Does Medicaid pay for home care?
Yes, but only through state programs with strict rules. Medicaid can pay for in-home help such as bathing, dressing, meals and housework. You need a medical need and limited income and assets. Each state sets its own program names and limits.
Most in-home Medicaid help comes in two forms:
- A waiver. A home and community-based services waiver pays for care at home instead of a nursing home. It often has limited slots.
- A state plan personal care program. It is part of regular Medicaid. It usually has no cap on slots, but you must still pass an assessment.
Medicaid does not pay for everything. It pays for the services your state approves, for the hours it approves, through providers it approves. Many families find that the approved hours are fewer than the hours they need. Care that costs more than Medicaid pays is a private cost. For scale, CareScout’s 2025 Cost of Care Survey reports a national median of $35 an hour for a non-medical caregiver. At 44 hours a week, that is $35 x 44 x 52 / 12 = about $6,673 a month. That is our estimate, not a Medicaid figure.
This guide covers the nine states where HomeCare.com serves families. A care advisor can talk through payment options that may apply to your situation. Call 800-974-3458 or use the link at the end.
Who qualifies for Medicaid home care?
You generally qualify if you need a nursing facility level of care and meet your state’s income and asset rules. A state worker assesses your needs. Your doctor’s note helps, but the state decides.
Typical steps look like this:
- Contact your state’s intake point, often an Area Agency on Aging or the Medicaid office.
- Get a level of care assessment. See our glossary entry on level of care assessment.
- Complete the Medicaid financial application.
- Get on the waiver waiting list if the program has one. See Medicaid waiver waitlist.
- Choose providers or, where allowed, hire your own worker.
Income and assets matter. In 2026, state agencies in Alabama, Arizona, Colorado, Ohio, Texas and Virginia cite the same figure for an individual: $2,982 a month in income. This is 300% of the federal SSI benefit. Alabama, Arizona, Colorado and Texas also list a $2,000 resource limit. Maryland says 300% of SSI and $2,000 or $2,500 in countable assets, depending on category. The state does not publish the dollar amount on that page, so confirm with Maryland Access Point. Michigan and North Carolina pages we reviewed do not set a dollar figure. Rules for married couples, homes and gifts are complex. An elder law attorney can explain them.
What are the main Medicaid home care programs in each state?
Here is the main program or programs in each state, who qualifies in one line, and whether a family caregiver can be paid. The state names link to our state pages.
| State | Main program(s) | Who qualifies | Family caregiver payment |
|---|---|---|---|
| Alabama | Elderly and Disabled (E&D) Waiver | Elderly or disabled people at nursing facility level of care. 2026 limits: $2,982 a month income, $2,000 resources. | Limited. Personal Choices lets waiver members self-direct. Ask whether a relative can be the worker. |
| Arizona | Arizona Long Term Care System (ALTCS) | Adults with an age-related or physical disability, or an intellectual or developmental disability, at nursing facility level of care who meet financial limits. | Yes. Policy lets family be paid caregivers. A spouse or parent of a minor must give extraordinary care. |
| Colorado | Community First Choice (CFC), CDASS, IHSS, Elderly, Blind, and Disabled (EBD) Waiver | Health First Colorado members at an institutional level of care who meet financial rules. | Yes, with some restrictions. Family and friends can be paid attendants through CDASS or IHSS. |
| Maryland | Community First Choice, Community Options Waiver, Community Personal Assistance Services | People who need an institutional level of care (CFC) or nursing facility level of care (waiver), with Medicaid rules. | Limited. Maryland’s pages do not confirm family pay. Ask Maryland Access Point. |
| Michigan | MI Choice Waiver, Home Help Program | Adults at nursing facility level of care (MI Choice). Medicaid fee-for-service members who need hands-on help (Home Help). | Yes, in Home Help. A family member or friend age 18 or older can be hired, but not a spouse, a parent of a minor child, or someone who also gets Home Help. |
| North Carolina | Personal Care Services (PCS), CAP/DA Waiver | People with NC Medicaid who need help with daily tasks (PCS). Disabled adults 18 or older (CAP/DA). | Limited. CAP/DA lets you direct and hire your own assistant. PCS aides work for licensed agencies. |
| Ohio | PASSPORT, Ohio Home Care Waiver | Ohioans 60 or older at nursing home level of care (PASSPORT). Medicaid-eligible Ohioans 59 or under (Home Care Waiver). | Limited. Both allow self-direction. Ask the agency whether a relative can be your worker. |
| Texas | STAR+PLUS HCBS Waiver, STAR+PLUS with Community First Choice, Primary Home Care and Community Attendant Services | Adults 21 or older at nursing home level of care (waiver). People with community Medicaid and a personal care need (PHC and CAS). | Yes, through Consumer Directed Services. Relatives can generally be attendants, but not the spouse. |
| Virginia | Commonwealth Coordinated Care Plus (CCC Plus) Waiver | Older adults and people with disabilities at nursing facility level of care who are eligible for Medicaid. | Yes. Members can direct their own care. Spouses and parents of minors can be paid for extraordinary care, up to 40 hours a week. |
Most of these states also list a Program of All-Inclusive Care for the Elderly. See PACE for how it works. It is not available in every county. Alabama’s only PACE site is in Mobile.
What should I know about each state?
Alabama
The Elderly and Disabled Waiver pays for case management, homemaker help, personal care, respite, adult day health, adult companion services, meals and home changes. The 2026 limits are $2,982 a month in income and $2,000 in resources. Call the Alabama Department of Senior Services at 1-800-243-5463 to apply. The glossary explains the Alabama Elderly and Disabled waiver.
Arizona
ALTCS covers nursing facility care, hospice and home and community based services. At home, that includes attendant care, personal care and homemaker services. You do not have to live in a nursing home. Apply online in Health-e-Arizona Plus or call 602-417-7000. The glossary has an entry on the Arizona Long Term Care System.
Colorado
Community First Choice became active July 1, 2025. It covers personal care, homemaker help and health maintenance. The Elderly, Blind, and Disabled Waiver now delivers personal care and homemaker help through CFC. Contact your local Case Management Agency to start. The glossary explains Community First Choice.
Maryland
Maryland has three main routes. Community First Choice and the Community Personal Assistance Services Program need full Medicaid first. The Community Options Waiver adds services such as assisted living, medical day care and case management. It has a registry and a waitlist. Call Maryland Access Point at 844-627-5465.
Michigan
MI Choice covers community living supports, respite, adult day health, meals, chore services and personal emergency response. Call your local Area Agency on Aging or MI Choice waiver agency for intake. See MI Choice waiver. Home Help pays for hands-on help after an in-home assessment by an adult services worker at your county office. It does not cover supervision, prompting or transportation. See Michigan Home Help.
North Carolina
Personal Care Services covers help with eating, dressing, bathing, using the bathroom and moving around. An assessment must show needs in three of five daily tasks, or two tasks with one needing a lot of help or full help. CAP/DA offers in-home aide levels 1 and 2, adult day health, respite and more. NC also funds Home Care Independence, a consumer-directed program for adults 60 or older, in some counties. See the glossary on CAP/DA.
Ohio
PASSPORT is for Ohioans 60 or older. Your Area Agency on Aging runs it. Call 1-866-243-5678. The Ohio Home Care Waiver serves people 59 or under, and self-direction became available there on October 1, 2024. See PASSPORT in the glossary.
Texas
STAR+PLUS is Medicaid managed care for adults with disabilities and adults 65 or older. The HCBS waiver adds services for people who would otherwise need a nursing home. It covers personal attendant services, respite, home nursing, meals and minor home changes. Apply at yourtexasbenefits.com or call 2-1-1. Primary Home Care needs a score of at least 24 on Form 2060 and at least six hours of service a week, with some exceptions. See STAR+PLUS.
Virginia
The CCC Plus Waiver covers personal care, respite, adult day health, emergency response systems, assistive technology, home changes and private duty nursing. DMAS’s 2025 fact sheet lists a soft cap of 56 personal care hours a week, with exceptions. Ask your local Department of Social Services for a screening. See the CCC Plus waiver glossary entry.
How long is the wait, and can I get help sooner?
Waits depend on the program, the state and the year. Some waivers have a waiting list. State plan programs often do not. In our nine states, we confirmed a registry and waitlist only for Maryland’s Community Options Waiver. For the others, ask your agency.
While you wait:
- Ask your Area Agency on Aging about caregiver support, respite and home-delivered meals.
- Ask whether a state plan program can start sooner than the waiver.
- Keep your application and assessment paperwork in one folder.
- Ask whether private help can fill the gap. A care advisor at HomeCare.com can talk through payment options and hours that may fit your situation.
Will Medicaid pay a family member?
Sometimes. Arizona, Colorado, Michigan’s Home Help, Texas and Virginia have programs that can pay a relative, with limits. Most do not allow the spouse to be paid, or they require extraordinary care. The table above gives the one-line rule. If you want to be paid, read paid family caregiver programs. It explains pay, taxes and other routes.
What does Medicaid not cover?
Medicaid does not cover everything a family may need. Michigan’s Home Help does not pay for supervision, prompting or transportation. Some waivers limit hours, such as Virginia’s soft cap. Providers must also follow state rules. Alabama, for example, requires Medicaid in-home providers to use electronic visit verification. Read the program page for exclusions. If a service you need is not covered, ask your agency what else can help.
You may also wonder how Medicaid fits with other payers. See what Medicare does not cover and long-term care insurance claims.
Next step
Medicaid rules are hard to read at 11pm. A HomeCare.com care advisor can talk through payment options for your situation and what in-home care could look like. Call 800-974-3458 or request a call.
Our caregivers provide non-medical care. See personal care and live-in care.
Frequently asked questions
Does Medicaid pay for in-home care?
Yes, in every state below, but only through specific programs. Medicaid home care waivers and state plan personal care pay for help with bathing, dressing, meals and similar tasks. You must qualify medically and financially. Programs, limits and waitlists differ by state, so start with your state Medicaid agency.
What is a Medicaid waiver?
A Medicaid waiver lets a state pay for care at home or in the community instead of a nursing home. Federal rules call these home and community-based services waivers. Each state designs its own, so names, services and limits vary. Many have a cap on slots and a waiting list.
How do I apply for the MI Choice waiver?
Call your local Area Agency on Aging or MI Choice waiver agency for an intake screening. Michigan's health department says MI Choice serves older adults and people with disabilities who need nursing facility level of care and meet Medicaid income and asset rules. The agency walks you through the Medicaid application.
How long is the waiting list for waiver services?
It depends on the state and the waiver, and it can change. Maryland, for example, has a registry and a waitlist for its Community Options Waiver. No one can promise a wait time. Ask your local agency how many people are ahead of you and whether any services start sooner.
Can Medicaid pay a family member to provide care?
Sometimes. Arizona, Colorado, Michigan, Texas and Virginia all have programs that can pay a relative, with limits, such as rules about spouses. Other states do not say. Check the state row in the table, then ask the program whether your relative can be hired.
Sources
- Michigan Department of Health and Human Services: MI Choice Waiver Program
- Texas HHSC: STAR+PLUS
- Ohio Department of Aging: PASSPORT
- Virginia DMAS: Commonwealth Coordinated Care Plus (CCC Plus) Waiver
- Alabama Medicaid: Elderly and Disabled Waiver
- Colorado HCPF: Community First Choice Option
- Maryland Department of Health: Community Options Waiver
- NC Medicaid: Community Alternatives Program for Disabled Adults (CAP/DA)
