Traditionally- Medicaid has paid for long-term care in a nursing home- but because most individuals would rather be cared for at home and home care is cheaper- all 50 states now have Medicaid programs that offer at least some home care. In some states- including Virginia- even family members can get paid for providing care at home.
Medicaid is a joint federal-state program that provides health insurance coverage to low-income children- seniors- and people with disabilities. In addition- it covers care in a nursing home for those who qualify. Medicaid home care services are typically provided through home- and community-based services “waiver” programs to individuals who need a high level of care- but who would like to remain at home.
Medicaid’s home care programs are state-run- and each state has different rules about how to qualify. Because Medicaid is available only to low-income individuals- each state sets its own asset and income limits. For example- in 2019- in New York an applicant must have income that is lower than $845 a month and fewer than $15-150 in assets to qualify. But Minnesota’s income limit is $2-250 and its asset limit is $3-000- while Connecticut’s income limit is also $2-250 but its asset limit is just $1-600. In Virginia- the income limit varies depending on which covered group the individual falls into- but the asset limit is $2-000.
States also vary widely in what services they provide. Some services that Medicaid may pay for include the following:
- In-home health care
- Personal care services- such as help bathing- eating- and moving
- Home care services- including help with household chores like shopping or laundry
- Caregiver support
- Minor modifications to the home to make it accessible
- Medical equipment
In most states it is possible for family members to get paid for providing care to a Medicaid recipient. The Medicaid applicant must apply for Medicaid and select a program that allows the recipient to choose his or her own caregiver- often called “consumer directed care.” Most states that allow paid family caregivers do not allow legal guardians and spouses to be paid by Medicaid- but a few states do. Some states will pay caregivers only if they do not live in the same house as the Medicaid recipient.
To find out your Medicaid home care options- you should check with your elder law attorney.