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How Many Hours Will Medicaid Pay for Home Care?
Date Updated: January 10, 2025
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Sarah has produced thousands of articles in diverse niches over her decade-long career as a full-time freelance writer. This includes substantial content in the fields of senior care and health care. She has experience writing about wide-ranging topics, such as types of care, care costs, funding options, state Medicaid programs and senior resources.
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Kristi Bickmann, a licensed Long-Term Care Specialist, represents top-rated "Traditional" & "Hybrid" LTC companies. Serving associations such as the American Nurses Association, she's a licensed insurance agent in 27 states. Specializing in insurance products for seniors, Kristi helps hundreds of families every year protect assets, retirement, and loved ones. She understands aging concerns firsthand, having assisted her own parents. Kristi ensures accuracy on topics about senior long-term care and its consequences.
The hours Medicaid will pay for home care varies, depending on the location and an individual’s needs. Without national rules, each state Medicaid program sets its own guidelines regarding eligibility, maximum care hours and services. In many areas, family members can receive payment for caring for loved ones.
Outline of Home Care
Nonmedical home care agencies help people with everyday tasks, such as maintaining personal hygiene and doing domestic chores, in the comfort of their private homes. Trained aides visit people on agreed schedules to deliver set services as detailed in customized care plans. Such in-home support enables seniors to remain living at home through their retirement rather than moving into residential care settings.
Medicaid Coverage of Home Care
State rules vary for home care funding. Most cover basic home support through non-entitlement Home and Community-Based Services Waivers. Waiting lists may apply. To qualify, individuals must meet criteria related to:
- Age
- In-state residency
- Citizenship
- Financial need
- Medical need
Some states use Section 1115 Demonstrations Waivers to help older adults in need of in-home support. Additionally, a few jurisdictions include basic home care provisions in their regular state Medicaid plans. Because of significant variations nationwide, funded care hours also differ widely.
Factors Affecting the Number of Care Hours
Time-wise, seniors who need assistance with many activities of daily living, such as bathing and dressing, qualify for more hands-on support than those who need infrequent transportation and light help with housework. According to a 2019 report, people with severe care needs receive a median of 90 care hours each month, with supplemental unpaid assistance from family members.
Medicaid only pays for essential in-home support and companionship for qualifying individuals. Agencies devise personalized service plans with input from medical professionals, social workers and relatives. Those who want more face-to-face contact or additional chores must pay for extra services using other means.