Medicaid Waiver Waiting Lists in NC, SC, TN, VA and GA: What Families Need to Know

If you’re trying to arrange long-term support for a loved one with an intellectual or developmental disability, you may hear about Medicaid waivers, and then discover there’s a waiting list. That can feel discouraging, especially when you’re already managing services, appointments, and paperwork.

A waiver waiting list does not mean you should wait to apply. In many cases, starting early, keeping your information current, and asking about interim support can make a difference. The process varies by state, and eligibility is based on each program’s rules, not on a diagnosis alone.

This guide covers general starting points for North Carolina, South Carolina, Tennessee, Virginia, and Georgia. Program rules and contact details can change, so confirm current information with the state agency or local program before acting.

First, what is a Medicaid waiver?

Home- and community-based services (HCBS) waivers help some people receive services in their homes and communities rather than in an institution. Depending on the waiver and a person’s assessed needs, services may include personal support, respite, employment assistance, or help with daily activities.

A waiver is not the same as basic Medicaid coverage. A person may need to meet specific disability, functional, financial, and level-of-care requirements. Some programs also have a limited number of enrollment slots. A person can meet eligibility criteria and still wait for a slot to become available.

Autism, ADHD, or another diagnosis does not automatically qualify someone for every waiver. Ask the state program which diagnoses and support needs it considers, and whether it requires additional assessments.

What to do while waiting for a waiver

Even when you can’t control when a slot opens, you can take steps to keep the application process moving:

• Apply as soon as you understand that the program may be relevant. Ask the agency whether you can apply now, even if services are needed later.
• Keep a record of your referral and application dates. Save letters, emails, forms, and the names of people you speak with.
• Update your contact information promptly. Missed calls or letters can complicate communication about a slot.
• Ask about priority or emergency pathways. Some states have specific criteria for urgent situations.
• Ask about other services you may be able to use while waiting. A waiver is not necessarily the only source of help.
• Request information in a format that works for you. You can ask for written instructions, one step at a time, or a follow-up email.

A simple tracking sheet can help you record the program, contact person, application date, documents submitted, and next action.

North Carolina: NC Innovations Waiver

North Carolina’s NC Innovations Waiver supports eligible people with intellectual and developmental disabilities. The state says funding is limited, and the waiting list (formerly called the Registry of Unmet Needs, or RUN) is managed by local LME/MCOs. Each county has its own list, and people who have waited longer are generally served first. The state says it cannot predict an individual’s wait time.

NC Medicaid recommends applying as soon as there is a diagnosis, even if services may not be needed immediately. Contact the LME/MCO serving your county and ask to apply for the NC Innovations Waiver. The state’s application guide explains how to find the right organization and what to expect.

If you’re already on the list, keep your address and phone number current with your LME/MCO. Tell them if your support needs have changed and ask whether extraordinary circumstances or an emergency reserve slot may apply. You can also ask about 1915(i) services, which may offer some supports while a person waits; eligibility rules apply, and these services do not change a person’s place on the Innovations list. See the state’s waitlist information for details.

South Carolina: ID/RD Waiver

South Carolina’s Intellectual Disability/Related Disabilities (ID/RD) Waiver is administered by the South Carolina Department of Health and Human Services, with operations handled by the Department of Disabilities and Special Needs (SCDDSN). Applicants generally must meet program requirements, including Medicaid eligibility and an ICF/IID level of care. Having a disability diagnosis alone does not establish eligibility.

To begin, contact the SCDDSN Single Point of Entry at 1-800-289-7012 and ask about intake for the ID/RD Waiver. If a person meets requirements but no slot is available, the state’s waiver materials say they may be placed on a waiting list based on the earliest referral date. Ask for confirmation of the referral date and how to check that the application remains active. The ID/RD Waiver information describes eligibility and priority situations. Some circumstances, including a need to prevent serious and imminent harm, may be considered for reserved capacity; ask the state whether the person’s situation meets current criteria.

Tennessee: Employment and Community First CHOICES

Tennessee’s Employment and Community First (ECF) CHOICES program is a primary route for many people with intellectual or developmental disabilities seeking long-term services and supports. Tennessee describes limited funding and enrollment priorities; qualified applicants who cannot enroll right away may be placed on a referral list.

The state’s older intellectual-disability waivers (Comprehensive Aggregate (CAC), Self-Determination, and Statewide) are generally closed to new enrollment, with limited exceptions. Because the right route depends on a person’s needs and circumstances, ask TennCare or an ECF CHOICES health plan which process applies.

You can review program details and the self-referral route on the official Tennessee ECF CHOICES page. Ask what documentation is needed, whether an assessment is required, how priority is determined, and whether other services may be available during the wait.

Virginia: Developmental Disability Waivers

Virginia has three Developmental Disability (DD) waivers: Community Living, Family and Individual Supports, and Building Independence. People who are eligible but do not receive a slot may be placed on a waitlist. Priority is based on assessed need, and the process includes diagnostic and functional eligibility reviews as well as Medicaid financial eligibility.

A local Community Services Board (CSB) or Behavioral Health Authority (BHA) is the starting point for intake and screening. Ask which agency serves your area and how to begin the eligibility process. The state’s 2026 DD Waiver overview reported 14,258 people on the waitlist as of November 25, 2025, including 2,727 in Priority One. Those figures are a dated snapshot, not an estimate of any individual’s wait.

Virginia’s Individual and Family Support Program may also help some people on the DD Waiver waitlist connect with community resources or limited financial assistance. Ask the CSB/BHA about current availability and eligibility.

Georgia: NOW and COMP waivers

Georgia’s two main waivers for people with intellectual or developmental disabilities are the New Options Waiver (NOW) and Comprehensive Supports Waiver Program (COMP). The Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) handles day-to-day operations, including regional intake and evaluation.

Start with the state’s Medicaid waiver programs page, which directs applicants to DBHDD for NOW and COMP. Ask the DBHDD regional office serving your area how to submit a referral, what information is needed, and whether the person may be placed on a waiting or planning list. Georgia’s Medicaid page describes the programs and application route but does not provide a single statewide waitlist count, so request current, region-specific information directly.

Make a plan that works for your family

Waiting for support can bring uncertainty, but you do not have to keep every detail in your head. Store application records in one place, note dates and follow-up tasks, and ask agencies to clarify anything that is unclear. If circumstances change, report that promptly and ask whether it affects priority or eligibility.

Ridgeline Care Network provides virtual, non-clinical benefits navigation and care coordination for neurodivergent individuals and families across NC, SC, TN, VA, and GA. We can help organize information, prepare questions, and identify next steps; program agencies make eligibility and enrollment decisions, and we cannot guarantee coverage or approval. You don’t have to be neurodivergent to reach out. Learn more about our service area, book a free initial consult, or call (833) 732-6200.

This article is for general information, not legal, clinical, or benefits-eligibility advice. Waiver rules and availability can change. Contact the responsible state or local agency for current requirements and decisions.