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Paying for Care

Does Medicaid Cover In-Home Care? Understanding HCBS Waivers

Does Medicaid cover in-home care? Learn how Medicaid HCBS waivers work, who qualifies, what services are included, and how to apply in your state.

For many families, Medicaid is one of the most important ways to pay for long-term care, yet it’s also one of the most confusing. So, does Medicaid cover in-home care? Often, yes, through programs designed to help people stay home instead of moving to a nursing home. Here’s how it works.

Quick answer: Yes, Medicaid can cover in-home care for people who meet their state’s financial and functional eligibility rules. Most in-home personal care is provided through Home and Community-Based Services (HCBS), often under waiver programs. Covered services, eligibility rules, and waiting lists vary by state.

Medicaid vs. Medicare

These two programs are often confused:

  • Medicare is federal health insurance, mainly for people 65 and older. It generally doesn’t cover ongoing non-medical home care.
  • Medicaid is a joint federal and state program for people with limited income and assets. It’s the largest public payer of long-term care, including care at home.

Some people qualify for both. For a broader look, see our guide on how to pay for home care.

Comparison of Medicare and Medicaid. Medicare is federal health insurance mainly for people 65 and older and generally does not cover ongoing non-medical home care. Medicaid is a joint federal and state program for people with limited income and assets and is the largest public payer of long-term care, including care at home.

Does Medicaid Cover In-Home Care? How It Works

Home and Community-Based Services (HCBS)

HCBS programs help people who need nursing-home-level care receive support at home or in the community instead. Many states offer these through waivers, which let states provide services beyond traditional Medicaid.

State Plan Personal Care Services

Some states include personal care services as part of their regular Medicaid plan, without requiring a waiver.

Managed Long-Term Services and Supports

In many states, long-term care is delivered through Medicaid managed care plans, which coordinate in-home services.

What Services May Be Covered

Depending on the state and program, services can include:

  • Personal care, like bathing, dressing, and toileting
  • Homemaker services, like light housekeeping and meal preparation
  • Respite care for family caregivers
  • Adult day services
  • Home modifications and medical equipment
  • Case management
  • Consumer-directed care, where the participant hires their own caregiver, sometimes a family member. See Can Family Members Get Paid to Be Caregivers?

Who Qualifies?

Eligibility usually involves two parts:

  1. Financial eligibility: income and asset limits set by the state. Your home and certain other assets may be exempt, and some states have special rules for married couples to protect the spouse who lives at home.
  2. Functional eligibility: typically, the person must need a level of care similar to what a nursing home provides, determined through a state assessment.

Medicaid also has a look-back period for asset transfers. Giving away assets before applying can delay eligibility, so get advice before making financial moves.

Waiting Lists

Many HCBS waivers have limited slots, so there may be a waiting list. That’s one reason to apply early, even if you’re paying privately for now.

How to Apply

  1. Contact your state Medicaid agency or local Area Agency on Aging to learn about available programs.
  2. Gather documents, such as proof of income, assets, citizenship, and medical information.
  3. Complete the application and the functional assessment.
  4. Ask about waiting lists and whether interim services are available.
  5. Consider expert help. An elder law attorney or benefits counselor can help you navigate rules and avoid costly mistakes.

Choosing a Provider

Not every home care agency participates in every Medicaid program. Ask providers directly whether they accept your state’s program. Our list of questions to ask a home care agency includes payment questions to cover.

Frequently Asked Questions

Does Medicaid pay for 24-hour home care?

Some programs can cover significant hours, but around-the-clock care is less common and depends on state rules and assessed needs.

Can I keep my home and qualify for Medicaid?

In many cases, a primary residence is exempt, within limits. Rules vary, and estate recovery may apply later. Talk with an elder law attorney.

How long does Medicaid approval take?

It varies by state and program. Applications can take weeks to months, and waivers may have waiting lists.

How Briggs Home Care Can Help

Payment options vary by location. Your local Briggs Home Care team can explain which programs they work with and help you plan care that fits your situation. Explore our services, find a location near you, or call 1-833-960-CARE (2273).

This article is general information, not legal or financial advice. Medicaid rules vary by state and change over time.

Related Reading

Trusted outside resource: Medicaid.gov

Related Resources