STEPS FOR ENROLLMENT

Inform the enrollment broker that you want to apply for services — they will start by scheduling your first in-home visit.

• You will be asked to prepare a list of papers for the visit — be sure to read the provided list.
• PA IEB will send your family doctor a Physician Certification Form to fill out and send back.

• At the visit, a representative from PA IEB will talk with you about your needs and abilities.
• You will complete your Medicaid application and other required forms.
• Once your MA application is submitted, your local County Assistance Office (CAO) will review it and may follow up with a letter if additional forms or information is needed.

• After the first visit, the IEB will contact your local Area Agency on Aging (AAA) and have them schedule an in-home assessment of need with you – the assessment is called Functional Eligibility Determination (FED).
• The results of your assessment will then be sent to PA IEB for review.

• PA IEB needs to receive your Function Eligibility Determination (FED), as well as the Physician Certification Form within 86 days of the first in-home visit.
• If both forms are received and you meet the clinical program eligibility, your application is sent to the CAO.

• The CAO will determine if you financially qualify for waiver services. If anything is still missing from your application, they will send a letter stating how to submit needed information.
• Once your application is complete, the CAO will either approve or deny it.

Click the link below to apply online with the PA Independent Enrollment Broker

https://paieb.com/en/waiver-application