Does Medicaid Pay For Home Health Care?
Does Medicaid Pay For Home Health Care?

Does Medicaid Pay For Home Health Care?

Home care services can be provided through several agencies and programs, with Medicare providing limited reimbursement of medically necessary homecare following hospital stays. Long-term care insurance can cover an array of home healthcare services on an ongoing basis while Medicaid has several homecare programs which may cover some or all costs incurred when using these services.

What is Home Health Care? Home healthcare refers to assistance that a person receives at home from qualified healthcare professionals such as nurses, home health aides and therapists. Furthermore, trained family caregivers may also offer their assistance as part of their homecare services contract.

Home healthcare services aim to assist those in daily activities of living such as bathing and eating. Home healthcare can also include therapy services like physical, occupational, speech or respiratory therapy; wheelchairs, oxygen tanks or walker canes may be provided if necessary.

Doe Medicaid Cover Home Health Care? The answer to this question depends on where one lives and the type of home healthcare services needed. Most states offer some form of home healthcare service to Medicaid beneficiaries – this can either be through regular state Medicaid (institutional or regular Medicaid), or optional Medicaid waivers known as HCBS Waivers (1915(c) Waivers or 1115 demonstration waivers).

Numerous individuals also utilize privately-paid home care services. This option can often provide more flexibility and less restriction than the options provided by traditional Medicaid home healthcare programs, allowing individuals to choose their providers more freely. It can be provided in either their own home, a friend’s or relative’s house or residential facilities such as adult foster care homes and assisted living residences.

For accessing these home care services, an individual must meet eligibility requirements under either their regular state Medicaid plan or an HCBS waiver program. Eligibility criteria vary between states but generally consist of income limits equal to 300% of SSI benefits and asset limits of $2,000. Furthermore, eligibility requires needing home healthcare services as assessed and planned by their physician, plus meeting an eligibility plan set forth by any program such as PACE or MLTC managed care plans that assess, coordinate and authorize these services before paying them as they become necessary.