Medicaid home care services: 2026 family caregiver overview

Yes. Medicaid pays for home care for eligible beneficiaries through several programs: (1) State Plan Personal Care Services (PCS), (2) HCBS waiver programs (1915(c) waivers, 1115 demonstration waivers), (3) PACE (Programs of All-Inclusive Care for the Elderly), (4) CDPAP / consumer-directed services in some states. Coverage scope and eligibility vary by state.

Medicaid eligibility requires meeting both income and asset limits set by your state, plus a functional (clinical) need for the level of care. Income limits typically run 138-300% of federal poverty level for HCBS waivers; asset limits typically $2,000 for individuals, $3,000 for couples (with spousal protection). Functional eligibility is assessed by the state Medicaid agency or contracted assessor using a standardized tool (e.g. UAS-NY in New York, MN-CHOICES in Minnesota).

HCBS (Home and Community Based Services) waivers let states use Medicaid funds to pay for in-home and community-based care that would otherwise have to be delivered in a nursing home. Each state runs its own waiver programs (often 5-15 different waivers per state, each targeting different populations: elderly, IDD, brain injury, etc.). Waivers commonly cover personal care, respite, adult day, home modifications, and case management.

AveeCare is software used by home care agencies that bill Medicaid. We help agencies capture EVV, build 837P claims, and reconcile state Medicaid payments. Family caregivers do not use AveeCare directly; they receive care from agencies that use AveeCare.