seniors 60+ on a sliding fee scale.

Washington

Waiver: Community Options Program Entry System (COPES).
Agency: Washington State DSHS, Aging & Long-Term Support Administration (ALTSA).
Phone: 1-800-422-3263.
Cap: None. Environmental modifications approved on documented medical necessity with no fixed dollar ceiling.
Quirk: Washington COPES is the other no-cap waiver alongside Oregon's K Plan. ALTSA assessors schedule within 30-45 days of initial call, and a credentialed provider can install within 2 weeks of approval. Curved rails are routinely funded in full. Joint Base Lewis-McChord drives heavy HISA volume on top of COPES in Pierce and Thurston counties.

The waiver names, agencies, and phone numbers differ by state, but the application process follows the same five-step pattern everywhere:

1. Call your intake point. This is either your state Medicaid helpline, your local Area Agency on Aging (find yours at eldercare.acl.gov or call 1-800-677-1116), or your state's Aging and Disability Resource Center. Tell them you want to be screened for HCBS waiver eligibility with a stairlift in the care plan. They will run a 15-minute phone pre-screen for basic income and medical eligibility.
2. Schedule the in-home assessment. A state-contracted case manager or assessor visits your home and runs a functional-needs evaluation — typically 60 to 90 minutes. They document ADL limitations, cognitive status, current living situation, and the specific stair obstacle. This assessment generates the level-of-care determination that controls everything downstream.
3. Get the physician documentation. Your primary care physician or a PT/OT writes a letter of medical necessity that specifies: the diagnosis, the ADL limitations caused by that diagnosis, the specific stair obstacle in the home, and why a stairlift is the least-restrictive alternative to nursing-facility placement. Generic letters get rejected. Specific letters get approved.
4. Wait for the waiver approval and care plan. The state or MCO issues a financial and clinical eligibility determination (typically 2-6 weeks after the home visit). If approved, the case manager writes the Plan of Care with the stairlift listed as an Environmental Accessibility Adaptation. The case manager submits the modification request with the physician letter, the provider quote, and the functional assessment.
5. Install. A credentialed provider installs the stairlift and bills Medicaid or the MCO directly. The family writes no check. Total elapsed time from first phone call to working stairlift: 30 to 90 days in most states.

The single most important step is number 3. A weak physician letter is the number-one reason stairlift authorizations are denied on first submission. We provide a medical necessity letter template to your doctor at no charge — ask when you call for your free assessment.

Roughly one in four first-time HCBS stairlift authorization requests is rejected. Almost all of them are fixable. These are the five reasons we see most often and how to get past each one:

1. "Assets over limit"

You have more than $2,000 in countable assets ($3,000 married). Fix: spend down legitimately — pre-pay funeral expenses, pay off debt, buy exempt items (a car, household furnishings). Or establish a Miller Trust / Qualified Income Trust if your state allows one. A Medicaid planning attorney can do this for $500-$2,000 and typically pays for itself by preserving waiver eligibility. Your Area Agency on Aging can refer you to an attorney who specializes in Medicaid planning.

2. "Level of care not met"

The functional assessment did not document enough ADL limitations to meet nursing-facility level of care. Fix: ask your primary care physician for a formal functional assessment or have a physical therapist do a Home Safety Evaluation. Both generate clinical documentation that strengthens the reapplication. Focus on documenting difficulty with bathing, dressing, toileting, transferring, and mobility — not just stair climbing.

3. "Stairlift not medically necessary"

The physician letter was too generic. Fix: ask for a letter that specifies four things: (a) the diagnosis, (b) the ADL limitations caused by that diagnosis, (c) the specific stair obstacle in the home, and (d) why a stairlift is the least-restrictive alternative to nursing-facility placement. A letter that says "patient has difficulty with stairs" gets denied. A letter that says "patient with bilateral knee osteoarthritis and COPD is unable to safely ascend the 14-step interior staircase from kitchen to bedroom without risk of fall, and a stairlift is the minimum intervention that avoids nursing-facility placement" gets approved.

4. "Provider not credentialed"

The installer you picked is not enrolled with your state's Medicaid program or your MCO's provider network. Fix: switch providers before the authorization expires. We are credentialed Medicaid providers in 34 states — ask us before you apply.

5. "Waiver enrollment cap reached" (waitlist)

Some states — notably Louisiana, California, and parts of Florida — have limited waiver enrollment slots and maintain waiting lists. Fix: get on the waitlist immediately, even before you are certain you want the stairlift. While waiting, explore the VA HISA grant if the applicant is a veteran, the IRS medical expense deduction (Section 213(d)), and state-funded alternatives like Pennsylvania's OPTIONS program or Connecticut's state-funded CHCPE tier.