Medicaid home care: what it covers and how family can provide it

What is Medicaid home care?

Medicaid home care is the umbrella term for services Medicaid pays for in a person's home instead of a hospital or nursing home. It covers two broad kinds of help:

• Medicaid home health care — skilled nursing, therapy, and home health aide visits, ordered by a doctor as part of a plan of care. Federal law makes home health a mandatory Medicaid benefit, so every state covers it.
• Medicaid personal care services — hands-on help with daily activities like bathing, dressing, eating, toileting and moving around, often with meals, laundry and light housework. Personal care is an optional state plan benefit, but most states offer it through the state plan, Community First Choice or home and community-based waivers.

Together they make up Medicaid home care services. Unlike Medicare, Medicaid covers ongoing, long-term personal care — the daily help most families actually need. See does Medicare pay family caregivers for the difference.

Medicaid home care services: what's covered

Exact coverage depends on the state and program, but a Medicaid home care program commonly includes:

Waivers can add more, like home-delivered meals, emergency response systems and case management. For definitions of each, read what in-home care is and home health vs. home care.

Medicaid home health and the Medicaid home health aide

Medicaid home health works a lot like Medicare's: a doctor orders it, a licensed agency provides it, and the plan of care is reviewed regularly. The difference is that Medicaid doesn't require the person to be homebound, and it can continue as long as the need does.

A Medicaid home health aide is a certified aide employed by a licensed agency who helps with personal care and simple health tasks under a nurse's supervision. Home health aide services for Medicaid patients are often combined with personal care hours. If you're interested in becoming one, see home health aide and caregiver jobs. For skilled needs, see in-home nursing care.

Who qualifies for Medicaid home care

Two tests apply everywhere:

1. Financial eligibility. Income and assets under the state's Medicaid limits. For long-term care, many states use higher income limits than regular Medicaid, and some allow spending down or special trusts.
2. Functional need. An assessment showing the person needs help with daily activities. Waiver programs usually require a nursing-home level of care.

Some programs are entitlements — anyone who qualifies gets services — while many waivers have limited slots and waitlists. Your state page shows which is which; for example California (no waitlist), Florida (priority-ranked waitlist) or Texas (long interest lists).

New York Medicaid home care eligibility

New York has one of the largest Medicaid home care programs, and its rules changed in 2025. People applying for personal care or CDPAP for the first time on or after September 1, 2025 generally must:

• Qualify for New York Medicaid that covers community-based long-term care.
• Meet the "minimum needs" requirement: needing at least limited hands-on help with more than two activities of daily living — or, with a dementia or Alzheimer's diagnosis, supervision with more than one.
• Need community-based long-term services for more than 120 days to enroll in a managed long-term care (MLTC) plan.

People already receiving personal care or CDPAP, or continuously enrolled in an MLTC plan, as of September 1, 2025 keep their eligibility under the old rules. In New York City, Medicaid applications go through HRA; elsewhere, through the county Department of Social Services. See home care in New York, the New York caregiver program, and county pages like Brooklyn, Queens and Erie County.

Michigan Medicaid Home Help program

Michigan's Medicaid Home Help program is a good example of a state plan personal care program built around individual caregivers. MDHHS pays for hands-on help with activities of daily living and some instrumental activities like housework and meal preparation, after an adult services worker assesses the need.

The client chooses their own caregiver and is the employer. An individual caregiver — who can be an adult child or another relative, though not a spouse — enrolls in the state's CHAMPS system, passes a background check, and is paid directly by MDHHS. The rate is $17.13 an hour as of January 2026. Home Help is an entitlement with no waitlist.

To apply for the Michigan Medicaid Home Help program, contact your county MDHHS office. See the Michigan caregiver program and Oakland County.

Finding home care agencies that accept Medicaid

If your family wants an agency to provide the care, you'll need home care agencies that accept Medicaid — or, for skilled care, home health agencies that accept Medicaid. Not every agency does, and the ones that do often have to be in your relative's managed-care plan network.

1. Start with the Medicaid plan or case manager. They have the list of contracted Medicaid home care agencies.
2. Ask the agency whether it's enrolled with Medicaid, in your relative's plan, and accepting new clients.
3. Check licensing and quality — see how to choose a home care agency.

A home care that accepts Medicaid listing online isn't always current, so confirm by phone. The same goes for home health care that accepts Medicaid: it's a network question, not just a yes-or-no. When you ask whether an agency is home health that accepts Medicaid, also ask about its waitlist for aides. Some agencies call themselves home health care that takes Medicaid or home health that takes Medicaid but only accept certain plans. Our guides to home care near me and local home care agencies can help.

Medicaid home health care: a family member as the provider

This is the part many families miss: Medicaid home care doesn't have to come from a stranger. In all 50 states and DC, at least one program lets the person receiving care choose a relative. There are three ways to become a paid caregiver through Medicaid:

So Medicaid home health care by a family member is usually personal care through self-direction rather than skilled nursing. A relative can become a home health aide through Medicaid by getting certified and working for an agency, but that's the less common route. Being a caregiver through Medicaid via self-direction usually needs no certification. Read consumer-directed care and how to become a paid caregiver for a family member.

Which relatives can be paid

Adult children, grandchildren, siblings and most other relatives can be paid almost everywhere. Two relationships have extra rules:

• Spouses can be paid in 16 states, in some programs in 20 more, and not at all in 15 — see the spouse table in Medicaid family caregiver programs.
• Parents of minor children can be paid broadly in 13 states and in some programs in 18 more — see paid parent caregivers.

How to get home care through Medicaid

Getting home care through Medicaid — or home health care through Medicaid — follows the same order in most states:

1. Apply for Medicaid, marking that you need long-term care, if your relative isn't enrolled.
2. Request a home care assessment from the state, county, Area Agency on Aging or managed-care plan.
3. Choose how care is delivered — an agency, self-direction or a live-in program.
4. If family will provide care, enroll the caregiver with the payroll agency.
5. Reassess when needs change. Hours can go up after a decline.

Sunroom Care helps families through these steps at no cost — we're paid by the program, not by you, and we're not a state agency. Check eligibility in two minutes.

Where to go next