Does Medicaid Cover In-Home Care?
Yes. Medicaid covers some types of in-home care, including medical home health services and certain long-term support services. What is covered depends on the kind of help you need, your medical or daily living needs, your state’s rules, and the Medicaid program you qualify for.
What Types of In-Home Care Does Medicaid Cover?
Medicaid may cover medical care in the home as well as help with everyday activities. These are different types of services with different eligibility rules.
Medical Home Health Care
Medical home health services are provided by trained healthcare workers. Depending on the person’s needs and state coverage, services may include:
Skilled nursing care
Home health aide services
Medical supplies or equipment
Physical therapy
Occupational therapy
Speech therapy
Personal and Long-Term Care
Some people need help with daily activities, such as:
Bathing
Getting dressed
Eating
Using the bathroom
Moving safely around the home
Preparing meals or completing household tasks
States may provide this help through Home and Community-Based Services, often called HCBS. These programs help eligible people receive long-term support at home or in the community instead of in a nursing facility.
In Arizona, some long-term services are offered through the Arizona Long Term Care System, or ALTCS. In Louisiana, programs include Long Term–Personal Care Services and several waiver programs, such as the Community Choices Waiver.
Who Qualifies for Medicaid In-Home Care?
You must meet the rules for both Medicaid coverage and the specific in-home service you need. Having Medicaid does not mean that every type of in-home care is automatically covered.
Eligibility may depend on:
Your household income and other Medicaid requirements
A medical condition, disability, or functional need
An assessment of how much help you need at home
A healthcare provider’s order or care plan
Whether you meet the required level of care for a long-term support program
Whether the program has available space or uses a priority list
For example, Arizona’s ALTCS program is for people who meet financial and medical requirements and need a nursing-facility level of care. A person who qualifies may still receive services in their own home rather than moving into a nursing home.
Louisiana has several programs for different groups, including older adults, people with adult-onset disabilities, and people with intellectual or developmental disabilities. Each program has its own rules.
Call your state Medicaid office or your Medicaid health plan to ask for an assessment and learn which programs may fit your needs.
Can Nest Health Come to My Home Through Medicaid?
Yes. Nest Health provides clinical healthcare in the home for eligible Medicaid families covered by participating health plans. This is different from a home aide who helps with bathing, dressing, cooking, or other daily activities.
A Nest care team can provide many of the services you would normally receive at a doctor’s office, including:
Checkups and preventive care
Sick visits
Care for asthma, diabetes, high blood pressure, and other ongoing conditions
Medication support
Mental and behavioral health screenings
Care for parents, babies, children, and teens
Help coordinating specialists and other services
Nest can often care for more than one family member during the same visit. Virtual visits and 24/7 clinical support are also available when appropriate.
Learn more about Nest Health’s whole-family medical care.
Bring the Doctor’s Office to Your Family
Nest Health provides medical, behavioral, and social care for eligible Medicaid families. Instead of traveling to different offices for every family member, your family can receive connected care from one team at home and online.
Call 866-222-NEST (6378) to find out whether Nest services are available to your family at no additional cost through your Medicaid health plan.
