Medicaid Home Health Care and Nonmedical Home Care: Your Questions, Answered

Yes, Medicaid covers the cost of medically necessary home health care services that are prescribed or ordered by a physician. Eligible services must also be provided by licensed health care professionals, such as a registered nurse, licensed vocational nurse, or an occupational, physical, or speech therapist.

Examples of home health care services covered by Medicaid include:

• Health monitoring
• Medication management
• IV medication administration
• Injury treatment
• Wound dressing
• Rehabilitative therapies
• Pain management
• Medical testing
• Skilled nursing

Medicaid-covered home health care providers may be publicly operated agencies, a nonprofit organization, or a private company. Medicaid pays these providers directly to provide care.^[01]

Although they may seem similar, home care and home health care provide different services. Home care typically refers to nonmedical care, while home health care refers to medical care provided at home.

Medicaid eligibility requirements for home health care

Medicaid eligibility differs from state to state. In most states, home health care is a guaranteed benefit for seniors who require a nursing home level of care.

Nursing home level of care is determined by an assessment of a person’s physical ability to perform daily tasks, their medical needs, and behavior. Also considered is an individual’s financial status, and states typically rely on income thresholds set by the Social Security Administration. In 2025, an individual qualifies for Supplemental Security Income (SSI) if their monthly income is less than:^[02]

• $2,020 from job earnings (before taxes and deductions), or
• $988 from non-work sources, such as unemployment insurance or a pension

“Understanding Medicaid eligibility, and how to access Medicaid benefits takes a fair amount of time and research,” says Vicki Demirozu, founder of Giving Care with Grace, a soft skills training program for caregivers.

“I suggest that folks start thinking about their loved one’s future need for home care at least 5 years before they might need it,” suggests Demirozu.

In the United States, more than half of people over the age of 65 are expected to need care.^[03]

“So around age 60, or even a little earlier, is a good time to start thinking about and talking with your loved one about what care might look like for them,” says Demirozu.

Will Medicaid pay for 24-hour home health care?

Some state Medicaid programs cover private duty nursing for individuals who require more advanced medical care, such as 24/7 nursing care. These 24-hour skilled nursing services might be covered in the event a patient needs a feeding tube, IV medications, or mechanical ventilation.^[04]

Eligibility criteria for private duty nursing programs vary by state, but a common requirement is a stated medical need for round-the-clock skilled nursing services. In several states, Medicaid only covers part-time home health care with a limited number of service hours per day.

Can you afford home care?

Yes, Medicaid may also cover the costs of nonmedical home care, but specific services, coverage, and eligibility requirements vary from state to state.

Home care services covered by Medicaid vary, but often include help with activities of daily living and other tasks, such as:

• Bathing
• Dressing
• Continence care
• Mobility
• Cooking
• Light housekeeping
• Transportation
• Household chores

Medicaid eligibility requirements for nonmedical home care

To qualify for in-home care through Medicaid, at a minimum, seniors must be 65 or older and meet their state’s specific financial requirements.

Because each state has different eligibility requirements, it’s important to review your loved one’s state Medicaid page.

Yes, some states will pay family caregivers for the nonmedical home care services they provide. Depending on the state, caregivers may need to complete training and certification to qualify.

Medicaid won’t pay unlicensed family caregivers to provide medically necessary home health care services, as these must be provided by licensed health care professionals.^[01]

Home and community-based services (HCBS) offer financial support to help Medicaid recipients continue to live in their own homes or communities instead of an institutional setting, like a nursing home.^[05] Nonmedical home care is typically covered under HCBS programs.

HCBS are often, but not always, provided through Medicaid waivers. Nearly every state offers at least one Medicaid waiver, but it’s important to note that unlike home health care, HCBS programs aren’t considered an entitlement program. This means that enrollment isn’t guaranteed, and participants may be placed on a waitlist.

Because each state provides HCBS in a different way, the requirements to qualify for these programs vary. Check the Medicaid state waivers list for more information on specific programs in the state where your loved one lives.

What services are covered under HCBS?

Each state designs its own HCBS program, including which services will be covered. Commonly covered services include a combination of medical and nonmedical services, such as:^[05]

• Case management
• Home health care
• Personal care
• Adult day care
• Respite care

Expert advice for affordable home care

If you’re looking for home health care or nonmedical home care for a loved one, reach out to their state’s Medicaid office for more information. Individual state offices can provide guidance on eligibility requirements and applying for coverage. You can also contact your local Area Agency on Aging, which can direct you to resources that help seniors remain in their homes.

“I advise families to get to know the people who are resources in their local communities. Elder law attorneys and geriatric care managers have a wealth of knowledge on the topics of Medicaid policies in each state and can help you sort out whether Medicaid is an option for your loved one,” says Demirozu.

For seniors who don’t qualify for Medicaid but are still interested in learning more about the benefits of home care, A Place for Mom can help. Our Senior Living Advisors can help your family explore home care options in your area that fit your budget — all at no cost to you. Please note that A Place for Mom cannot refer to Medicaid-only facilities or home care agencies.