Alaska Home Care Medicaid

Last updated: August 21, 2026 Jurisdiction: Alaska

Alaska operates five HCBS waivers

Alaska's Department of Health lists five Medicaid Home and Community Based Services waivers: Alaskans Living Independently, or ALI; Alaskans with Physical and Developmental Disabilities, or APDD; Children with Complex Medical Conditions, or CCMC; Intellectual and Developmental Disabilities, or IDD; and Individualized Supports, or ISW. These waiver programs are designed for people who meet an institutional level of care but receive services in a home or community setting instead of a facility (Alaska HCBS waiver overview).

For older adults, the most directly relevant program is ALI. CMS describes ALI as serving people age 65 or older and adults with physical disabilities ages 21 through 64 who meet nursing-facility level of care, while the state page identifies ALI as for adults age 21 and older who need nursing-facility-level care (CMS Alaska waiver factsheet; Alaska HCBS waiver overview).

Assessment and service planning

Applicants must meet Medicaid financial limits through DPA and be assessed for the required level of care. The Department says the SDS Intake and Assessment Unit or SDS IDD Unit, depending on program, determines level of care, and that nurses or other trained personnel perform functional assessments with nurse-supervisor review (Alaska HCBS waiver overview).

The waiver overview lists services such as respite, chores, residential living, care coordination, and environmental modifications, with services planned by the participant's team and approved by SDS through a support plan. CMS's waiver factsheet lists additional service categories for ALI, including adult day, care coordination, meals, nursing oversight, specialized equipment, and transportation (Alaska HCBS waiver overview; CMS Alaska waiver factsheet).

Waitlists are program-specific

Alaska's current HCBS page states that 50 people are selected from the IDD waitlist each year to apply. It also says an ISW waitlist will begin when the federally approved participant limit is reached, and ISW participants must agree to an overall service-cost cap (Alaska HCBS waiver overview).

The state page does not publish a comparable live numerical ALI waitlist or enrollment-cap figure. A person seeking ALI services should therefore ask SDS or the care coordinator about current availability, service authorization, and whether the immediate need can be met through another covered pathway rather than assuming all waivers use the IDD or ISW rules (Alaska HCBS waiver overview).

CMS shows Alaska's APDD waiver as approved from July 1, 2026 through June 30, 2031. CMS also separately lists the Alaska waiver categories and their target populations, confirming that a waiver's name and age or disability criteria matter when planning at home (CMS APDD waiver record; CMS Alaska waiver factsheet).

Home-care focus for older adults: ALI serves older adults and certain physically disabled adults who meet nursing-facility level of care. Alaska publishes IDD and ISW waitlist rules but not a live ALI waitlist count on the located public page (Alaska HCBS waiver overview).

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Alaska operates five HCBS waivers

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