All 50 states have at least one Medicaid/Medicare program that provides financial support to individuals living outside of nursing homes. Further, one must meet a very specific criteria before qualifying for a state sponsored home care program. One of the qualifications is the level of care that is needed for the patient, for example, homebound patients typically require skilled care at home, and if they are incapable of covering the associated costs with hiring a private duty nurse, then they will most likely qualify for a home health care waiver program by their state. Fortunately, even if one does not qualify for a Medicare home health care program, they may still be eligible for a Medicaid HCBS waiver program (Home and Community Based Service)

How to Qualify in Florida

To qualify, one must meet the following criteria:

• If you are under the care of an attending physician and have a physician’s order for home health services
• If a medical condition or disability that substantially limits your ability to perform everyday living activities
• Require services that can be safely, effectively, and efficiently provided in the home or other authorized setting
• If you are certified homebound by your doctor/nurse

Types of Programs Covered by Medicaid

As of October 2021, the services that are covered by Medicaid/Medicare for individuals living at home or in a facility extends beyond simple home health care services like companionship or light house-keeping. Medicare/Medicaid covers a variety of services, and the services offered are personalized for the patient and are delivered on an as-needed basis – the list of services is long & updates frequently, make sure to stay on top of it by checking out Medicare’s official home health services page here.

Home health care

The simplest and most common form of home care that Medicaid covers for eligible individuals. Simply put, home health care is a non-medical services provided by trained caregivers, though sometimes other health-providers with medical training may be involved, such as nurses and doctors.

Personal care

Personal care is also one of the most common forms of care that Medicaid covers. Personal care is offered to individuals who are incapable of handling their day-to-day living activities and/or require support with their daily living activities – activities include personal hygiene, dressing, eating, transferring/assistance with mobility, and maintaining continence. Most states cover personal care via Medicaid.

Homemaker services

Homemaker services include assistance with everyday household chores such as light house-keeping, cooking, cleaning, furniture relocating, groceries, and meal prep. Homemaker services may overlap with services from other types of care, for example, it is very common to see overlap in services between homemaker & home health care programs. As a matter of fact, certain states use these two terms synonymously; and some states consolidate both programs into one.

Family and caregiver assistance

Recently recognized as one of the most important care programs for maintaining stability in a home living environment. This program includes respite care, short term relief for primary caregivers. Qualifying for this program shouldn’t be a problem as it is included in almost every Medicaid sponsored relief program, in almost all states.

Accessibility in home & environment

This program is for those who need special accessibility modifications such as installing car ramps, or grab bars at home. This program is typically partially funded by Medicaid, though eligibility & coverage varies.

Medical equipment & supplies

This program is for individuals who require specific medical supplies to ensure independence & health. This program is partially funded by Medicaid.

Hospice care

This program is reserved for terminally-ill individuals who are expected to live no more than 6 months. Eligibility varies, though in most cases individuals can qualify if they can substantiate that staying at home will provide more benefits than staying at a hospital or in an assisted living facility.

Home health care services covered by Medicaid

Part-Time skilled nursing care
Physical therapy
Occupational therapy
Speech-language pathology services
Medical social services
Part-time or intermittent home health aide services
Injectable osteoporosis drugs for women

Services that AREN’T covered by Medicaid

Around the clock care at home
Ready-meals delivered to your home
Homemaker services IF it is the only care that you need
Personal care IF it is the only care that you need