Does Medicaid cover home health care?
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Yes. Home health is mandatory in every state, and longer-term personal care at home is covered in most states through waivers and state plan options. Federal rule: mandatory (home health); optional (personal care, waivers).
What federal law says
Home health services are on the mandatory list. Under 42 CFR 440.70 the state must cover part-time or intermittent nursing, a home health aide, and medical supplies, equipment and appliances suitable for use in the home; physical, occupational and speech therapy at home are optional additions. The benefit requires a physician's order and is meant for skilled, intermittent needs.
Ongoing help with bathing, dressing, meals and similar daily tasks is personal care, an optional benefit (section 1905(a)(24)) that most states offer, and the larger programs run through home and community-based services waivers under 1915(c), which 47 states and DC operate, plus the 1915(i), 1915(j) and Community First Choice (1915(k)) options. Waivers can have waiting lists; state plan options cannot.
Many states let you hire and direct your own caregiver, including a family member other than a spouse in most states, through self-directed programs.
Children under 21
EPSDT covers medically necessary home health, private duty nursing and personal care for children under 21 in every state.
What to ask your state plan
- Ask for a level-of-care assessment; it is the gate to waiver services, and the state must do it within a reasonable time.
- If a waiver has a waiting list, ask whether a 1915(i) or Community First Choice option covers the same services without one.
- Find your state's agency, program name and phone on Medicaid by state.
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Common questions
Does Medicaid cover home health care?
Yes. Home health is mandatory in every state, and longer-term personal care at home is covered in most states through waivers and state plan options.
Does Medicaid cover home health and in-home care for children?
EPSDT covers medically necessary home health, private duty nursing and personal care for children under 21 in every state.
How do I find out whether my state's Medicaid covers home health and in-home care?
Three places. Your plan's member handbook or benefit summary, which lists the covered services and limits; the state Medicaid agency's provider manual for the service, which is public and states the medical-necessity criteria; and the member services line on your card, which can run a coverage check for a specific procedure code. Our state pages list each agency's phone and portal.
Sources
- 42 CFR 440.70 (home health services, medical supplies and equipment)
- medicaid.gov: home and community-based services
- medicaid.gov: EPSDT (children under 21)
Gov-Grants.org is an independent guide, not a carrier and not a government agency. We never charge fees, and every fact above links to its source with the date we checked it. Program details change; confirm on the official site before applying.