Home care
How Medicaid Pays for Home Care, State by State
Save'Does Medicaid pay for home care' has the same answer everywhere — yes — and a completely different mechanism in each state. This guide names the program that actually runs in each state and explains the three rules that decide whether you get in, and how long you wait.
Last updated: August 2026History
Waiver, state plan, or both
A state plan personal care benefit is an entitlement: if you meet the criteria, the state must cover it, and there is no waiting list. A home and community-based services waiver is the opposite — the state waives certain federal rules in exchange for capping how many people it serves, which is why waivers have slots and waiting lists and state plan benefits do not.
Most waivers require a nursing-facility level of care: functionally, that you would qualify for a nursing home if you were not getting help at home. That assessment, not the diagnosis, decides eligibility.
How each state pays for home care through Medicaid
Each row is that state's own published summary, naming the program that actually runs there. Programs are renamed and restructured — confirm with the agency named in your state's row.
| State | What the state's own guide reported |
|---|---|
| Alabama | Yes, but only through a waiver. Alabama covers personal care at home under Medicaid waivers and nowhere else — there is no state-plan personal care benefit to fall back on, and Alabama has not adopted Community First Choice. That single design choice explains most of what Alabama families run into: a waiver may legally limit how many people it serves, so qualifying financially and actually receiving hours are two separate events. |
| Alaska | Yes, and through a route most states do not have. Alaska covers personal care at home as a state plan benefit rather than a waiver, and it is one of the small group of states that adopted Community First Choice — a pathway federal rules forbid from capping enrollment. |
| Arizona | Yes, and Arizona does it in a way no neighbouring state copies. Arizona has no home care waiver at all. It covers long-term care through ALTCS, a demonstration program that has run as statewide capitated managed care since the late 1980s, and it does not maintain a waiting list. |
| Arkansas | Yes, and Arkansas has two separate doors rather than one. State plan Personal Care is an ordinary Medicaid benefit — no waiver, no enrollment cap, no list. ARChoices in Homecare is the waiver, which buys far more and can make you wait. |
| California | Yes, and more generously than almost anywhere. Medi-Cal pays for home care mainly through In-Home Supportive Services, which is an entitlement rather than a capped waiver: qualify, and it is owed to you, with no slot to wait for. |
| Colorado | Yes, and Colorado gives you two ways in rather than one. Help with bathing and dressing can come through the Elderly, Blind and Disabled waiver, or through Health First Colorado's long-term home health benefit, which is an ordinary state plan service rather than a waiver slot. |
| Connecticut | Yes, for people who qualify financially and functionally. Connecticut covers home care two ways: the Connecticut Home Care Program for Elders, a waiver for people who would otherwise need a nursing home, and Community First Choice, a state-plan attendant benefit that cannot be capped or waitlisted. |
| Delaware | Yes, for people who qualify. Delaware covers home care through Diamond State Health Plan-Plus, a single Medicaid demonstration that folds long-term care into managed health plans rather than running a separate stack of waivers. |
| Florida | Yes, for people who qualify, through Statewide Medicaid Managed Care Long-Term Care. Florida covers personal care, homemaker services, respite, and adult day care at home for people who meet a nursing-home level of care. |
| Georgia | Yes, through a waiver — but Georgia built more than one, and they are not interchangeable. The Community Care Services Program, SOURCE, and the Independent Care Waiver Program each cover personal support at home for a different population, with different case management and different capacity. |
| Hawaii | Yes, through QUEST Integration — the single Medicaid program that covers nearly everyone in Hawaii. Rather than running a separate waiver for older adults, the state folded long-term services into one managed care program, so home care comes through the same health plan that covers doctor visits. |
| Idaho | Yes — Idaho Medicaid pays for home care, through two separate doors. Personal Care Services sit in Idaho's regular Medicaid state plan, so anyone who qualifies medically and financially can get them. The Aged and Disabled Waiver pays for a wider set of services, but only for people who need a nursing-home level of care, and a waiver is a benefit a state is allowed to cap. |
| Illinois | Yes, Illinois Medicaid pays for home care, but which door you use depends on your age. Adults 60 and over go through the Community Care Program, run by the Illinois Department on Aging. Adults under 60 with disabilities go through the Home Services Program, run by the Department of Human Services. |
| Indiana | Yes, and Indiana reorganised how in 2024. Medicaid members aged 60 and over now receive home care through PathWays for Aging, a managed long-term services program. Adults under 60 who need that level of care use the Health and Wellness waiver. |
| Iowa | Yes. Iowa Medicaid pays for home care through its home- and community-based waivers, and its distinguishing feature is who does the hiring. Through Consumer Directed Attendant Care, an Iowan can choose an individual person to provide the help rather than accept whoever an agency sends. |
| Kansas | Yes, but in Kansas nearly every answer runs through KanCare, the state's managed care program. Kansas put its long-term services inside managed care, so home care is authorized by a health plan working from a state-approved waiver rather than by the state paying providers directly. |
| Kentucky | Yes, and Kentucky pays for it in a way that confuses almost everyone. Your Kentucky Medicaid card probably names a managed care plan, but waiver home care is carved out of that plan and paid directly by the state instead. So the plan on the card is not who authorizes the aide. |
| Louisiana | Yes. Louisiana Medicaid pays for home care through two different doors. Long Term Personal Care Services is a state plan benefit: help with bathing, dressing, and meals, authorized as ordinary Medicaid. The Community Choices Waiver is a separate capped program that adds more, and Louisiana fills it from a Request for Services Registry. |
| Maine | Yes, and in Maine the answer comes with a section number. MaineCare files its home care benefits as numbered sections of the MaineCare Benefits Manual, and the section a person qualifies under decides both what arrives and whether they wait. Sections 96 and 12 are regular benefits with no slot limit. |
| Maryland | Yes, and Maryland's version has a feature most states lack. Maryland runs Community First Choice, an attendant-care benefit built under a federal authority that forbids the state from capping enrollment. If someone qualifies, there is no slot to wait for. The Community Options Waiver is a separate, capped program that adds what Community First Choice does not, and that is where Maryland's waiting actually happens. |
| Massachusetts | Yes. MassHealth pays for home care, and it does it in a way that surprises people: its Personal Care Attendant program has no agency option. The member is the legal employer, recruiting and supervising their own attendant. Elders come in through an Aging Services Access Point instead. |
| Michigan | Yes, through two programs that run on opposite principles. Home Help is a regular Michigan Medicaid benefit, it has no slot limit, and the person receiving care picks their own provider, which in Michigan can often be a relative. MI Choice is a capped waiver, administered by regional waiver agents, that adds what Home Help cannot. |
| Minnesota | Yes. Minnesota's Medicaid program, called Medical Assistance, pays for home care two ways: Community First Services and Supports, a state plan benefit that replaced Personal Care Assistance, and five home and community based waivers including the Elderly Waiver. |
| Mississippi | Yes, but almost entirely through waivers rather than the regular benefit package. Mississippi has not added optional personal care to its Medicaid state plan, so the hands-on help most families mean by home care comes from the Elderly and Disabled Waiver or one of four others. |
| Missouri | Yes. MO HealthNet — Missouri's Medicaid program — covers personal care as a regular state plan benefit, not only through waivers, and it runs one of the country's oldest consumer-directed programs. |
| Montana | Yes, and Montana's structure differs from most of its neighbors'. Montana adopted Community First Choice, which makes attendant care a regular state plan benefit rather than a capped waiver slot — so it cannot carry a waiting list. |
| Nebraska | Yes. Nebraska Medicaid covers personal assistance services as part of its regular benefit package, and adds an Aged and Disabled Waiver on top for people who would otherwise need a nursing facility. |
| Nevada | Yes, in two different ways, and the difference decides how long you wait. Nevada Medicaid covers Personal Care Services as a regular state plan benefit, so anyone who qualifies is entitled to it. |
| New Hampshire | Yes, and in New Hampshire the answer runs through one program more than any other. Choices for Independence is the Medicaid waiver that pays for personal care, homemaker help, and adult day services for people who would otherwise need a nursing home. It is a waiver, not an entitlement, which means the state is allowed to limit how many people it serves at once. |
| New Jersey | Yes, and New Jersey does it differently from most states. Rather than running standalone waivers for older adults, the state folded its home care into Managed Long Term Services and Supports, delivered through NJ FamilyCare managed care plans. |
| New Mexico | Yes, and in New Mexico it comes through Turquoise Care — the Medicaid managed care program that replaced Centennial Care in 2024. Paid help at home is called the Community Benefit, and it arrives in two forms: agency-based, where a contracted agency sends an aide, or self-directed, where the member manages a budget and hires their own worker. |
| New York | Yes, and more broadly than in most states. New York covers personal care as a regular Medicaid benefit, runs Community First Choice, and operates CDPAP — the program that lets you hire and direct your own aide, including most relatives other than a spouse. |
| North Carolina | Yes. North Carolina Medicaid pays for home care through two separate doors. Personal Care Services is a state plan benefit: meet the functional test and the hours are an entitlement with no waiting list, but they are capped each month. The Community Alternatives Program waivers cover far more hours and more services, and they are limited by enrollment slots, so they can carry a wait measured in years. |
| North Dakota | Yes. North Dakota Medicaid pays for home care, but it routes the money differently than most states: through Qualified Service Providers, a state roster of enrolled agencies and individuals. An individual can enroll as a QSP, and that individual can be a family member other than a spouse. |
| Ohio | Yes, but only through a waiver. Ohio has no general state plan personal care benefit, so Medicaid-funded help at home runs through capped waiver programs. PASSPORT is the one for people 60 and older, administered regionally through Area Agencies on Aging. |
| Oklahoma | Yes. Oklahoma Medicaid, called SoonerCare, pays for home care through two separate programs. State plan Personal Care is a benefit: meet the criteria and it is yours, with no waiting list, though the hours are modest. The ADvantage waiver covers far more — case management, respite, home modifications — but it has a limited number of slots and can carry a wait. |
| Oregon | Yes, and Oregon is one of the few states where the answer arrives with no waiting list attached. Oregon covers attendant care through the K Plan — its version of Community First Choice, a Medicaid state plan option that federal rules forbid from capping enrollment. |
| Pennsylvania | Yes, for Pennsylvanians who clear both a financial test and a functional one. Pennsylvania buys nearly all of its Medicaid home care through Community HealthChoices, a mandatory managed long-term services program for adults 21 and older. |
| Rhode Island | Yes, and Rhode Island reaches it by a route almost no other state uses. There is no separate home care waiver here to apply to. Rhode Island folded its waivers into a single statewide demonstration years ago, so the usual question — which waiver am I on the list for? — has no Rhode Island answer. |
| South Carolina | Yes, for South Carolinians who pass both a money test and a functional one. The state buys home care through a division of its Medicaid agency called Community Long Term Care, and for most older adults the relevant program is the Community Choices waiver. |
| South Dakota | Yes, mainly through one program with an acronym for a name. The HOPE waiver — Home and Community-Based Options and Person-Centered Excellence — is South Dakota's route to paying for care at home for older adults and adults with disabilities at risk of entering a nursing home. |
| Tennessee | Yes, and Tennessee does it entirely through managed care. TennCare has no fee-for-service side to fall back on, so home care reaches a Tennessean through a program called CHOICES, delivered by the health plan they are enrolled in. CHOICES sorts people into three groups. |
| Texas | Yes, Texas Medicaid pays for home care, but through several separate doors rather than one benefit. Attendant help with bathing, dressing, and meals runs through state plan programs and through STAR+PLUS managed care. Community First Choice cannot be waitlisted. |
| Utah | Utah Medicaid pays for home care almost entirely through 1915(c) waivers, which means limited slots and a wait. Utah has not adopted Community First Choice, the state plan option some neighboring states use and which cannot be capped. |
| Vermont | Vermont Medicaid pays for home care through Choices for Care, and it works unlike almost any other state's. Vermont covers long-term care under a single statewide demonstration rather than the waivers most states use. |
| Virginia | Yes. Virginia Medicaid pays for home care mainly through the CCC Plus waiver, which covers personal care, respite, and adult day health for people who meet a nursing-facility level of care. Unlike Virginia's developmental disability waivers, it has historically had no waiting list. |
| Washington | Yes, for people who qualify. Washington runs most personal care through Community First Choice, a state-plan benefit that cannot be capped or waitlisted, with the COPES waiver layered on for people needing more. |
| West Virginia | Yes, through two programs. West Virginia Personal Care sits in the Medicaid state plan and functions as an entitlement — meet the criteria and it is yours. The Aged and Disabled Waiver offers a wider package but is capped, which is what a waiting list actually is. |
| Wisconsin | Yes, and Wisconsin answers this differently from most states. Adults who qualify enroll in Family Care or IRIS — and because Wisconsin treats adult long-term care as an entitlement rather than a capped waiver, there is no waiting list for them. Medicare does not cover ongoing personal care. |
| Wyoming | Yes, but through one door rather than several. Wyoming's main route is the Community Choices Waiver, and a waiver is a program the state is allowed to cap. Wyoming did not adopt the state-plan attendant benefit that some neighbours run, so there is no uncapped alternative sitting beside it. |
The three rules that decide whether you get in
First, financial eligibility: income and asset limits for long-term care Medicaid are distinct from ordinary Medicaid, and many states allow a spend-down or a qualified income trust for people just over the line.
Second, functional eligibility: the level-of-care assessment. Third, capacity: whether the program has an open slot. A person can pass the first two and still wait, which is why applying early matters more than most families are told.
Many states also run a self-directed option, where the person budgets their own hours and may hire a family member as the paid caregiver.
Who to call first
Find your state's program name, then call the agency named in the row — often the Area Agency on Aging or the state's aging and disability resource center — and ask two questions: how long the assessment takes, and whether there is currently a waiting list. Apply while you are still managing, not after the crisis.
Related: what home care costs without Medicaid · how Medicaid covers long-term care.
Common questions
Related
Say it back
How would you explain this to someone you love?
Two or three sentences, just as you’d say it. Gale reflects back what you focused on — a mirror, not a quiz.
When to Escalate Rather Than Wait for a Waiver
- —A caregiver who can no longer safely provide the help needed
- —Repeated falls, wandering, or medication errors when alone
- —Weight loss, dehydration, or missed medications noticed between visits
Sudden confusion, a fall with a head injury, chest pain, or trouble breathing is an emergency: call 911.
This article describes Medicaid home care programs by state. It is general information, not legal or financial advice; program names, limits and waiting lists change, so confirm current rules with your state's Medicaid agency.
Did this answer your question?
References
- 1.Centers for Medicare & Medicaid Services (2025). Self-Directed Services. Medicaid.gov. linkSource carried forward from the state pages consolidated here; it is cited by 50 of them.
- 2.KFF (Kaiser Family Foundation) (2025). A Look at Waiting Lists for Medicaid Home- and Community-Based Services from 2016 to 2025. KFF. link ✓Source carried forward from the state pages consolidated here; it is cited by 46 of them.
- 3.KFF (Kaiser Family Foundation) (2025). Medicaid Home Care (HCBS) in 2025. KFF. link ✓Source carried forward from the state pages consolidated here; it is cited by 43 of them.
- 4.Centers for Medicare & Medicaid Services (2025). Home & Community-Based Services 1915(c). Medicaid.gov. linkSource carried forward from the state pages consolidated here; it is cited by 41 of them.
- 5.Administration for Community Living (2025). Costs of Care. ACL.gov (LongTermCare.gov content). link ✓Source carried forward from the state pages consolidated here; it is cited by 38 of them.
- 6.Centers for Medicare & Medicaid Services (2025). Home & Community Based Services Authorities. Medicaid.gov. linkSource carried forward from the state pages consolidated here; it is cited by 26 of them.
6 sources, numbered by first appearance. General health information, not medical advice. AI-assisted editorial content — citations link their sources. Editorial policy