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Does Medicaid Cover Long-Term In-Home Care?

4 answers | Last updated: Jul 27, 2014
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Caring.com User - Joseph L.  Matthews
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Joseph L. Matthews is a Caring.com Expert, an attorney, and the author of Long-Term Care: How to Plan & Pay for It and...
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All states provide some kind of long-term care for certain people, including the elderly, who live at home and who would require nursing home care if they didn't receive these See also:
Medicare Home Care

See all 378 questions about Paying for Care
services. These programs aren't technically part of Medicaid but are funded by Medicaid through waivers of normal Medicaid rules, which is how they get their designation as Home and Community-Based Services (HCBS) "waiver" programs.

Unlike Medicare coverage of home care or regular Medicaid home care coverage, these programs aren't limited to medical care and their coverage doesn't run out when a person's medical condition stabilizes. (The purpose of these waiver programs is to keep people out of nursing homes for as long as possible.)

Home and Community-Based Services programs can provide:

  • In-home healthcare, including nursing care and physical therapy.

  • Personal care services to help with the normal activities of daily living (ADLs), such as eating, bathing, and dressing.

  • Homemaker services, such as simple cooking, cleaning, and laundry.

  • Meal delivery.

  • Adult day services participation (care, companionship, and activities at an adult day services center).

  • Transportation assistance to and from medical care or other services.

  • Assistive devices, medical equipment, and supplies.

  • Minor home modifications (such as widening a doorway to accommodate a wheelchair, or installing a safety railing in a bathtub).

Eligibility for an HCBS waiver program has two parts. The first involves the need for care. The program must evaluate the applicant's need for medical care and/or assistance with activities of daily living. Usually, the applicant's need for care must be extensive enough that without in-home services, he or she would have to move into a nursing home.

The second part of eligibility is financial. An applicant must have low income and few assets, but these asset and income eligibility levels are usually significantly higher than for regular Medicaid coverage. In most states, an individual can have countable income (for a discussion of countable income, see How Medicaid Works) two or three times higher than for regular Medicaid eligibility. Similarly, an individual usually can have considerably more in assets -- the value of the person's home doesn't count at all -- than for regular Medicaid coverage. Also, in some states, income and assets resting solely in a spouse's name aren't counted.

The exact income and assets eligibility rules and amounts vary from state to state.

If someone qualifies for HCBS coverage of in-home care, in some states there are also programs that can pay a family member to provide some of this home care.

To find out exactly what Home and Community-Based Services are available in your state, and what the eligibility rules are, contact a local office of your state's Medicaid program. To find a local Medicaid office, go to the federal government's Benefits.gov website and choose your state. This takes you to a page with contact information for your state's Medicaid program and information about local offices.

 

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SandyKaye answered...

My dad is in a wheelchair, because of a series of strokes, living in CA. His care is so expensive my sister is talking about liquidating his assets to pay his bills so that he may remain at home. She has said that she can cash his small CD, Reverse his mortgage or sell his land in another State. Although he wont get much for the land because of the recession. What do we do when the money runs out? Are there any alternatives if he wants to stay at home? He has Medicare, but am unsure if he also has Medical.

 

hleeantiques answered...

good article on Medicaid, if it hadn't been for medicaid my step-father couldn't have afforded his nursing home. He had no assets so the first thing you need to do is transfer or sell assets. Then apply for help. I had no alternative but to put my father in a nursing home because I am on a walker, but there are alternatives out there for each specific family or caregivers and patients.

 

DrJanet answered...

I have been paying for home care services for my mom using my own credit card then having her reimburse me from her financial resources. Will these reimbursements be considered gifts to me, should she have to qualify for Medicaid in the future? Of course I would keep all relevant documentation showing where the money went.

 

 
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