Medicaid & Enabling Technology Waivers: 7 Common Questions Answered

Many Medicaid plans and state agencies are missing a critical opportunity to enhance member care: enabling technology waivers.

While these waivers can provide critical support through devices, software, and other assistive technologies, they remain underutilized. The reason is often simple—limited awareness. Plan administrators and providers may not fully understand how enabling technology works, what’s covered, or which qualified, credentialed partners can successfully deliver it at scale.

In this blog, we break down the top seven questions that Medicaid decision-makers frequently ask about enabling technology waivers, providing answers, resources, and practical guidance to help your plan maximize the benefits for your members.

1. What are enabling technology waivers and what are their purpose?

Enabling technology waivers are Medicaid‑funded service options available to members who qualify for Long‑Term Services and Supports (LTSS). Most often authorized through 1915(c) Home and Community‑Based Services (HCBS) waivers, these programs allow states to cover certain assistive and enabling technologies when they are medically necessary and aligned with an individual’s service plan.

The primary purpose of enabling technology waivers is to support members in remaining safely in their homes and communities, rather than transitioning to institutional settings. The covered technologies are intended to enhance independence, safety, and functional ability, and to support overall quality of life as part of a broader LTSS delivery model.

2. Who qualifies for enabling technology under these waivers?

Eligibility varies by state but generally aligns with LTSS qualification criteria. This means the member should:

• Be eligible for Medicaid in their state
• Require LTSS support
• Have a documented need for assistive or enabling technology to remain independent at home

For the specific eligibility criteria in your state, review the state’s waiver document, which is typically available on the state Medicaid website or through your Medicaid plan administrator.

3. What technology is eligible under the enabling technology waivers? And what are the benefit limits?

Eligibility and benefit limits also vary by state, just like member eligibility. While each state defines which devices and services are covered, common types of enabling or assistive technologyoften include:

• Smart home devices for safety, such as smart plugs and video doorbells
• Communication devices, including smart speakers and speech-generating devices
• Personal emergency response systems, like medical alert devices
• Home networking equipment, such as Wi-Fi routers and network hubs

For instance, in Tennessee, the state’s Home and Community-Based Services (HCBS) waivers provide coverage for assistive technologies like video doorbells, smart locks, smart hubs, and smart lights for up to 12 months annually.

To confirm the exact coverage and limits, review your state’s waiver documents.

4. What are the key components of implementing an Enabling Technology program?

After aligning your program with your state’s specific eligibility criteria, consider the following key elements:

• Assessing member needs: How will your team evaluate each member to identify the enabling technology best suited to their unique needs?
• Educating your care team: If your care team is conducting assessments, how will you train them on eligible technologies and the value they provide to members?
• Ordering and delivering technology: Once waiver-eligible technology is identified, how will it be ordered in a way that ensures coverage? And how will it be delivered to the member?
• Installing the technology: After the member receives the technology, who ensures devices are installed properly and work as intended in the home?
• Providing ongoing support: What happens if a member experiences issues? Who will provide troubleshooting and ongoing technical support?
• Measuring impact: How will your organization measure the impact of enabling technology on member outcomes, including their ability to remain independent and safe at home over time?

5. What outcomes or ROI can plans expect from enabling technology programs?

For health plans and state Medicaid agencies, services delivered through 1915(c) HCBS waivers can generate strong financial and clinical returns. One report estimates that for every $1 invested in assistive technology solutions, plans may realize up to $9 in economic benefit.¹ These savings are laregely driven by reductions in hospitalizations and emergency events, as well as decreased reliance on long-term institutional care. In addition to cost savings, assistive technology programs can improve member independence, safety, and overall quality of life.

6. What if my state isn’t currently structured to support an enabling technology waiver?

It’s not uncommon for existing state systems and policies to fall short in supporting the adoption and scale of enabling technology. Many Medicaid LTSS programs were designed before these solutions were widely available, which can create structural, regulatory, and funding barriers.

ADvancing States, a national nonprofit representing state agencies on aging, disabilities, and Medicaid LTSS administrators, recently published a comprehensive resource examining the current landscape of enabling technology in LTSS programs.² The report outlines key challenges while offering practical guidance for states looking to modernize their approach.

Ultimately, even without a fully developed waiver structure, states have multiple pathways to begin integrating enabling technology into their LTSS systems. By taking incremental steps and leveraging existing frameworks, states can expand access to innovative supports that enhance independence and safety for those receiving long-term services and supports.

7. How can Medicaid plans and providers increase awareness and utilization of enabling technology waivers?

The most effective way to increase awareness and utilization is to empower frontline staff who interact with members every day. Begin with clear, practical training on what the enabling technology waiver is, what technologies are covered, and any benefit limits. Then, walk staff through the end-to-end process—how to request, order, and coordinate delivery and setup for members. Finally, provide simple, easy-to-use tools (like assessment guides or decision aids) that help staff quickly match member needs to appropriate technology solutions during conversations and care planning. You can then reinforce with simple, ongoing communications, including real member examples and outcomes, to keep enabling technology top of mind for staff over time.

Have other questions about enabling technology waivers? Our team can help. Best Buy Health not only offers its own Best Buy Health Enabling Technology Program—we also bring deep expertise on the topic and are ready to support you. If you’d like to connect with our team, please reach out to [email protected].

1. At Scale: Global Partnership for Assistive Technology, The case of investing in assistive technology, 2020, https://atscalepartnership.org/atscale-publications/case-investing-assistive-technology
2. Advancing States, The State of Enabling Technology in LTSS Programs in 2024, https://www.advancingstates.org/sites/default/files/The%20State%20of%20Enabling%20Technology%20in%20LTSS%20Programs%20in%202024%208.7.pdf