Provo Senior AdvisorWhat is the New Choices Waiver?
The New Choices Waiver (NCW) is a Utah Medicaid 1915(c) home and community-based services waiver that pays for services so people who have been living long term in a nursing facility, assisted living facility or other licensed medical setting can live in a home or community setting instead.
It is the program Utah County families usually mean when they ask whether “Medicaid will pay for assisted living.” The answer is partly: NCW pays for assessed services, and the resident pays room and board from their own income.
Who qualifies for the New Choices Waiver?
An applicant must be at least 18, meet Utah Medicaid financial eligibility, need nursing facility level of care, not have a mental illness as the primary condition or need an intensive skilled level of care, and not be eligible for an ICF for people with intellectual disabilities.
The applicant must also fit one of these situations:
- Medicaid-paid nursing facility stay of 90 days or more
- Medicare-paid stay of at least 30 days in a licensed Utah medical institution, discharging to a Medicaid nursing facility for at least 60 days
- Already on another Utah HCBS waiver and in need of immediate or impending nursing facility care
- Living in a licensed assisted living facility or Type N small health care facility for 365 days or more
The last path is the one that reaches assisted living residents directly: someone who has lived in a licensed assisted living facility for 365 days or more may apply from there. Families who move a parent in on private funds sometimes plan around that date.
What does the New Choices Waiver pay for?
NCW pays for assessed services such as attendant care, adult residential services in a licensed facility, case management, medication assistance and respite, but not rent, food or other room-and-board costs.
- Adult day care
- Adult residential services
- Attendant care
- Case management
- Chore and homemaker services
- Emergency response systems
- Home-delivered meals
- Medication assistance
- Non-medical transportation
- Respite care
- Specialized medical equipment
Not every Utah County assisted living building accepts waiver residents, and those that do may set a room-and-board rate for them. Ask the building directly, and ask how many waiver residents it serves now.
Is there a waiting list for New Choices in Utah?
NCW serves a limited number of people and reserves most openings for people in nursing facilities, hospitals or other medical facilities; Utah DHHS says people in those settings and people already living in licensed assisted living or a Type N facility may apply at any time until the participant cap is reached, and it does not expect to exceed the cap.
Because availability can change, call before you build a plan around it: 801-538-6155 (option 6) or 1-800-662-9651 (option 6), or email newchoiceswaiver@utah.gov.
How does a Utah County family apply for New Choices?
Contact the New Choices Waiver program office at 801-538-6155, option 6, for an application; financial eligibility is decided separately by Utah Medicaid, and a clinical assessment confirms nursing facility level of care.
Gather bank statements, income records, insurance cards and any power of attorney before you call. If a parent is in a nursing home after a hospital stay at Utah Valley or American Fork Hospital, ask the facility social worker about NCW early in the stay.
Side by side
| New Choices pays for | New Choices does not pay for | |
|---|---|---|
| Care | Assessed services such as attendant care | Rent or meals |
| Setting | Services in licensed assisted living or at home | A guaranteed bed in any building |
| People | Adults 18+ needing nursing facility care | People whose primary condition is mental illness |
| Timing | Applications from qualifying settings | Immediate approval |
Sources: Utah Admin. Code R432-270, Utah DHHS and DLBC pages, MAG Aging & Family Services, CareScout and VA rate tables as cited; see our editorial standards.
