ADvantage Services

The ADvantage home-and community-based services Medicaid waiver program provides services to help people stay at home and in the community instead of going to a nursing home. The program assists older adults and adults who have physical and other disabilities stay independent and close to family and friends. ADvantage promotes individual choice and self-direction to the greatest extent possible.

Services provided include case management, personal care, home-delivered meals, specialized medical equipment and supplies, skilled nursing, assisted living and adult day health.

To be eligible for ADvantage services, a person must:

Be qualified financially for Soonercare Medicaid (for maximum income, resource and payment standard to qualify for Soonercare, refer to the form listed)
Meet medical Level of Care (LOC) criteria
Be at least age 65 (includes individuals with intellectual/developmental disabilities who are age 65 or older) or an adult with physical or other disabilities age 21 to 64 without cognitive impairment

How to Apply and Who to Contact

Call the Medicaid Services Unit at 1-800-435-4711.

You may also apply by printing and completing the Request for Benefits form and mailing or taking it to your local DHS office. You may also apply by going to your local DHS office during business hours.

What to Bring to the required interview with a DHS worker

Social Security cards or numbers; Medicare or insurance cards; proof of US citizenship (birth certificate, voter registration card or US Passport); proof of immigration status if not a US citizen (legal permanent resident card, I-94 or other immigrant registration card, passport or T visa); life insurance policies; statements of stocks, bonds or certificates of deposit (CDs); copy of vehicle title; copy of the title and mortgage statement for property you own other than where you live; a current benefit check or award letter; copies of child support or alimony check; dated check stubs for the last 30 days that show your name or Social Security number, date of pay, and income before deductions; a copy of last year's tax return only if self-employed, receiving dividends, rental income or mineral rights;Bank statements showing savings and checking account balances(Be prepared to provide financial information requested for the last five years before application)

*UPDATE 7/2019

Electronic Visit Verification Mandate – 21st Century Cures Act Section 12006

Enacted on December 13, 2016, the CURES Act is considered to be landmark legislation for healthcare quality improvement through innovation. It includes funding to combat the opioid epidemic, reauthorizes the National Institutes of Health and funds new research, streamlines the development of new drugs, provides continued support for the interoperability of health information systems, and it sets forth significant behavioral health provisions including strengthening mental health parity.

Section 12006(a) of the 21st Century Cures Act

mandates that states implement EVV for all Medicaid personal care services (PCS) and home health services that require an in-home visit by a provider.

States must require EVV use for all *Medicaid-funded PCS by January 1, 2019, and Home Health by January 1, 2023. Otherwise, the state is subject to incremental Federal Medicaid Assistance Percentage (FMAP) reductions up to 1 percent unless the state has both made a “good faith effort” to comply and has encountered “unavoidable delays."

*Includes ADvantage, SPPC, and CD-PASS Options

Public Comment and Input Information