Understanding Waivers
In Pennsylvania, a waiver allows certain Medicaid rules to be “waived,” so people who qualify can receive care and support in their homes or communities instead of living in a nursing home or institutional setting.
These programs are part of Home and Community-Based Services (HCBS). They help older adults and individuals with disabilities stay as independent as possible by providing services such as personal care, transportation, home modifications, respite care, and more.
Waivers give Pennsylvanians more freedom in choosing where and how they receive their care. If you’re eligible, you can get the assistance you need at home — with Medicaid funding — rather than moving into a facility.
What Is Maximus?
The state of Pennsylvania contracts with Maximus, a national company that manages health and human service programs, to run the PA Independent Enrollment Broker (PA IEB).
The PA IEB helps people apply for HCBS waivers. It makes sure applications are completed correctly and that each person is connected with the right program for their needs.
Maximus also maintains the official PA IEB website, which provides resources, application forms, and instructions. In 2024, the company was awarded a new five-year, $263 million contract to continue providing these services across the state.
How to Apply for Waiver Services
The official place to begin is the PA IEB website, run by Maximus:
paieb.com/en/apply-for-waiver-services.
“The PA IEB provides enrollment support for Pennsylvania’s Home and Community Based (HCBS) waiver programs.”
— paieb.com
Start Your Application
Begin online at the PA IEB website or by calling them. The application collects personal and contact information about the person needing services.
Applicants must be 18 years or older, or within 90 days of their 18th birthday.
Physician’s Certification Form
PA IEB sends your doctor a Physician Certification Form to confirm you require a specific level of care. Your doctor completes the form and returns it directly to PA IEB.
In-Home Visit and Medicaid Application
After you start, PA IEB schedules an in-home visit to learn more about your needs. If you don’t already receive Medicaid, you’ll also complete a
Medical Assistance (MA) application.
Functional and Clinical Assessment
A local agency, such as your Area Agency on Aging (AAA), performs a Functional Eligibility Determination to assess daily living abilities and support needs. This helps confirm whether you meet the medical criteria for waiver services.
County Assistance Office (CAO) Review
Once your physician’s form and functional assessment are received, PA IEB forwards your information to your local County Assistance Office (CAO).
The CAO reviews financial eligibility and makes the final decision. Typically, a decision must be made within 90 days from when your waiver application started.
If no decision is reached, or if you’re denied, you can request a fair hearing. Otherwise, if approved, you are enrolled in a Pennsylvania Home and Community-Based Waiver Program and can begin receiving services at home or in your community.
Who can apply for a waiver in Pennsylvania?
Pennsylvania residents who are at least 18 years old (or within 90 days of turning 18) and who meet both financial and medical eligibility requirements may apply.
What does the Physician Certification Form do?
It’s completed by your doctor to verify that you need a certain level of care (for example, nursing facility-level care), which is required for waiver eligibility.
How long does the waiver process take?
From start to finish, the determination process generally takes up to 90 days. Submitting documents promptly can help keep things on track.
What if my application is denied?
You have the right to appeal and request a fair hearing if you disagree with the decision or if a timely decision is not made.
How does Maximus (PA IEB) help during the process?
Maximus, operating as PA IEB, guides you through each step, sends required forms, schedules assessments, and coordinates with your doctor and local agencies to ensure everything is completed correctly.
Source and application portal: PA IEB — Apply for Waiver Services
