Does Medicaid Pay for In-Home Care?

Yes, Medicaid pays for in-home care, and it's the main payer for help with bathing, dressing, meals and housework. Each state names and runs its own program. Medicare does not pay for that daily help on its own. It pays for part-time skilled care, like a nurse or therapist. Often the first sign is small: the laundry piles up, or a shower feels too risky to take alone.

You may qualify if

• You have Medicaid, or can get it. In 2026, most states allow up to $2,982 a month in income for home care, Medicaid.gov says. Savings are usually capped at $2,000, KFF says. California and New York allow more savings.
• You need hands-on help with daily tasks, like bathing, dressing or using the bathroom.
• You can live safely at home with that help.

Not sure you qualify? Apply anyway, because the state decides after someone checks what help you need. A Pair Team advocate can check with you in one call.

Who pays for in-home care?

At $35 an hour, 44 hours of help a week costs about $80,080 a year, CareScout found in 2025.

How does Medicaid in-home care work?

Medicaid in-home care starts with an assessment. A nurse or social worker checks what you can do safely, and that decides your hours. Medicaid calls ongoing help with daily life "long-term services and supports" (LTSS). Help you get at home or in your community, instead of a nursing home, is called "home and community-based services" (HCBS).

Why is there a waiting list for Medicaid home care?

There's a waiting list because states can cap how many people get home care through programs called waivers, Medicaid.gov says. In 2026, almost 650,000 people were on waiting lists in 40 states, KFF found. About a quarter were older adults or people with physical disabilities.

States can't put regular Medicaid personal care behind a waiting list, and over 80% of people waiting can get it, KFF says. So get on the list, and ask for personal care while you wait.

What if my hours aren't enough, or I'm on a waiting list?

If your hours fall short, ask for a new assessment, and look at these:

• Adult day care: care and meals at a center by day, often paid by Medicaid. See adult day care.
• PACE: the Program of All-Inclusive Care for the Elderly (PACE) is for people 55 and older who need nursing home level care. It covers home care, adult day care and medical care, with no monthly premium if you have Medicaid, Medicare.gov says.
• Respite: short breaks for a family caregiver, through your Area Agency on Aging.
• Family caregiver pay: see paying for a caregiver.
• Medicare home health: if a wound or fall brings a skilled need, see Medicare home health care.

How to get Medicaid home care

1. Apply for Medicaid at your state Medicaid office, and say you need help at home.
2. Ask for a home care assessment for regular personal care and any waiver.
3. Write down a hard day: each task you need help with, and how long it takes.
4. Have family at the visit, since they often remember what you leave out.
5. Read your notice for your hours or your place on a list, then pick your aide.

What if Medicaid denies or cuts my hours?

If Medicaid denies or cuts your hours, you can ask for a fair hearing. Medicaid must send a notice at least 10 days before a cut, federal rules say. Ask for a hearing before the cut starts, and your hours usually stay the same until the decision. If you lose, the state may ask you to repay those hours. If a Medicaid plan made the call, appeal to the plan first.

What a Pair Team advocate does

Families often call us when the hours don't cover the week, or the state mentions a waiting list. This is what we do:

• Check in one call whether you can likely get Medicaid, and which programs fit.
• Help you apply and get ready for the assessment, so the assessor sees a hard day.
• Ask for personal care while you wait, and appeal if hours come back too low.
• Help with what usually comes with it: bathroom safety, a walker or hospital bed, rides and meals.

An advocate is covered by Medicare if you qualify. It takes two minutes to find out.

Check if you qualify for a Pair Team advocate

Frequently asked questions

What is the difference between home care and home health care?

The difference between home care and home health care is the kind of help. Home care is an aide helping with daily life, and home health care is skilled care from a nurse or therapist. Every state's Medicaid must cover home health, KFF says.

Does Medicaid pay for 24-hour care at home?

Medicaid pays for 24-hour care at home only in some state waivers, KFF says. Most people get set hours each week, so if you need care day and night, ask about PACE.

Can I get Medicaid home care if I have Medicare too?

Yes, you can get Medicaid home care with Medicare if you qualify for Medicaid. Over half of people using Medicaid home care have Medicare too, KFF says. See having Medicare and Medicaid together.

Will Medicaid take my house if I get home care?

Medicaid won't put a claim on your house during your life because you get home care, Medicaid.gov says. After you die, your state must try to recover what it paid after you turned 55. It must wait while your spouse, a child under 21, or a blind or disabled child is living.

How many hours of home care will Medicaid pay for?

The hours of home care Medicaid pays for depend on your assessment and your state's limits. In California, In-Home Supportive Services pays up to 283 hours a month for people who need the most help.

Find the rules for your state

• California: In-Home Supportive Services (IHSS), run by each county.
• New York: personal care and the Consumer Directed Personal Assistance Program (CDPAP).
• Nevada: Medicaid Personal Care Services can pay a helper, even your adult child, to help you bathe, dress and eat.
• Every other state: call your state Medicaid office. Or call or text the Eldercare Locator at 1-800-677-1116 to reach your Area Agency on Aging.

Sources

• Home health services, Medicare.gov
• Long-term care, Medicare.gov
• PACE, Medicare.gov
• Home and Community Based Services, Medicaid.gov
• Home and Community-Based Services 1915(c), Medicaid.gov
• Long Term Services and Supports, Medicaid.gov
• Self-Directed Services, Medicaid.gov
• Spousal Impoverishment and post-eligibility treatment of income, Medicaid.gov
• Estate Recovery, Medicaid.gov
• Where Can People Get Help With Medicaid and CHIP?, Medicaid.gov
• Updated 2026 SSI and Spousal Impoverishment Standards, CMS Informational Bulletin, April 27, 2026
• 2026 Medicare Parts A and B Premiums and Deductibles, CMS
• 42 CFR 431.211, Advance notice, eCFR
• 42 CFR 431.230, Maintaining services, eCFR
• 42 CFR 438.408, Resolution of appeals and state fair hearings, eCFR
• Eldercare Locator, Administration for Community Living
• National Family Caregiver Support Program, Administration for Community Living
• A Look at Waiting Lists for Medicaid Home- and Community-Based Services from 2016 to 2026, KFF
• Medicaid's Home Care Support for Family Caregivers in 2025, KFF
• What is Medicaid Home Care (HCBS)?, KFF
• Cost of Care Survey 2025, CareScout