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Medicaid and Home Health Care: Your Questions, Answered

7 minute readLast updated March 28, 2024
fact checkedon March 28, 2024
Written by Kevin Ryan, senior living writer
Reviewed by Letha McDowell, CELA, CAPCertified Elder Law Attorney Letha Sgritta McDowell is a past president of the National Academy of Elder Law Attorneys.
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For many seniors, living independently in their home becomes increasingly challenging — but moving to a nursing home isn’t always the preferred solution. Medicaid covers home health care, making these services more affordable for those who want to age in place. Medicaid is subject to federal standards, but each state independently administers its own Medicaid programs. As a result, Medicaid coverage and eligibility requirements for in-home care are different in every state. Many states offer coverage for both medically necessary home health care and nonmedical home care services. This includes payment through state plans or waiver programs, which expand coverage to individuals who may not typically qualify.

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Key Takeaways

  1. Home health care is in-home medical care provided by licensed medical professionals. It’s usually prescribed by a doctor.
  2. Medicaid can help seniors pay for home health care. Though eligibility requirements and services vary, each state may provide financial assistance with home health care.
  3. The services are often provided through home and community based Medicaid waivers. Waivers are a way states provide services not normally covered by Medicaid.
  4. Medicaid may pay for 24-hour home health care. However, each state has different rules, and some don’t offer this benefit.

Does Medicaid cover home health care costs?

Yes. Medicaid covers the costs of the following home health care services for seniors who qualify:[01]

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

The above services are provided in a patient’s residence by licensed health care professionals, such as a registered nurse, licensed vocation nurse, or an occupational, physical, or speech therapist.

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 often 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 2024, an individual qualifies for Social Security Income (SSI) if their monthly income is less than $1,971.[02]

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, like 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.[01]

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

Will Medicaid pay for home health care by a family member?

No, unlicensed family caregivers won’t be paid for home health care services. A home health care provider must meet a number of federal and state licensing requirements to be covered by Medicaid.

Medicaid-covered home health care agencies are supervised by a doctor or registered nurse and primarily offer skilled nursing and therapy services designed to meet your loved one’s medical needs.[03] The agency could be publicly operated, a nonprofit organization, or a private company. Medicaid pays those providers directly to provide care.

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Let our free assessment guide you to the best senior living options, tailored to your budget.

Does Medicaid cover in-home care?

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

Although they may seem similar, home care and home health care provide different services to seniors.

Medicaid typically pays an approved home care agency directly for all services necessary to keep a senior living in their own home. In-home care services covered by Medicaid vary, but often include help with activities of daily living and other tasks like the following:

  • Bathing
  • Dressing
  • Continence care
  • Mobility
  • Cooking
  • Cleaning
  • Transportation
  • Household chores

Medicaid eligibility requirements for in-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. In-home care is typically covered under home and community based services (HCBS) which, unlike home health care, is not an entitlement program. This means that enrollment in HCBS programs is not guaranteed and participants may be placed on a waitlist.

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

Will Medicaid pay for in-home care by a family member?

Yes. In some states, Medicaid pays family members for the home care services they provide. For a family member, getting paid to provide care services can make the duty of caregiving more feasible.

Medicaid can also provide in-home care assistance for seniors who want to take direct responsibility for their care, which is referred to as self-directed care.[04]

What are home and community based services?

Home and community based services (HCBS) are designed to help Medicaid recipients continue to live in their own homes or communities instead of an institutional setting like a nursing home.[05] Generally, these services are intended for seniors, people with physical disabilities, mental illness, and intellectual or developmental disabilities.

HCBS are commonly provided through Medicaid waivers, which are a way for states to offer programs not traditionally covered by Medicaid, like nonmedical home care, adult day care, and assisted living. Nearly every state offers an HCBS waiver, however, it’s important to note that unlike state Medicaid plans which are entitlement programs, participation in waivers is usually capped. This means that many waiver programs have 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 waivers in your state.

Expert advice for affordable home care

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How do you find home care?

If you’re looking for home care or home health care for an elderly 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.

For seniors who do not qualify for Medicaid but are still interested in learning more about the benefits of in-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.


  1. Congressional Research Office. (2022, September 15). Medicaid coverage of long-term services and supports.

  2. Social Security Administration. (2024). Who can get SSI?

  3. Centers for Medicare and Medicaid Services. (2022, September 6). Home health providersCMS.gov.

  4. Centers for Medicare & Medicaid Services. Self-directed services. Medicaid.gov.

  5. Centers for Medicare & Medicaid Services. Home & community based services. Medicaid.gov.

Meet the Author
Kevin Ryan, senior living writer

Kevin Ryan is a content specialist at A Place for Mom, focused on home care topics that include defining the differences between home care and other senior care types, home care costs, and how to pay. Kevin’s desire to support seniors and their families stems from his previous career as a teacher, plus his experience as a writer and community journalist.

Edited by

Danny Szlauderbach

Reviewed by

Letha McDowell, CELA, CAP

The information contained on this page is for informational purposes only and is not intended to constitute medical, legal or financial advice or create a professional relationship between A Place for Mom and the reader. Always seek the advice of your health care provider, attorney or financial advisor with respect to any particular matter, and do not act or refrain from acting on the basis of anything you have read on this site. Links to third-party websites are only for the convenience of the reader; A Place for Mom does not endorse the contents of the third-party sites.

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