Will Medicaid pay for my dad's ventilator and skilled nursing care in my home?

Bonnie, houston, tx asked...

My Dad is in a nursing home and is on a ventilator. Medicaid is paying for his nursing home care and therapy. He is, however, over 200 miles from home and family. There is no facility close to home that will take him on a ventilator. Will Medicaid pay for his ventilator and skilled nursing care in my home?

Expert Answer

The answer probably depends on how much actual skilled care he needs. Medicaid coverage varies from state to state. But in all states, the extent of home care Medicaid will cover is far less than what is provided -- and paid for by Medicaid -- in a nursing home. In general, Medicaid covers regular, but not daily, home care through a certified home care agency. This can include some nursing and therapy, but does not include open-ended, extensive skilled nursing care.

In addition to how much skilled care in general your father needs, there's also the specific question of whether Medicaid will pay for a ventilator at home, and for the nursing care required to monitor his ventilator use. Before you even get to the question of whether Medicaid will pay for it, though, you need to find out whether using the ventilator at home is medically appropriate. To answer that, you have to discuss the matter with the doctor who is caring for your father.

If it's medically appropriate to use the ventilator at home, then you can begin to find out whether Medicaid will cover it. Medicaid -- as well as Medicare Part B -- covers the use of durable medical equipment. But whether Medicaid will cover, at home, the specific ventilator your father uses depends on whether they also cover the amount of nursing care it takes to monitor that ventilator use.

There are two avenues for you to find out more about whether Medicaid coverage at home for your father is possible. One is to contact the Texas state Medicaid program through their web site , or simply by dialing 211 on the phone, which gets you to a state department of health and human services information line. Another is to contact Medicaid-certified home health care agencies near where you live. Since your father would have to receive Medicaid-covered care through one of these agencies, you can enlist their help by describing your father's medical situation and asking them to determine whether Medicaid would be likely to cover home care for him, and whether they would accept him as a patient. To find Medicaid-certified home care agencies near you, go to the Texas Medicaid program's online search service .