Does Medicaid Pay For Home Health Care?

Legal & Law May 1, 2024

does medicaid pay for home health care

Home health care is an integral component of any comprehensive homecare plan for older individuals or those with disabilities. It can help with an array of medical and non-medical tasks that enable an individual to live safely at home and reduce long-term institutional care needs. Medicaid offers several home health options for essential services; however, understanding each state’s Medicaid program requirements may be daunting and this article serves as a guide for understanding available coverage through medicaid for home health care services.

Medicaid is a joint federal and state program that provides healthcare coverage to low-income individuals. While its home care offerings may differ by state, they generally cover skilled nursing and physical therapy as medically necessary services prescribed by physicians; custodial services and meal preparation typically don’t fall within their coverage.

Medicaid home care eligibility and application procedures differ by state, but in general are relatively straightforward. Income thresholds depend on which state one resides in; calculation tools provided by Medicaid agencies allow one to calculate this figure easily. Cash, investments and vacation homes typically do not fall within its scope. Individuals seeking Medicaid should contact either their local Medicaid office or professional who specializes in the program to receive up-to-date information regarding eligibility requirements and specific rules regarding home care coverage.

Individuals seeking home health care services funded by Medicaid can find agencies accepting their funding online or seek recommendations from friends, family and health professionals for trustworthy agencies experienced with working with Medicaid patients. Preparing the home for home health care services also plays a key role, including clearing pathways leading directly to where care will be administered as well as making sure it’s easy to navigate around in.

New York and a handful of other states offer Medicaid home care recipients programs that enable them to self-direct their home attendants, known as Consumer Directed Personal Assistance Program (CDPAP). Through CDPAP waiver participants can select and compensate caregivers who could include family members.

To qualify for home health care with Medicaid, an individual must first enroll in Medicare Part B. This part of the program provides home health aide services as prescribed by their physician and requires homebound individuals (defined as being unable to leave without assistance) be homebound; number of visits per week/month varies by state; in cases when their condition improves enough that home health care no longer qualifies as medically necessary coverage will end accordingly.

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