Home Care as Long Term Care
Does Medicaid Pay for Long-Term Care at Home?
Yes — Medicaid offers several programs that provide long-term care in a senior’s home. This can include medical care, non-medical support for daily living, and even home modifications to promote independence. Examples range from home health care to personal care assistance and safety equipment like personal emergency response systems.
Important: Being eligible does not guarantee you will receive services. Some programs have waitlists or enrollment limits.
What Types of Services Can Medicaid Cover at Home?
Medicaid-funded in-home long-term care services can include medical, non-medical, and home adaptation supports. Availability varies by state and by program. Common examples include:
- Assistive Technology & Devices: Wheelchairs, adaptive utensils, specialized software, etc.
- Attendant / Personal Care: Help with Activities of Daily Living (ADLs) like bathing, dressing, mobility, eating, toileting, plus Instrumental Activities of Daily Living (IADLs) like cooking, cleaning, laundry, and medication management.
- Care / Case Management: Coordination of care providers and benefits.
- Caregiver Training
- Chore Services: Household help from basic repairs to heavy yardwork.
- Community Transition Services: Assistance returning home from a nursing facility.
- Companion Services
- Durable & Home Medical Equipment
- Environmental Accessibility Adaptations: Home modifications such as ramps, stair lifts, or walk-in tubs.
- Financial Management Services
- Home Delivered Meals
- Home Health Care
- Homemaker Services
- Non-Medical Transportation
- Nursing Services
- Personal Emergency Response Systems (PERS)
- Respite Care
- Special Medical Equipment
- Transportation
How Do Medicaid Programs Differ in Paying for Care at Home?
Medicaid has three primary program types relevant to seniors needing in-home long-term care:
| Program | Eligibility | Coverage for In-Home LTC | Limitations |
|---|---|---|---|
| Nursing Home Medicaid (Institutional) | Low income/assets; nursing home level of care | No — facility-based care only | Does not pay for in-home LTC |
| Medicaid Waivers (HCBS) | Similar to Nursing Home Medicaid; functional need | Yes — wide range of in-home and community-based services | Not an entitlement; limited slots; possible waitlists |
| Aged, Blind & Disabled (ABD) Medicaid | Lower income/assets than Waivers; often stricter criteria | Yes — limited in-home services | Fewer services than Waivers but no waitlist |
Who Can Provide the In-Home Care Under Medicaid?
Care can be delivered by providers assigned by Medicaid or chosen by the recipient under “self-directed care” options. Self-direction allows beneficiaries to select from approved providers and, in some states, hire friends or family members — even spouses — to provide personal care assistance.
What Are the Key Things to Remember About Medicaid Home Care?
- Medicaid can fund both medical and non-medical care at home.
- Programs and services vary by state and eligibility type.
- Waivers offer the most services but may have long waitlists.
- ABD Medicaid offers fewer services but guarantees access if eligible.
