ABA Family Legal Guide

The Rights of Older Americans

Health and Long-Term Care Benefits

Paying for Long-Term Care

What if I don't want to live in a nursing home? Are home care services available under Medicare or Medicaid?

Yes, but to a limited extent. The home health-care benefit under Medicare focuses mainly on skilled nursing and therapeutic services needed on a part-time or intermittent basis. The benefit is described in the section on Medicare, see above.

Medicaid home health care is usually quite limited, too. However, several state Medicaid programs also provide "personal care" services to Medicaid-eligible individuals who need help with normal activities of daily living, such as dressing, bathing, using a toilet, eating, and walking. Many states also have instituted Medicaid waiver programs that allow the state to use Medicaid dollars for home- and community-based services that normally would not be covered. These waiver programs usually target people who otherwise would have to live in a nursing home. Some of these services include personal care, adult day care, housekeeping services, care coordination and management, and respite care, which enables primary caregivers to take a break from their responsibilities.