Does Medicaid Cover Home Care Services for Seniors?

16 May 2022

Does Medicaid Cover Home Care Services for Seniors

The cost of in-home care services is affordable compared to other alternative options. And if this factor is not enough for senior care, elders and their families can also count on insurance programs like Medicaid. But does Medicaid cover home care services for seniors

The simple answer to the main question is possible, yes. But to assure it’s a big yes, let us check first what Medicaid is and its requirements to be eligible for their coverage.

Medicaid is a public insurance program intended for individuals with low-income. Compared to Medicare, Medicaid is governed by federal and state regulations. It is the reason there are different specific policies to know depending on where an applicant resides. And these particulars included who is eligible for the program based on financial and functional capacities.

For the financial factors, Medicaid checks the income and assets of an applicant. The assessment of the income limits depends on a state’s preferred basis, which is typically among 100% of Supplemental Security Income (SSI), Federal Benefit Rate, or 100% of the Federal Poverty Line (FPL). In 2022, the Department of Health and Human Services (HHS) determined $13,590 per individual for 48 states. Note that Alaska and Hawaii have different guidelines. Meanwhile, the usual limit for the asset is $2,000.

Another essential point is that seniors under the Medicare program can still be eligible for Medicaid. Moreover, applicants who wish to get Medicaid support should not hesitate to apply even if their income or asset worth goes beyond the set limitation. Feasibly, they are qualified for a particular state’s program. Some implement exemptions from the concern of income and assets. Plus, there are privileges given to applicants like seniors and people with disabilities.

If an elder meets the basic eligibility requirements for Medicaid, it most probably supports the care support. In terms of in-home care services, the functional criteria give weight to the approval.

The functional aspect of Medicaid is about the medical condition of the care recipient. Again, the exact requirements differ from state to state. Some demand that it should be strictly medical-related, while others may have more lenient policies on accepting assistance for activities of daily living (ADLs). But most states favor it if the applicant has proof that its in-home care is prescribed and allowed by a doctor. 

For seniors, primarily, the need for in-home care services is reasonable. A problem in mobility alone can hinder them from performing essential tasks for their health or overall well-being. It involves bathing, eating and meal preparation, toileting, taking medicine on time, etc. Thus, it makes sense for them to receive in-home care services, including the Assistance with Instrumental Activities of Daily Living (IADL). These involve light housekeeping, meal preparation, laundry, and others.

In-home care for seniors is also an approach to let them enjoy benefits like living with their family and staying in a place where they feel safe and comfortable.

Another point, these services are also favorable for Medicaid in terms of cost. Add that several agencies are also doable with the insurance program. It comes to the next point, choose an in-home care agency that is also into Medicaid