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Non-Medical Home Care Provider Medicaid Requirements

Many Medicaid recipients have disabilities or health issues that make it difficult to perform basic daily living tasks such as dressing, housecleaning, and cooking. In some cases, these individuals may be entitled to non-medical home care services paid for by Medicaid. Eligibility for these services depends on the rules set by state Medicaid administrators who also certify the agencies that provide this type of care.

  1. Medicaid Policy

    • Medicaid is a government program that provides medical coverage to people living on a low income. While federal guidelines only require Medicaid agencies to provide home care services to recipients who are supported by other federal benefit programs, such as Social Security, or who have significant disabilities, each state sets its own home care guidelines. In many states, such as New York, both medical and non-medical home care is available to anyone who receives Medicaid benefits.

    Medicaid Certified Agencies

    • Medicaid recipients who need home care, whether medical or non-medical, often work with a home care agency that is certified to be reimbursed for its services via Medicaid funds. Home care agencies usually must be licensed by the state in which they operate, and then must apply to the state's Medicaid agency to be certified for Medicaid reimbursement. While Medicaid rules require home health aides to complete an approved training program, there are no such rules for personal care attendants or aides who perform non-medical tasks.

    Cash & Counseling

    • Some states now participate in the Cash & Counseling program, which gives Medicaid recipients more flexibility and choice in their use of home care provider services. Instead of being required to use the services of a home care agency worker, a Medicaid recipient who is otherwise entitled to home care services can take charge of hiring a home aide of their own choosing, or may also decide to purchase equipment that will enable them to care for themselves. Cash & Counseling recipients also work with a case manager to develop a plan and a budget for their Cash & Counseling benefit.

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