Medicaid offers a number of programs to assist eligible seniors in paying for in-home care and home health care. Medicaid provides long-term care and medical services to low-income elderly and disabled individuals.

It may be challenging to choose the best in-home care alternatives for a loved one and to figure out how to pay for care. Continue reading to find out more about the many Medicaid programs that may assist eligible seniors in getting the care they need while still living in their homes.

What kinds of home care is Medicaid going to pay for?

The Medicaid programs that each state gives seniors financial help to cover the costs of the following various kinds of in-home care services are listed below.

At a senior’s home, home health care professionals provide medical services including physical therapy, wound care, and prescription administration. These services are offered by a health care professional, such as an occupational therapist or licensed nurse, as per a doctor’s prescription.

Non-medical services including companionship, light housekeeping, and aid with daily living tasks are offered as part of in-home care.

Which Medicaid programs provide home care that is long-term?

Since each state is allowed to develop its own programs and establish eligibility rules within the confines of federal regulations, navigating Medicaid may be challenging. The fundamental kinds of Medicaid programs that cover long-term care provided at home are as follows:

Nursing home care and home health care are two federally required long-term services and support benefits that are included in each state’s standard Medicaid program. Any extra advantages that a state has decided to provide are also included in the state plan. This might include alternatives for Home and Community-Based Services (HCBS), such as Community First Choice (CFC) and the HCBS state plan option under section 1915(i). These HCBS benefits provide long-term services and support to people who would otherwise need care in an institution but are able to live in their own homes and communities.

The typical Medicaid program of a state is an entitlement program, meaning that enrollment and benefits are guaranteed to everyone who satisfies the qualifying conditions.

Medicaid HCBS Waivers – With the use of waivers, states may extend Medicaid coverage to certain populations. Waivers aren’t regarded as entitlement programs since they aren’t part of a state’s standard Medicaid program. Often, enrollment is limited and may only be available in select service regions. Even if a senior qualifies for an HCBS waiver, there can be a considerable waiting list before they can start receiving benefits.

Program of All-Inclusive Care for the Elderly (PACE) — PACE offers seniors on Medicare, Medicaid, or both a full range of services that may help them stay in their own homes.

These Medicaid systems usually offer benefits in one of two ways: managed care or consumer-directed care, however, specific laws and features vary by state. Beneficiary of managed care must get their services through Medicaid managed care organizations and authorized providers. Medicaid recipients may choose the provider and location of their treatment thanks to consumer-directed care. (This can include hiring a relative to offer care at an elderly person’s home.) Certain Medicaid schemes could combine managed and patient-directed care delivery.

Is home health care covered by Medicaid?

Yes, Medicaid provides in-home care for seniors who fulfil the specific financial and functional qualifying requirements set out by their state.

The following list of home healthcare service types may be covered:

  • Taking care of wounds
  • medicine administration
  • monitoring general well-being
  • Adult day health services
  • Services for occupational, physical, and speech therapy
  • To find out more about home health care eligibility criteria and benefits, check with your local Medicaid office. States may cover additional services.

Is in-home care covered by Medicaid?

Indeed, many states’ Medicaid programs pay for certain personal care services as well as other non-medical care including companion care and housekeeping. State-by-state variations in specific services mean that they could be accessible via both Medicaid waivers and the state’s normal Medicaid program.

For instance, the Community First Choice program in Texas is a state Medicaid plan choice that offers long-term support and services to qualified seniors in their homes, including help with washing, dressing, and grooming.

A Medicaid HCBS waiver that offers seniors many non-medical in-home care choices is the Multipurpose Senior Services Program in California. Seniors may get help with things like personal care, food preparation, and washing via this Medi-Cal in-home care program.

Contact the state’s Medicaid office for further details about the Medicaid programs that support home care in that state.

Would 24-hour home health care be covered by Medicaid?

A senior’s home care is not normally covered by most Medicaid programs. Typically, individuals who need intense skilled nursing services are the only ones who can get such a high degree of care. This service is offered in certain states via an elective private-duty nursing program.

For instance, residents of Colorado who are eligible for Health First Colorado, the state’s standard Medicaid program, may be able to get up to 23 hours of care each day via the Private Duty Nurse program. The treatment must be deemed medically essential in order to qualify. A doctor must prescribe a care plan for a senior, and a home health service must create it.

Medicaid’s required home health care coverage often only offers sporadic or intermittent services. The precise quantity, length, and extent of these services, however, are up to each state to decide. Some people are kinder than others.

For instance, Ohio seniors who qualify for Medicaid-covered home health care are only eligible for “intermittent services.” According to the law, this is limited to eight hours of duty per day and a maximum of 14 hours per week.

How to get eligible for Medicaid-funded home care or home health services at home

The following criteria will determine if an elderly person is eligible for Medicaid home health care or other types of care:

  • Their age and/or level of infirmity
  • Medicaid programs and eligibility requirements in the state where they reside
  • Their assets, taxable income, and maybe medical costs
  • Their capacity for both function and thought
  • Their health requirements
  • Medicaid eligibility requirements vary greatly from state to state and from program to program in terms of finances, health, and functional requirements. It might be challenging to comprehend Medicaid eligibility rules and how to apply for in-home care. Contacting your loved one’s local Area Agency on Aging or a reputable elder law attorney who is familiar with Medicaid in their state is the best approach to begin started. These tools may assist you and your loved one in researching the various care alternatives and financing options.


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Are you looking for compassionate and reliable home care services in Orange, Osceola, Brevard, or Seminole counties? Look no further than our professional team at Embracing Home Care! Our highly trained caregivers provide personalized care for seniors and individuals with disabilities, ensuring that they can continue to live independently in the comfort of their own homes. With a variety of services including personal care, transportation, meal preparation, and companionship, we strive to improve the quality of life for our clients and provide peace of mind for their families. Contact us today at 321-758-2036 to learn more about our affordable and flexible home care options and to schedule a consultation with one of our care coordinators. Let us help you or your loved one live life to the fullest!  We serve Central Florida cities like Orlando, Apopka, Ocoee, Winter Garden, Sanford, Altamonte Springs, Casselberry, Palm Bay, Melbourne, Titusville, Kissimmee, St.  Cloud, Celebration, Lake Mary, Oviedo, Longwood, Winter Springs, Cocoa Beach and more.

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