For older Iowans who want to avoid a hospital or nursing-facility stay, the state's primary tool is the Elderly Waiver, which delivers extra Medicaid-funded services so a person age 65 or older can keep living at home. To qualify, an applicant needs to already be Medicaid eligible, have income under three times the SSI limit, hold assets below $2,000, and need a level of care that would ordinarily be provided in a nursing facility — a determination made through an assessor's formal level-of-care evaluation.
As of the January 2026 guidance, the annual income threshold tied to that three-times-SSI standard works out to less than $35,788. There's a broader reorganization underway too: Iowa HHS is combining six diagnosis-based waivers into new Children and Youth and Adults with Disabilities waiver programs, but after hearing concerns about access for people 65 and older, the agency chose to keep the Elderly Waiver on its own separate track rather than folding it into the consolidation.