Does Medicaid Pay For Home Care & Home Health Care?

Does medicaid pay for home care? What exactly does Medicaid cover, and how can you access these services? We’ll break them down—from what services are covered to how to qualify—in this article. 

As we age, our homes can become a source of comfort and security, but they can also become a challenge when we need medical care. This is why for many seniors, Medicaid becomes their safety belt, covering essential home health care services that allow them to recover safely and comfortably at home. 

What is Covered by Medicaid? 

Medicaid offers a variety of home care and home health care services to help seniors and people with disability to maintain their independence and age in place. Here’s a breakdown of what’s typically covered:

Home Care Services

  • Personal care assistance: Help with activities of daily living (ADLs) such as bathing, dressing, eating, and toileting.
  • Help with instrumental activities of daily living (IADLs): Assistance with tasks like housework, laundry, meal preparation, and transportation.
  • Companionship care: Social interaction and emotional support.
  • Homemaker services: Light housekeeping and errands.
  • Adult daycare programs: Social activities, meals, and supervision in a group setting.

Home Health Care Services

  • Skilled nursing care: Provided by registered nurses or licensed practical nurses.
  • Therapy services: Physical therapy, occupational therapy, and speech therapy.
  • Medical social services: Help with care coordination and planning.
  • Durable medical equipment: Wheelchairs, walkers, and hospital beds.
  • Home health aides: Assist with personal care and light housekeeping tasks.

Medicaid’s home healthcare benefits focus on providing medical support to seniors and those with healthcare needs to safely recover and manage their conditions at home, while the home care services address their day-to-day living needs.

Eligibility Requirements 

You need to remember that Medicaid’s home care and home health care benefits are not limited to just seniors. While many older adults do qualify for Medicaid coverage, the program is available to a wider range of low-income individuals, including:

  • Seniors aged 65 and older
  • People with disabilities, regardless of age
  • Pregnant women
  • Children and families with limited financial resources

To qualify, individuals must meet specific financial and functional criteria, which include caps on monthly income and total assets. 

  • Financially, Medicaid looks at both income and assets, with limits varying by state.
  • Functionally, applicants usually need to demonstrate a need for assistance with daily living activities or medical care.

Different states have different rules and thresholds, so it’s important to check local requirements to know what services are available to you or your loved ones.

Medicaid vs. Medicare

Many people confuse Medicaid with Medicare, but they are two distinct programs with different purposes and eligibility requirements. Here’s a brief comparison:

  • Medicare is a federal health insurance program for people 65 and older, certain younger people with disabilities, and people with End-Stage Renal Disease (ESRD). Medicare primarily covers medical services, such as doctor visits, hospital stays, and prescription medications.
  • Medicaid is a joint federal-state program that provides health coverage to low-income individuals, including children, adults, and people with disabilities. Medicaid covers a broader range of services, including long-term care, home care, and community-based services.

While Medicare is primarily focused on medical services, Medicaid is more focused on supporting daily living needs and long-term care. Some people may be eligible for both Medicare and Medicaid, depending on their income and health needs.

With all this knowledge in hand, it’s reassuring to know that Medicaid is there to support us in our greatest times of need. And as we look to the future, it’s crucial that we continue to advocate and support programs like Medicaid. Doing this can ensure that everyone has access to the care and support they deserve, in the comfort and security of their own homes.


KEY TAKEAWAYS:

  • Medicaid covers various home care and home health care services for seniors and people with disabilities.
  • Medicaid eligibility requires meeting specific financial and functional criteria.
  • Medicaid’s home healthcare benefits focus on medical support, while home care services address daily living needs.
  • Medicaid provides health coverage to low-income individuals, including children, adults, and people with disabilities.
  • Medicaid eligibility is not limited to seniors, but also includes people with disabilities and low-income families.