The Medically Fragile program is a home and community-based alternative to placement in a hospital and/or skilled nursing unit of a nursing facility to receive Medicaid-funded assistance for care. This program allows Medicaid eligible persons who meet institutional level of care requirements to remain at home or in the residential setting of their choosing while receiving the necessary care.
- Be at least 19 years of age
- Meet hospital and/or skilled nursing level of care
- Meet SoonerCare financial eligibility
- Must be living at home or a residential setting
Potential members are referred for the Medically Fragile Waiver through the common intake form. Once the intake form is submitted, their name is place on the Medically Fragile waiting list. Once there is a slot available for enrollment, the potential member will be assessed for financial eligibility. If the potential member meets the financial and medical criteria, they are eligible for the waiver and asked to pick a case management agency. The case manager will begin the service plan process of enrollment. Each year the member must meet the financial and medical criteria to continue services on the Medically Fragile Waiver.