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There are two main types of waiver program. One waiver program is related to certain health care needs of a particular population, and the other waives normal visa requirements for foreign nationals of specific countries under a limited set of circumstances. The health waiver program, which is also commonly known as a Medicaid or Medicare waiver program, provides additional funding for certain health or medical services that the federal government only partially funds. On the other hand, the Visa Waiver Program (VWP) allows foreign citizens of 36 countries — as of 2011 — to travel to the U.S. for business or pleasure for a period of 90 days or less without obtaining a visa.
Health waiver programs differ substantially from one state to the next, because state law and administrative regulations govern the operation of these programs, and various state agencies are responsible for administering these programs. Despite their differences, the purpose behind all state health waiver programs is to allow some people to stay in their homes, despite a need for skilled care that typically is provided in a nursing home setting. A person's eligibility for a health waiver program is dependent on his or her medical condition, prognosis, and the type of treatment necessary for the person to remain at home. Some states have different types of health waiver programs based on the patient's medical condition, such as a program for people with developmental disabilities, or a program for senior citizens.
Just as health waiver programs limit participation to only eligible people, foreign citizens who wish to participate in the U.S. Department of State’s VWP must meet certain criteria. VWP participants must be eligible to travel under the VWP; that means they must obtain authorization through the Electronic System for Travel Authorization prior to traveling, they must be enrolled in the U.S. Department of Homeland Security’s screening program, and they must further be screened before actually entering the U.S. at the port of entry. All VWP participants must have a valid passport, and must be able to demonstrate their intent to remain in the U.S. for no longer than 90 days and their ability to support themselves during their stay in the U.S. Additionally, countries may not participate in the VWP unless they meet certain eligibility requirements, such as maintaining enhanced security and law enforcement cooperation with the U.S., and enforcing counterterrorism and other security measures.
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