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What Is Medicaid-Sponsored Home Care?
Date Updated: January 3, 2025
Written by:
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.
Reviewed by:
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.
Medicaid-sponsored home care is when the government pays for in-home care services via state Medicaid plans or waiver programs. However, exact coverage and eligibility criteria vary among jurisdictions. Services support seniors aging in place, often preventing them from needing to move to a residential care setting.
Typical Home Care Services
Home care aides assist seniors with essential household tasks, including cleaning, laundry and light maintenance. They also run errands for seniors who find it difficult to leave their homes and may provide local transportation and escort services to appointments. In-home care aides ensure seniors can maintain their personal hygiene by helping them bathe, brush their teeth and groom. Caregivers also assist older adults with other activities of daily living, such as moving throughout the home, transferring between the bed and a chair and getting dressed.
In-home services support seniors’ nutrition by preparing meals and shopping for groceries. Some care plans include companionship hours to prevent loneliness and social isolation. Senior companions facilitate diverse in-home enrichment activities, tailored to meet individuals’ preferences, such as playing cards and discussing current affairs. Unlike home health care providers, home care agencies don’t provide clinical or therapeutic services.
Medicaid Coverage of Home Care
Although rules vary from state to state, seniors must meet functional and financial criteria to qualify for public funding. Typically, they must require assistance with several activities of daily living and have limited income and assets. Applicants must also be U.S. citizens or qualifying noncitizens, and their primary home must be in the state where they apply for financial assistance.
Most states don’t pay for in-home care via regular Medicaid. Instead, many operate Home and Community-Based Services waiver programs and S.1115 Demonstration Waivers. These programs extend Medicaid coverage to individuals who wouldn’t otherwise meet strict eligibility criteria. However, funding limits apply for such programs, meaning wait-lists may apply.
Other Ways to Pay for Home Care
According to Genworth’s Cost of Care Survey, in-home care costs roughly $5,720 monthly across the United States as of 2024. However, prices vary significantly among cities and states. Keep in mind, this cost is typically for one individual, so couples requiring care may face higher expenses depending on the services needed for each person. The care services provided also impact agencies’ charges.
Older adults who don’t qualify for Medicaid must use alternative methods to pay for in-home care. These include:
- Income and savings
- Family financial assistance
- VA benefits
- Loans
- Long-term care insurance
- Reverse mortgages