First steps
Start here
If you have never applied, this page is the whole first move. It takes about ten minutes to read and one form to act on.
What a "waiver" actually is
Regular Medicaid pays for medical care. It does not usually pay for someone to help your child get dressed, or for respite so you can sleep, or for a job coach at 22.
A Medicaid waiver sets aside some of the normal rules so those supports can be paid for at home and in the community, instead of only in an institution. New Mexico runs several. Two are for people with intellectual and developmental disabilities: the DD Waiver and Mi Via. A third, the Medically Fragile Waiver, is for people whose condition was diagnosed before age 22 and needs daily skilled nursing.
The important thing to hold on to: a waiver is not welfare and it is not a favor. It is a program your child may be entitled to, with rules you are allowed to read.
Apply before you feel ready. New Mexico's wait list is ordered by the date your completed application arrives, not by need and not by how organized your paperwork is. Years pass on this list. The application date is the single most valuable thing you can get today.
The first four moves
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Get the application
The form is the HCBS Waivers and ICF/IID Application, and it covers the DD Waiver and Mi Via together. You do not pick a program yet. It is available in English and Spanish from the Health Care Authority, or from the Pre-Service Specialist for your part of the state.
Pre-Service Intake Bureau: 505-350-0034 or 505-470-5825. Fax 505-533-6077. Central Registry: 505-630-9555 or 575-997-7980.
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Send it in even if documents are missing
Your application date is the day the Pre-Service Intake Bureau receives the completed application packet, and everything downstream is ordered by it. Once it is in, you have 60 days to send supporting documentation, and a Pre-Service Specialist will contact you if something is needed.
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Gather the evidence of disability
Eligibility is decided against the definition of developmental disability in New Mexico Administrative Code 8.290.4. What helps: educational evaluations, the IEP, a Review of Existing Evaluation Data, multidisciplinary evaluation reports, psychological or neuropsychological evaluations, medical diagnosis records, and any autism spectrum evaluation.
Send copies. Keep every original in your own file, forever. You will be asked for the same documents again.
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Wait for a Match letter, then keep your address current
A "Yes Match" letter means your child meets the criteria and their name goes on the Central Registry wait list under your application date. A "No Match" letter is not necessarily the end: you can reapply when new evaluation information exists, and you can call your Pre-Service Specialist to ask exactly what was missing.
Update DDSD every time you move or change your phone number. The allocation offer is mailed to the address on file, and a letter that does not reach you can close out.
Do not just wait
Being on the list does not mean nothing happens for years. While you wait, look at:
- State General Funds (SGF), a limited pot of services for people who finished the eligibility process and are on the wait list. Ask your regional office for the SGF liaison.
- Turquoise Care, New Mexico's Medicaid managed care program, and its community benefits. If you are unsure whether your child is covered, the Income Support Division information line is 1-855-309-3766.
- EPSDT, which for Medicaid purposes covers anyone under 21 and can pay for medically necessary services well beyond what adults get.
- School and early childhood services, which run on their own track and their own law. See children and school.
Next: see the whole process in order, or skip ahead to the two programs side by side.