Medicare vs. Medicaid—What Seniors Need to Know for Home Care
In-home care services provide seniors with compassionate support, ensuring comfort, safety, and independence while aging at home.
By Drew Davis, Owner
When it comes to in-home care services, many seniors and their families wonder, Who pays for what? Medicare and Medicaid are two government-funded programs that can help cover the cost of senior care, but they differ in what they provide, who qualifies, and how coverage works. Understanding these differences is essential for making informed decisions about senior home care packages and planning for long-term care.
If you’re asking, "How much does 24/7 in-home care cost per month?" or looking for ways to reduce out-of-pocket expenses, this guide will break down Medicare vs. Medicaid coverage for home care services, what’s included, and how to determine the best option for your loved one.
What Is Medicare and How Does It Cover In-Home Care?
Who Qualifies for Medicare?
Medicare is a federal health insurance program primarily for:
✔ Seniors aged 65 and older.
✔ Younger individuals with certain disabilities.
✔ People with end-stage renal disease (ESRD) or ALS.
What In-Home Care Services Does Medicare Cover?
Medicare only covers medically necessary care, meaning it must be prescribed by a doctor. Coverage includes:
✅ Short-term skilled nursing care (after a hospital stay).
✅ Physical therapy, occupational therapy, and speech therapy.
✅ Home health aide assistance (bathing, dressing, limited personal care).
✅ Medical equipment (walkers, wheelchairs, oxygen tanks).
What Medicare Does NOT Cover:
❌ 24/7 in-home care or long-term custodial care.
❌ Non-medical care like meal prep, housekeeping, and transportation.
❌ Assisted living or nursing home stays.
Key Takeaway: Medicare helps seniors recover from illness or injury at home, but it does not cover long-term senior home care packages.
What Is Medicaid and How Does It Cover In-Home Care?
Who Qualifies for Medicaid?
Medicaid is a state and federally funded program designed for:
✔ Low-income seniors.
✔ Individuals who meet specific financial and medical requirements.
What In-Home Care Services Does Medicaid Cover?
Medicaid provides broader coverage than Medicare and includes:
✅ Personal care assistance (help with dressing, bathing, toileting).
✅ Homemaker services (housekeeping, laundry, meal prep).
✅ Long-term in-home care services (24-hour care in some states).
✅ Adult day care programs.
✅ Medical transportation.
What Medicaid Does NOT Cover:
❌ Luxury assisted living facilities.
❌ Private duty nursing unless medically necessary.
❌ Higher-end medical equipment (some restrictions apply).
Key Takeaway: If your senior loved one needs long-term in-home care services, Medicaid offers more extensive coverage than Medicare, especially for low-income individuals.
How Much Does 24/7 In-Home Care Cost Per Month?
The cost of round-the-clock in-home care varies based on location, level of care needed, and agency rates.
National Average Cost:
✔ $18,000 to $24,000 per month for 24/7 in-home care.
State-by-State Differences:
✔ California: $25,000+ per month for 24-hour care.
✔ Texas: $18,000 to $22,000 per month for live-in care.
Ways to Reduce Costs:
Apply for Medicaid waivers (available in many states).
Use veteran benefits for home care.
Consider a hybrid care model (combining family caregiving with part-time professional care).
Comparing Medicare vs. Medicaid for In-Home Care
Which One Is Best for Your Loved One?
✔ Medicare is ideal for short-term medical care after surgery or illness.
✔ Medicaid is best for long-term care needs, including daily assistance and senior home care packages.
How to Apply for Medicare and Medicaid for Home Care
Applying for Medicare Home Health Services:
✔ Speak with your doctor about eligibility for home health care.
✔ Find a Medicare-approved home care agency.
✔ Check coverage details at Medicare.gov.
Applying for Medicaid Home Care Assistance:
✔ Check state-specific eligibility requirements at Medicaid.gov.
✔ Apply for Home and Community-Based Services (HCBS) Waivers.
✔ Work with a caseworker to determine benefits.
How Quality In-Home Care Helps Seniors Live Comfortably
Even with Medicare and Medicaid, navigating in-home care services can be overwhelming. That’s where quality in-home care for seniors in California makes a difference.
✅ Personalized care plans tailored to your loved one’s needs.
✅ Assistance with daily activities (bathing, dressing, mobility support).
✅ Companion care to prevent loneliness.
✅ Meal prep and medication reminders for safety and nutrition.
✅ Transportation services for doctor’s visits and errands.
With the right home care support, seniors can age in place safely and comfortably.
Understanding Medicare vs. Medicaid for home care is essential in planning long-term senior care. Whether your loved one needs short-term medical support or long-term personal care, knowing the differences can help you make the best financial decision.
If you’re looking for affordable, high-quality in-home care, we’re here to help. Our senior home care packages ensure compassionate, professional care while maximizing benefits through Medicare, Medicaid, and private pay options.
📞 Contact us today to learn how we can support your loved one with expert in-home care services!
LEGAL DISCLAIMER
This blog provides general information and discussions about the key differences and coverage options of Medicare and Medicaid for in-home care services for seniors. It is not intended and should not be construed as medical or legal advice.