Medicaid home health care services help elderly people stay living in their own homes. Typically, people who are able to live at home prefer that to being in a nursing home or care facility. But some people may need a little extra help to live safely at home. That’s where Medicaid in-home care comes in.
The federal government requires all 50 states to offer some kind of home health benefits through Medicaid. But Medicaid programs change from state to state. As a result, the amount of in-home care and what types of Medicaid home health care services are available depends on where you live.
Also, the term home care may apply to other places besides someone’s personal home. Medicaid in-home care can be provided at the home of a friend or relative, an adult foster care home or an assisted living facility.
The federal government requires all 50 states to offer some kind of home health benefits through Medicaid
State Medicaid programs may cover a wide range of services. There are also different ways that states choose to cover Medicaid home health services. Even if certain in-home care services aren’t covered by a state’s regular Medicaid plan, they may still be offered through Home and Community Based Services (HCBS) programs.
The chart below shows the types of Medicaid home health services that are typically available in most states.
Medicare in-home care service
Description
Some in-home care services like skilled nursing care and occupational, physical or speech therapy are delivered by medical professionals. Other services, such as doing chores around the house and making meals, can be provided by family members, friends or paid caregivers.
As stated before, the rules for Medicaid depend on the state where you live. How much care you can get may also depend on the type of Medicaid program you’re enrolled in. The level of home health care Medicaid provides is typically based on the needs of individual. Some Medicaid programs may pay for a personal care assistant to come in for several hours a day on multiple days of the week. Other programs may only cover adult day care for a few days each week.
There are 2 main requirements you’ll need to meet to qualify for Medicaid home health care services:
There are other ways to get extra help to make life easier. If you qualify for both Medicaid and Medicare, you could get a Dual Special Needs Plan (D-SNP). A D-SNP plan works together with your Medicaid health plan. You’ll keep all your Medicaid benefits. Plus, you’ll get many extra benefits that Original Medicare doesn’t cover.* Dual Special Needs plans have a $0 premium for members with Extra Help (Low Income Subsidy). See if you qualify for a Dual Special Needs Plan.
*Benefits and features vary by plan/area. Limitations and exclusions apply.
Answer a few quick questions to see what type of plan may be a good fit for you.
Medicaid or dual-eligible plan benefits can change depending on where you live. Search using your ZIP code to find the right plan to meet your health care needs.
Looking for the federal government’s Medicaid website? Look here at Medicaid.gov.
Plans are insured through UnitedHealthcare Insurance Company or one of its affiliated companies, a Medicare Advantage organization with a Medicare contract and a contract with the State Medicaid Program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is available to anyone who has both Medical Assistance from the State and Medicare. Benefits, features and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply. Benefits, premiums and/or co-payments/co-insurance may change on January 1 of each year.
Dual Special Needs plans have a $0 premium for members with Extra Help (Low Income Subsidy).
Benefits, features, and/or devices vary by plan/area. Limitations, exclusions and/or network restrictions may apply.
This service should not be used for emergency or urgent care needs. In an emergency, call 911 or go to the nearest emergency room. The information provided through this service is for informational purposes only. The nurses cannot diagnose problems or recommend treatment and are not a substitute for your provider's care. Your health information is kept confidential in accordance with the law. The service is not an insurance program and may be discontinued at any time. Nurse Hotline not for use in emergencies, for informational purposes only.
UnitedHealthcare Connected® for MyCare Ohio (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Ohio Medicaid to provide benefits of both programs to enrollees.
UnitedHealthcare Connected® (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and Texas Medicaid to provide benefits of both programs to enrollees.
UnitedHealthcare Connected® for One Care (Medicare-Medicaid plan) is a health plan that contracts with both Medicare and MassHealth (Medicaid) to provide benefits of both programs to enrollees.
This is not a complete list. The benefit information is a brief summary, not a complete description of benefits. For more information contact the plan or read the member handbook. Limitations, copays and restrictions may apply. For more information, call UnitedHealthcare Connected® Member Services or read the UnitedHealthcare Connected® member handbook.
UnitedHealthcare Senior Care Options (SCO) is a Coordinated Care plan with a Medicare contract and a contract with the Commonwealth of Massachusetts Medicaid program. Enrollment in the plan depends on the plan’s contract renewal with Medicare. This plan is a voluntary program that is available to anyone 65 and older who qualifies for MassHealth Standard and Original Medicare and does not have any other comprehensive health Insurance, except Medicare. If you have MassHealth Standard, but you do not qualify for Original Medicare, you may still be eligible to enroll in our MassHealth Senior Care Option plan and receive all of your MassHealth benefits through our Senior Care Options (SCO) program.
Every year, Medicare evaluates plans based on a 5-Star rating system. The 5-Star rating applies to plan year 2024.
The choice is yours
We will provide you with information to help you make informed choices, such as physicians' and health care professionals' credentials. This information, however, is not an endorsement of a particular physician or health care professional's suitability for your needs.
The providers available through this application may not necessarily reflect the full extent of UnitedHealthcare's network of contracted providers. There may be providers or certain specialties that are not included in this application that are part of our network. If you don't find the provider you are searching for, you may contact the provider directly to verify participation status with UnitedHealthcare's network, or contact Customer Care at the toll-free number shown on your UnitedHealthcare ID card. We also recommend that, prior to seeing any physician, including any specialists, you call the physician's office to verify their participation status and availability.
Some network providers may have been added or removed from our network after this directory was updated. We do not guarantee that each provider is still accepting new members.
Out-of-network/non-contracted providers are under no obligation to treat UnitedHealthcare plan members, except in emergency situations. Please call our customer service number or see your Evidence of Coverage for more information, including the cost- sharing that applies to out-of-network services.
In accordance with the requirements of the federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973 ("ADA"), UnitedHealthcare Insurance Company provides full and equal access to covered services and does not discriminate against qualified individuals with disabilities on the basis of disability in its services, programs, or activities.
Network providers help you and your covered family members get the care needed. Access to specialists may be coordinated by your primary care physician.
Paper copies of the network provider directory are available at no cost to members by calling the customer service number on the back of your ID card. Non-members may download and print search results from the online directory.
To report incorrect information, email provider_directory_invalid_issues@uhc.com. This email box is for members to report potential inaccuracies for demographic (address, phone, etc.) information in the online or paper directories. Reporting issues via this mail box will result in an outreach to the provider’s office to verify all directory demographic data, which can take approximately 30 days. Individuals can also report potential inaccuracies via phone. UnitedHealthcare Members should call the number on the back of their ID card, and non-UnitedHealthcare members can call 1-888-638-6613 / TTY 711, or use your preferred relay service.
If you’re affected by a disaster or emergency declaration by the President or a governor, or an announcement of a public health emergency by the Secretary of Health and Human Services, there is certain additional support available to you.
If CMS hasn’t provided an end date for the disaster or emergency, plans will resume normal operation 30 days after the initial declaration.