Many families in Ohio wonder whether Medicare or Medicaid will pay for home care when an aging parent begins needing extra assistance.
The two programs sound similar, but they provide different types of coverage.
Medicare generally covers qualifying short-term or intermittent skilled home health care, while Medicaid may help eligible older adults receive ongoing personal care and other long-term services at home.
Understanding the difference can help families find the right assistance for their loved ones.
What Is the Difference Between Medicare and Medicaid?
Medicare and Medicaid are government health coverage programs, but they serve different purposes.
Medicare is a federal health insurance program primarily for adults age 65 and older, as well as certain younger individuals with qualifying disabilities or medical conditions.
Medicaid is a joint federal and state program that provides health coverage and other eligible services to people who meet financial and other requirements.
In Ohio, Medicaid also offers programs that can help qualifying older adults remain in their homes rather than move into nursing facilities.
Does Medicare Pay for Home Care in Ohio?
Yes, Medicare may cover certain home health services when specific eligibility requirements are met.
Medicare-covered home health services may include:
Part-time or intermittent skilled nursing care
Physical therapy
Occupational therapy
Speech-language pathology services
Medical social services
Home health aide care when the individual also qualifies for covered skilled services
A Medicare-certified home health agency generally must provide the covered services.
However, Medicare does not normally cover ongoing personal care or homemaker services when those are the only services someone needs.
For example, an older adult who needs assistance with bathing, dressing, laundry, and meal preparation but does not require qualifying skilled care generally cannot rely on Medicare to pay for those services.
Does Ohio Medicaid Pay for Home Care?
Yes. Ohio Medicaid may cover certain home and community-based services for eligible individuals.
Unlike Medicare's limited home health benefit, some Medicaid programs can help people receive longer-term assistance with everyday activities.
Covered services depend on the person's eligibility, the specific Medicaid program, and their approved service plan.
For older adults age 60 and above, one important option is Ohio's PASSPORT program.
What Is Ohio's PASSPORT Program?
Ohio's PASSPORT program is a Medicaid waiver program designed to help eligible older adults receive long-term services and supports in their homes and communities.
The program offers an alternative to receiving long-term care in a nursing facility.
Depending on an individual's assessment and approved service plan, services may include:
Personal care assistance
Homemaker services
Home-delivered meals
Adult day services
Emergency response systems
Other authorized home and community-based services
Not every participant receives the same services or number of care hours.
Who Qualifies for Ohio's PASSPORT Program?
PASSPORT generally serves Ohio residents who:
Are age 60 or older
Meet applicable Medicaid financial eligibility requirements
Meet the required nursing facility level of care
Can receive services safely through an approved home and community-based care plan
Meet other applicable program requirements
Eligibility is determined through the appropriate state and local assessment and Medicaid eligibility processes.
Families should contact their local Area Agency on Aging to learn about current requirements.
Does Medicaid Pay for Personal Care and Homemaker Services?
Yes. Eligible individuals may receive personal care and homemaker services when those services are covered by their Medicaid program and authorized in their care plan.
Personal Care Services
Personal care focuses on assisting individuals with daily personal activities, such as:
Bathing
Dressing
Grooming
Toileting
Mobility and transfers
Eating assistance
Homemaker Services
Homemaker services focus on helping individuals with approved household tasks, such as:
Light housekeeping
Laundry
Meal preparation
Essential household tasks
These services can help older adults maintain a comfortable living environment while receiving the assistance they need.
Can Medicare and Medicaid Work Together?
Yes. Some individuals qualify for both Medicare and Medicaid. They are often called dual-eligible beneficiaries.
Medicare generally pays first for services it covers, while Medicaid may help with certain additional costs and services according to program rules.
For example, an eligible older adult might receive Medicare-covered skilled home health services and separately receive Medicaid-authorized personal care assistance.
The services must meet each program's requirements.
How Much Does Medicaid Pay for Home Care in Ohio?
There is no single amount paid for every participant.
Medicaid home care payments depend on factors such as:
The program providing coverage
The type of service
The approved number of service units or hours
Applicable Medicaid payment rates
The participant's service authorization
Families should understand that the amount paid to a home care agency is not necessarily the same as the amount a caregiver earns.
Some Medicaid long-term care programs may also have participant cost-sharing requirements.
Can Families Choose Their Home Care Agency?
Eligible participants generally have a choice among qualified and available providers authorized to deliver their approved services.
When choosing a home care agency, families may want to consider:
Services offered
Caregiver availability
Reliability and communication
Experience supporting older adults
Whether the agency serves their location and accepts their program authorization
A dependable provider can make receiving assistance at home more comfortable.
Medicaid Home Care Services in Franklin and Delaware Counties
Elegant Home Care Agency provides personal care and homemaker services for eligible individuals in Franklin and Delaware counties, Ohio.
We help older adults receive assistance with everyday activities while supporting their comfort, dignity, and independence.
Families can learn more about our local services:
PASSPORT Home Care in Franklin County
https://www.eleganthomecareagency.com/passport-home-care-franklin-county
PASSPORT Home Care in Delaware County
https://www.eleganthomecareagency.com/passport-home-care-delaware-county
How to Apply for Medicaid Home Care in Ohio
Families interested in PASSPORT can begin by contacting their local Area Agency on Aging.
For Franklin and Delaware counties, the Central Ohio Area Agency on Aging (COAAA) can provide information about eligibility, assessments, and the application process.
COAAA Phone: (614) 645-7250
Families can also contact Elegant Home Care Agency to learn more about our available personal care and homemaker services.
Elegant Home Care Agency
Serving Franklin and Delaware Counties, Ohio
Phone: (614) 500-0733
Website: www.eleganthomecareagency.com
Frequently Asked Questions
1. Does Medicare pay for someone to help my mother bathe and dress?
Medicare may cover limited home health aide assistance when the person meets its home health eligibility requirements and also needs qualifying skilled services. It generally does not pay for personal care alone.
2. Does Medicaid cover long-term home care in Ohio?
Yes. Eligible individuals may receive long-term home care through qualifying Ohio Medicaid programs, including PASSPORT.
3. Is Ohio PASSPORT the same as Medicare?
No. PASSPORT is an Ohio Medicaid waiver program, not a Medicare benefit.
4. Can someone have both Medicare and Medicaid?
Yes. Individuals who meet both programs' eligibility requirements may receive benefits from each.
5. Does Medicaid pay for 24-hour home care?
Medicaid does not automatically authorize 24-hour care. Services depend on the applicable program, assessed needs, and approved care plan.
6. How do I find Medicaid home care services near Columbus, Ohio?
Contact the Central Ohio Area Agency on Aging to ask about PASSPORT eligibility and available providers. You can also contact Elegant Home Care Agency to learn about our personal care and homemaker services in Franklin and Delaware counties.
