Forms & Documents
Every waiver application in one place. Select your state to view and download official forms.
Alabama
AL3 programs0 forms
ABD MedicaidE&DHome Meals
Alaska
AK11 programs0 forms
ABD MedicaidALIMedicare SavingsSNAP/FoodAlaska Senior MedicareEnergy AssistanceLTC OmbudsmanHome MealsCaregiver SupportSenior Legal AidProperty Tax Relief
Arizona
AZ11 programs0 forms
ABDALTCSQMB/SLMB/QINutrition Assistance ProgramSHIPLIHEAPSenior Property ValuationLTC OmbudsmanHome MealsCaregiver SupportSenior Legal Aid
Arkansas
AR11 programs0 forms
AABDMedicare SavingsSNAP/FoodARK Choices Program WaiverSHIIPPACEEnergy AssistanceLTC OmbudsmanHome MealsCaregiver SupportSenior Legal Aid
California
CA18 programs0 forms
Medi-Cal for Aged and DisabledIHSSMedicare SavingsMSSPSNAP/FoodSSI/SSP Cash AssistanceHICAP Medicare CounselingALWEnergy AssistanceCaregiver SupportCalifornia PACE ProgramsProperty Tax ReliefHome Meals250% California WorkingWeatherizationLTC OmbudsmanSenior Legal AidSCSEP
Colorado
CO12 programs0 forms
ABD MedicaidEBDMedicare Buy-In ProgramsSNAP/FoodSHIPColorado PACE ProgramLEAPPTEXLTC OmbudsmanHome MealsCaregiver SupportSenior Legal Aid
Connecticut
CT14 programs0 forms
ABD MedicaidQMB/SLMB/QICHCPESNAP/FoodSSI SupplementConnecticut PACE ProgramProperty Tax ReliefConnPace (ConnecticutCEAPCaregiver SupportSHIPHome MealsSenior Legal AidLTC Ombudsman
Delaware
DE10 programs0 forms
ABD MedicaidDiamond State Health PlanQMB/SLMB/QISNAPEnergy AssistanceDelaware SHIP MedicareLTC OmbudsmanHome MealsCaregiver SupportSenior Legal Aid
Florida
FL10 programs0 forms
MEDS-ADSMMC-LTCQMB/SLMB/QISNAPSHINE (Serving HealthCaregiver SupportLIHEAPLTC OmbudsmanHome MealsSenior Legal Aid
Georgia
GA10 programs0 forms
ABDMedicare SavingsEDWPSNAPLIHEAPHome MealsCaregiver SupportGSMPSenior Legal AidLTC Ombudsman
Hawaii
HI3 programs0 forms
ABDHCBSAABD
Idaho
ID10 programs0 forms
ABD MedicaidA&DMedicare SavingsSNAPSHIPLIHEAPLTC OmbudsmanHome MealsCaregiver SupportSenior Legal Aid
Illinois
IL13 programs0 forms
AABDHCBS Medicaid Waiver ProgramsMedicare SavingsSNAP/FoodPACEAABDEnergy AssistanceProperty Tax ReliefIllinois SHIP (Senior HealthLTC OmbudsmanHome MealsSenior Legal AidCaregiver Support
Indiana
IN10 programs0 forms
Indiana PathWays for AgingPathWays for Aging WaiverMedicare SavingsSNAPSHIPIEAPNFCSPLTC OmbudsmanHome MealsSenior Legal Aid
Iowa
IA3 programs0 forms
ABDNursing Home MedicaidElderly Waiver Program (HCBS
Kansas
KS11 programs0 forms
ABD MedicaidHome and Community BasedKanCare Medicare Buy-InSNAP/FoodPACESenior Health InsuranceEnergy AssistanceCaregiver SupportLTC OmbudsmanHome MealsSenior Legal Aid
Kentucky
KY12 programs0 forms
ABDHCBQMB/SLMB/QISNAPPACEKentucky SHIP (State HealthLIHEAPNFCSPLTC OmbudsmanDAILSenior Legal AidProperty Tax Relief
Louisiana
LA10 programs0 forms
ABD MedicaidMedicare SavingsSNAP/FoodAdult Day Health Care WaiverEnergy AssistanceLA SHIPHome MealsCaregiver SupportLTC OmbudsmanSenior Legal Aid
Maine
ME12 programs0 forms
MaineCare Aged, Blind, andMaineCare Elderly and AdultsMedicare SavingsSNAP/FoodSHIPEnergy AssistanceSSI SupplementLTC OmbudsmanProperty Tax ReliefHome MealsSenior Legal AidCaregiver Support
Maryland
MD5 programs0 forms
Maryland Medical Assistance -Maryland Medical Assistance -Maryland Medical Assistance -Maryland HCBS Waivers -Maryland EID Program -
Massachusetts
MA14 programs0 forms
ABD MedicaidFEWQMB/SLMB/QISNAP/FoodPACEEnergy AssistanceSPAPSHIP (State Health InsuranceClause 41C Senior CircuitLTC OmbudsmanState Supplement to SSIHome MealsSenior Legal AidCaregiver Support
Michigan
MI13 programs0 forms
ABD MedicaidMI Choice Waiver ProgramMedicare SavingsSNAP/FoodMichigan PACEMichigan SHIPState Emergency ReliefCaregiver SupportProperty Tax ReliefLTC OmbudsmanHome MealsSSI SupplementSenior Legal Aid
Minnesota
MN13 programs0 forms
MAEWMedicare SavingsSNAPPACESHIPMSALIHEAPPTFLTC OmbudsmanHome MealsCaregiver SupportSenior Legal Aid
Mississippi
MS10 programs0 forms
ABD MedicaidElderly and Disabled WaiverMedicare SavingsSNAP/FoodEnergy AssistanceMississippi SHIP (StateHome MealsCaregiver SupportLTC OmbudsmanSenior Legal Aid
Missouri
MO12 programs0 forms
ABDADWMedicare SavingsSNAP/FoodPACELIHEAPSHIPProperty Tax ReliefLTC OmbudsmanHome MealsCaregiver SupportSenior Legal Aid
Montana
MT3 programs0 forms
ABD MedicaidBig Sky Waiver ProgramMontana Medicaid for Workers
Nebraska
NE10 programs0 forms
ABD MedicaidNebraska Aged and DisabledMedicare SavingsSNAPSHIPCaregiver SupportLIHEAPLTC OmbudsmanHome MealsSenior Legal Aid
Nevada
NV11 programs0 forms
MAABDHCBSQMB/SLMB/QISNAPPACELIHEAPCaregiver SupportSHIPLTC OmbudsmanHome MealsSenior Legal Aid
New Hampshire
NH11 programs0 forms
ABD MedicaidChoices for IndependenceMedicare SavingsSNAP/FoodEnergy AssistanceSHINEProperty Tax ReliefLTC OmbudsmanHome MealsCaregiver SupportSenior Legal Aid
New Jersey
NJ14 programs0 forms
ABDMLTSSMedicare SavingsSNAP/FoodPAAD (PharmaceuticalEnergy AssistanceNew Jersey PACE (Program ofNew Jersey SHIP (State HealthProperty Tax ReliefCaregiver SupportLTC OmbudsmanHome MealsNew Jersey SSI StateSenior Legal Aid
New Mexico
NM10 programs0 forms
Centennial Care Aged, Blind,QMBCentennial Care Home andSNAP/FoodSHIPLTC OmbudsmanLIHEAPHome MealsSenior Legal AidCaregiver Support
New York
NY14 programs0 forms
ABD MedicaidQMB/SLMB/QISNAPEPICHCBSHIICAPLIHEAPSSIPACELTC OmbudsmanHome MealsProperty Tax ReliefSenior Legal AidCaregiver Support
North Carolina
NC13 programs0 forms
ABD MedicaidMedicare SavingsSNAPCAP/DASHIIPPACELIEAPCaregiver SupportLTC OmbudsmanHome MealsSSI SupplementSenior Legal AidProperty Tax Relief
North Dakota
ND10 programs0 forms
ABDHCBSMedicare SavingsSNAP/FoodEnergy AssistanceSMPSenior Legal AidCaregiver SupportLTC OmbudsmanHome Meals
Ohio
OH12 programs0 forms
ABDPASSPORT WaiverMedicare Premium AssistanceSNAP/FoodMyCare Ohio PACEOSHIIPEnergy AssistanceCaregiver SupportLTC OmbudsmanProperty Tax ReliefHome MealsSenior Legal Aid
Oklahoma
OK10 programs0 forms
SoonerCare Aged Blind andADvantage Waiver ProgramMedicare SavingsSNAP/FoodSHIPLIHEAPCaregiver SupportLTC OmbudsmanCSFPSenior Legal Aid
Oregon
OR3 programs0 forms
APDOPI-MCaregiver Support
Pennsylvania
PA14 programs0 forms
ABD MedicaidCommunity HealthChoicesMedicare SavingsSNAP/FoodPACEPACEEnergy AssistancePennsylvania SHIPProperty Tax ReliefLTC OmbudsmanHome MealsCaregiver SupportSSI SupplementSenior Legal Aid
Rhode Island
RI13 programs0 forms
EADLTSSMedicare SavingsSNAP/FoodPACEEnergy AssistanceSSI SupplementRhode Island SHIPProperty Tax ReliefLTC OmbudsmanHome MealsCaregiver SupportSenior Legal Aid
South Carolina
SC11 programs0 forms
ABDCommunity Choices WaiverMedicare SavingsSNAP/FoodPACESouth Carolina SHIPEnergy AssistanceLTC OmbudsmanHome MealsCaregiver SupportSenior Legal Aid
South Dakota
SD10 programs0 forms
ABD MedicaidHOPE WaiverMedicare SavingsSNAPLIHEAPSHIPHome MealsCaregiver SupportLTC OmbudsmanSenior Legal Aid
Tennessee
TN10 programs0 forms
TennCare CHOICES in Long-TermMedicare SavingsTennCare CHOICES HCBS WaiverSNAP/FoodSHIPEnergy AssistanceLTC OmbudsmanHome MealsCaregiver SupportSenior Legal Aid
Texas
TX15 programs0 forms
STAR+PLUS Home andMedicare SavingsSNAP/FoodTexas Medicaid for theTexas SHIP Medicare CounselingCEAP/LIHEAPPrimary Home Care (CommunityRespite CareHome MealsTexas PACE ProgramsLTC OmbudsmanWeatherizationSenior Legal AidTexas Senior Companion ProgramSCSEP
Utah
UT5 programs0 forms
ABD MedicaidAging Waiver (Home andMedicaid ExpansionNew Choices WaiverPhysical Disabilities Waiver
Vermont
VT12 programs0 forms
MABDChoices for Care HCBS WaiverQMB/SLMB/QISNAPSSI SupplementGeneral Assistance FuelProperty Tax ReliefSHIPLTC OmbudsmanCaregiver SupportSenior Legal AidHome Meals
Virginia
VA12 programs0 forms
ABDMedicare SavingsCommonwealth Coordinated CareSNAPPACEVICAPLIHEAPCaregiver SupportLTC OmbudsmanHome MealsProperty Tax ReliefVirginia Senior Citizens Law
Washington
WA10 programs0 forms
ABD MedicaidMedicare SavingsSNAP/FoodTailored Supports for OlderWashington State HealthLTC OmbudsmanEnergy AssistanceSenior Legal AidCaregiver SupportHome Meals
West Virginia
WV10 programs0 forms
ABD MedicaidADWMedicare SavingsSNAPLIEAPSMPLTC OmbudsmanHome MealsCaregiver SupportSenior Legal Aid
Wisconsin
WI14 programs0 forms
Medicaid for the Elderly,Family Care IRIS andMedicare SavingsSNAP/FoodWisconsin PACE ProgramWisconsin SHIP (Senior HealthWisconsin SeniorCareWHEAPProperty Tax ReliefLTC OmbudsmanHome MealsSSI SupplementSenior Legal AidCaregiver Support
Wyoming
WY10 programs0 forms
ABD MedicaidCCWMedicare SavingsSNAPLIHEAPSHIIPLTC OmbudsmanSenior Legal AidHome MealsCaregiver Support