Is Medicaid Home Health Care Available in My State?

In this article...
  • Medicaid beneficiaries can get home health care services if they are ill, injured, disabled or meet other qualifications. Learn about your state's rules.
Woman uses blood pressure machine at home

Medicaid is a U.S. government program that provides healthcare coverage to children and adults who meet eligibility requirements. Both the federal government and individual states fund the program together. The federal government requires that states offer Medicaid coverage to certain mandatory groups:

  • Low-income families
  • Eligible pregnant females
  • Qualified newborn babies
  • Supplemental Security Income (SSI) beneficiaries
  • Certain individuals with disabilities
  • Qualified Medicare beneficiaries
  • Other groups

States may add beneficiary classes to these eligible groups. Individual states also determine which services are covered and how beneficiaries can access healthcare services. Because of this setup, medical programs vary significantly from one state to another. That includes coverage for Medicaid home health care services. 

Does Medicaid Pay for Home Health Care?

Medicaid pays for certain types of home health care in specific situations, typically under home and community-based service (HCBS) programs and long-term services and supports (LTSS). You must meet eligibility requirements set by your state’s Medicaid programs to qualify.

Unfortunately, there are no uniform standardized rules, laws and guidelines for home health care services under Medicaid across the United States. Cases are handled on a state-by-state basis. 

The following chart provides a short overview on Medicaid home health care services by state and Washington D.C., with links to the applicable program information to help you find answers to your Medicaid home health care questions.

State

Medicaid Home Health Care Policy

State

Medicaid Home Health Care Policy

State

Medicaid Home Health Care Policy

Alabama

All ages who meet eligibility requirements can get HHC.

Louisiana

HHC services are available under the state Medicaid program.

Ohio

Medicaid beneficiaries of any age may be eligible for HHC services with doctor certification. Hourly limits apply.

Alaska

Three HCBS programs offer HHC to children and adults.

Maine

MaineCare pays for HHC. Assessments are required to qualify.

Oklahoma

SoonerCare offers HHC services under its HCBS program, ADvantage.

Arizona

ALTCS covers HHC for older adults, and disabled persons.

Maryland

There are several options for HHC under the MD HCBS programs and LTSS.

Oregon

The Oregon Health Plan (OHP) covers HHC for eligible conditions.  

Arkansas

Medicaid Personal Care Benefit (p..47) - Physician-ordered HHC services may be provided. Limitations apply.

Massachusetts

MassHealth covers medically necessary HHC on a PT or intermittent basis when certain conditions are met.

Pennsylvania

PA has several HCBS programs for HHC services.

California

Various HCBS programs support HHC services under Medi-Cal for older adults, disabled persons, beneficiaries with mid- to late-stage AIDS, and for some mental health diagnosis

Michigan

There are a variety of programs in MI for HHC services.

Rhode Island

RI’s Medicaid LTSS programs provide HHC services.

Colorado

Eligible beneficiaries may receive acute or long-term home health services from licensed and certified Home Health Agencies.

Minnesota

There are several MinnesotaCare programs that offer HHC services.

South Carolina

Healthy Connections provides HHC services for renewable 60-day periods.

Connecticut

HUSKY includes HHC among its basic benefits. The state also has many home care support services for children with  autism, older adults, and others.

Mississippi

Five Medicaid HCBS programs cover HHC.  

South Dakota

Three HCBS programs provide HHC services – ADLS, CHOICES, and the transitioning HOPE waiver. A Long-Term Care Partnership program may use Medicaid eligibility for some HHC services.

Delaware

Diamond State Health Plan – Plus includes a Long Term Care Community Services program that pays for HHC.

Missouri

HHC services are available under the state Medicaid plan MO HealthNet, as well as HCBS programs.

Tennessee

CHOICES under TennCare provides a broad range of HHC and other in-home services.

Florida

Eligible Medicaid beneficiaries who have a physician’s order for HHC, a disabling medical condition, and require services that can be safely provided at home can get HHC.

Montana

The Big Sky HCBS program  allows up to 180 annual HHC visits for eligible beneficiaries of all ages. Additional services may be approved.  

Texas

Doctor-prescribed HHC services are covered by the state Medicaid program.

Georgia

Two HCBS programs pay for some or all the costs for HHC services. One applies only to people who receive both SSI and Medicaid benefits.

Nebraska

The state Medicaid program provides necessary HHC services prescribed by a physician, with limitations.

Utah

There are several HCBS programs allowing HHC for different groups.

Hawaii

Med-QUEST pays for HHC.  Medicaid recipients must have a doctor evaluation and apply for the home care.  

Nevada

The state plan covers HHC and provides HCBS for persons with mental health illnesses that need HHC.

Vermont

HHC and long-term in-home care services are among those provided by Green Mountain Care.

Idaho

Older adults and disabled persons can qualify for adult day health services, care from a home health aide, and respite care under the state’s Medicaid program..

New Hampshire

HHC is a covered Medicaid service for all ages.

Virginia

The Commonwealth Coordinated Care Plus (CCC Plus) program provides LTSS like HHC to eligible Medicaid beneficiaries.

Illinois

A Medicaid HCBS program allows disabled persons and older adults to receive limited HHC under the In-Home Care Program. The services are fairly limited.  

New Jersey

The Medicaid Managed LTSS program offers HHC services through MCOs.

Washington

Apple Health HCBS programs provide coverage for HHC services.

Indiana

Medicaid HCBS programs are administered through multiple divisions – Aging, Disability and Rehabilitative Services, and Mental Health and Addiction.

New Mexico

Centennial Care Community Benefit is an MCO providing HHC services.

Washington D.C.

DC Medicaid pays for some HHC services through the Elderly and Persons with Physical Disabilities (EPD) program.

Iowa

Several HHC services with limits are available under the state Medicaid program.

New York

Medicaid beneficiaries can get HHC through the Managed Long Term Care (MLTC) Plan, a

Consumer Directed Personal Assistance Program CDPAP),

Community First Choice Option (CFCO), or

Certified Home Health Agencies (CHHAs)

West Virginia

Several HCBS programs help Medicaid recipients get HHC services.

Kansas

KanCare offers home health services through KDADS (KS Dept for Aging and Disability Services). There are 7 HCBS programs.

North Carolina

Community Alternatives Programs (CAP), Money Follows the Person, and PACE are NC Medicaid options for HHC.

Wisconsin

IRIS and the Family Care Partnership program provide HHC services to WI Medicaid beneficiaries.

 

Kentucky

Short-term, medically necessary HHC services are available with annual limits under a Medicaid HCBS program for adults over 65 and persons with disabilities.

North Dakota

Recipients can get HHC services through various HCBS programs for long term care.

Wyoming

The state Medicaid program uses several different HCBS programs to deliver HHC service to recipients.