Medicaid Guidelines for Home Care

by Ben Lamm

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Home care is one of many long-term care options. It is preferred by a large percent of seniors, since it is often more comfortable to seek care in the comfort of one's home. Indeed, according to a recent United States of Aging survey, as many as 77% of seniors indicated that they intend to live at home for the rest of their lives. This relatively new phenomenon also puts less strain on state resources, so most states have instituted some form of home care coverage for those in need. These services are typically paid for via Medicaid programs. Read on for more information on how they work.

Medicaid and Home Care

Home care programs vary by state, but there is a home-care provision in most states. These provisions cover both younger people who may need care due to injury, disease, or disorder, along with elderly people with home care needs.

The Services Available

Medicaid home care services are generally provided through the Medicaid waiver programs. The most common program for home care is the Home and Community Based Services (HCBS) program.

Home and Community-Based Services programs

The type of HCBS program available in your area depends on local resources and state Medicaid rules. Generally, HCBS programs can provide:

  • Many forms of home care, including both nursing care and visiting therapists.
  • Daily living assistance.
  • Transportation assistance or errand assistance.
  • Meal services, prepared either in the home or via delivery.
  • Companionship or day services.
  • Some durable medical equipment
  • Home modifications for making the home accessible.

Eligibility Requirements

In all states, eligibility primarily hinges on two factors: the need for care and financial need. The need must be high enough that the only alternative to home care services is a skilled nursing facility. Financial need depends on the state, so it can vary greatly.

A Note on Family Caregivers

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Many states recognize the role that family caregivers play in the long-term care puzzle. In these locations, programs are available that will pay a family caregiver for their services. This can solve many problems when a family member must give up paid employment to care for a loved one.

Veterans Assistance

There are also programs available just for veterans. These Medicaid-funded HCBS VA services allow veterans to receive nursing home level care in their own home. The recipient, their doctors, and their caregiver must develop a care plan and submit it for approval through the program. The veteran can usually use the services of a family caregiver for a portion of the paid-for care through the program.

Reviewed June 2017

Ben Lamm writes for Senior Planning Services, a company specializing in helping seniors achieve Medicaid-sponsored senior living and community based services for the elderly.

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