Medicaid and in-Home Care: Eligibility, Benefits & State Rules

Traditionally, Medicaid has, and still continues to, pay for nursing home care for persons who demonstrate a functional and financial need. However, in-home care provides an alternative for seniors who require assistance to remain living at home, but prefer not to relocate to nursing home residences. In-home care via Medicaid not only helps elderly persons to maintain their independence and age at home, but is also a more cost-efficient option for the state than is paying for institutionalization.

To be eligible for Medicaid, and hence, in-home care, specific eligibility criteria must be met. In addition to being a resident in the state in which one applies, there is also financial and functional requirements.

In-home care services may be available via one’s regular state Medicaid plan, but may also be offered through Home and Community Based Services (HCBS) Medicaid waivers or Section 1115 demonstration waivers.