Medicaid Long Term Care Coverage for Home Modifications & Assistive Technology

Summary
Home modifications can become necessary for people who are older or have a chronic illness, and almost every state has a Medicaid program that will help pay for the cost. Wheelchair ramps, widening of hallways, grab bars, and even simple improvements like brighter lighting are all considered home modifications, and the idea behind these changes is to keep the home livable, so your loved one can remain as independent as possible for as long as possible. Every state has different rules about who is functionally and financially qualified, but one aspect of Medicaid Long Term Care that is consistent is the goal of keeping people in their homes and delaying the move into full-time nursing care. Changing a house to make it safer and more accessible fulfills that goal.

 

What Defines a Home Modification According to Medicaid?

Home modifications are also called assistive technology or adaptive technology, and they are upgrades to the physical structures in a home that make it more livable for someone who is disabled or simply frail due to aging. Examples of home modifications include the following:

– Accessory apartments: additions to the home that provide a safe living space for the disabled person or their caregiver
– Larger digital displays: make important readouts like clocks, climate controls, and computer monitors easier to see for someone who is vision-impaired
– Easy-use fixtures: oversized light switches, levers instead of knobs on faucets, etc.
– Grab bars or handrails: usually in the bathroom, hallway, or stairs
– Brighter lighting
– Roll-out shelving for easy access to food, clothes, and other stored items
– Push-button automatic door openers
– Security systems for remote monitoring
– Personal Emergency Response Systems (PERS) in case of an accident (a.k.a. Medical Alerts)
– Flooring upgrades, like replacing carpet with smooth surfaces for a wheelchair
– Stair lifts to get up and down stairs while seated in an electric chair
– Traction strips in the bathroom or wherever a slick floor might be dangerous (like on stairs)
– Transfer chairs or benches for getting into a wheelchair or the tub/shower
– Walk-in tub/shower that is wheelchair accessible with a seat
– Wheelchair ramps
– Widening doorways and/or hallways

 Don’t Do It Yourself. If home modifications are necessary for your loved one, it’s best to have an occupational therapist assess what upgrades you need. Occupational therapists know what’s required at the time and into the future, and stay up-to-date on available options. “Needs assessments” are included in many Medicaid Long Term Care programs described on this page.

 

Difference Between Labor and Materials

Depending on the state and particular Medicaid program, it might be necessary to distinguish between labor and materials when making home modifications. Materials are the equipment, like stair lifts or grab bars, that are installed in the home, and labor is the work to install it. It is possible that your state’s Medicaid Long Term Care program covers the cost of materials, but not labor.

Materials would be classified officially as durable medical equipment, or DME, which is usually listed under the covered costs of Medicaid programs described on this page, especially Home and Community Based Services (HCBS) waivers.

While Medicaid might not cover costs for installing home modifications, this doesn’t mean you need to pay out-of-pocket for installation. Many communities have local organizations that provide the labor to install home modifications for free. Medicaid programs are for low-income individuals, and contractors often offer reduced rates and even free labor for those considered financially needy. To connect with programs that help find volunteers or reduced rates for labor to install home modifications, click here.

 

Types of Medicaid That Pay for Home Modifications

Home modifications are exactly the kinds of cost-saving services Medicaid is evolving to cover. The goal of many Medicaid programs is to keep someone in their own home or community for as long as possible, because nursing homes are expensive. Sometimes, a change as simple as installing a stair lift or wheelchair ramp can be the difference between staying at home or having to move.

 

Waivers

Home modifications fit the definition of Home and Community Based Services (HCBS) waivers, because they keep a person from having to move into a nursing home. Nursing homes are expensive, and Medicaid covers 100% of the costs of nursing care for qualified individuals, so it’s in the state’s interest to spend less money to keep the home accessible so your loved one can stay there longer.

 In some states, Medicaid might not pay for home modifications that increase the size or value of the home.

Exactly what home modifications a Medicaid waiver will help pay for depends on which state you live in. Some states distinguish between assistive technology, like brighter lighting, and actual physical modifications, like wheelchair ramps. Specific Medicaid programs might cover one and not the other. Additionally, it is possible that an HCBS waiver will cover the cost of equipment, but not the labor to install it.

 

Managed Care

Some states deliver Medicaid Long Term Care services through a Managed Care Organization. Managed care programs offer benefits similar to waivers, including labor and materials for home modifications, provided through Managed Care Organizations (MCOs) that have formed a relationship with Medicaid to make delivery of services more efficient. Medicaid Managed Care programs have replaced waivers in some states. They often take payments at a capped amount on a per member, per month basis.

 

Money Follows the Person

Often someone will spend time in a nursing home and then wants to return to their own home; they may have suffered an injury or needed to recover from surgery, or have come to realize full-time nursing care is not necessary. Returning to the home after a stay in nursing care might require adjustments including actual physical changes to the spaces to make them safer and more accessible.

Money Follows the Person is a Medicaid program that exists in most states and pays for home modifications that will allow someone to move back into their private home out of nursing care, and pays for home modifications to make that transition possible.

 

Consumer Directed Care

If Medicaid Long Term Care programs in your state are limited in terms of the home modifications they will cover, it is possible to go beyond the state requirements with an option called Consumer Directed Care. CDC gives recipients more control over what Medicaid can pay for by providing a predetermined budget that may be spent outside the lists of Medicaid-certified providers. In other words, consumer direction allows more flexibility for Medicaid recipients to spend their benefits, and home modifications would be among the options allowable. Recipients who manage their benefits under CDC would be able to pay for labor and materials both, even if the providers do not usually accept Medicaid.

 

Finding Medicaid Programs that Pay for Home Modifications

Medicaid is different in every state, but they all have some form of Long Term Care program and almost all of them have a benefit to cover home modifications. The eligibility criteria is different in every state, meaning it varies what level of functional and financial need qualifies a person to receive Medicaid benefits. The amount of financial help will also vary, as some programs offer coverage for materials and labor both, while others do not. Likewise, some states offer Consumer Directed Care (see above) and others do not.

What follows is a state-specific list of Medicaid programs that cover home modifications for people who are elderly or infirm and want to make their homes more livable to maintain independence and/or avoid having to move into a nursing home.

 Waivers are not an entitlement. It’s important to note that unlike Nursing Home Medicaid, waivers are not an entitlement. This means there are often a limited number of waivers available. After the limit is reached, anyone who qualifies will be put on a waiting list that can last months or even years.
Medicaid Programs that Cover Home Modifications & Assistive Technology by State – Updated Oct. 2021
Alabama – State of Alabama Independent Living (SAIL) waiver: This HCBS waiver includes among its benefits an assistive technology needs evaluation, as well as home modification equipment, installation, and repairs. For more information and an application, click here.

– Alabama Community Transition (ACT) waiver: For people who wish to move from a nursing home back into their own home, ACT covers assistive technology and home modifications up to $5,000. More information at this link.

Alaska

 

– Alaskans Living Independently (ALI) waiver: This HCBS waiver is for Alaskans who need full-time nursing care but want to stay in their homes. Benefits include home modifications and specialized medical equipment. Contact the Alaska Department of Health and Human Services for more information or to apply.

– Alaska Adults with Physical and Developmental Disabilities (APDD) waiver: For adults with intellectual or developmental disabilities, APDD helps cover costs including home modifications and specialized medical equipment. Contact the Alaska Department of Health and Human Services to apply.

Arizona

 

– Arizona Long Term Care Services: Anyone who qualifies can receive benefits under Arizona Medicaid (Arizona Health Care Cost Containment System, or AHCCCS), including home modifications and durable medical equipment. For more information including how to apply, click here.

– Arizona Self-Directed Attendant Care (SDAC): This “cash and counseling” program allows the recipient to manage their own benefits, and will cover the costs of remaining independent at home, including home modifications. For more, click here.

California

 

– Multipurpose Senior Services Program (MSSP): Under Medi-Cal, this benefit is for older adults at risk of needing to move into a nursing home, and it includes coverage for home modifications. Not every county in California is covered. For more, click here.

– Medi-Cal Home and Community-Based Alternatives: Assessing environmental needs in the home and covering the costs of home modifications (including maintenance) are among the benefits of this waiver, meant to keep seniors who need nursing care in their own homes. For more, click here.

Colorado

 

– Elderly, Blind & Disabled Waiver: Under Colorado Medicaid, the EBD waiver is for eligible people who would be at risk of moving into a nursing home. EBD waivers include the option for Consumer Directed Care, meaning recipients have more flexibility on who can provide home upgrades. For more, including how to apply, click here.
Connecticut

 

– Community First Choice (CFC) waiver: Connecticut Medicaid’s Community First Choice waiver allows for consumer directed care and does not have a waiting list. The benefits include home modifications up to $10,000. For more, click here.

– Connecticut Home Care Program for Elders (CHCPE): For adults over 65 who are at risk of nursing home placement, and qualify for Medicaid, the CHCPE is an HCBS waiver with benefits including assistive technology and minor home modifications. For more, click here.

Delaware

 

– Diamond State Health Plan Plus: DSHP-Plus, managed under Delaware Medicaid, offers a number of benefits to Delaware seniors who qualify, including home modifications up to $10,000 per year. For more, click here.
District of Columbia

 

– Elderly and Persons with Disabilities Waiver: This HCBS waiver is available to eligible Washington D.C. residents who want to stay in their homes, with benefits including “environmental accessibility adaptations” (meaning home modifications). For more, click here.
Florida – Statewide Medicaid Managed Care Long-Term Care (SMMC LTC): Florida Medicaid’s program to help those who need long-term care support is area-specific, so providers vary depending where your loved one lives, but the benefits covered include home modifications. For more, click here.
Idaho

 

– Aged & Disabled (AD) waiver: This Idaho Medicaid HCBS waiver for people at risk of nursing home placement offers flexibility with consumer directed care, and benefits for eligible recipients include home modifications. For more, click here.
Indiana

 

– Aged and Disabled (A&D) Medicaid Waiver: This waiver under Indiana Medicaid provides recipients with a home modification assessment and the home modifications themselves. A&D waivers can be self-directed, for flexibility to hire a preferred provider. For more, click here.
Iowa

 

– Iowa Medicaid Home and Community Based Services (HCBS) Elderly waiver: Residents who need a nursing home level of care can receive benefits including home and vehicle modifications. The consumer directed care option offers flexibility for who provides these services. For more, click here.
Kansas

 

– KanCare HCBS Frail Elderly waiver: Kansas Medicaid (KanCare) offers an HCBS waiver for recipients who need nursing-level care. Benefits include home modifications for better accessibility. Consumer directed care is an option under this program. For more, click here.
Kentucky

 

– Home and Community Based waiver: Kentucky Medicaid’s Home and Community Based waiver is for residents who need nursing-level care. Services paid for under this waiver include “environmental and minor home adaptation.” For more, click here.
Louisiana

 

– Community Choices Waiver: This waiver under Louisiana Medicaid is intended to keep someone in their own home rather than moving into a nursing home, and benefits include assistive technology and home modifications. For more, click here.
Maine

 

– Elderly and Adults with Disabilities waiver: Maine Medicaid (MaineCare) offers this HCBS waiver for people who need nursing-level care. Self direction is an option under this waiver, and benefits include an environmental assessment and home modifications. For more, click here.
Maryland

 

– Home and Community Based Options Waiver: Maryland Medicaid’s HCBO waiver (also called the Living At Home waiver) is for residents who need nursing-level care, and benefits include home modifications. For more, click here.

– Community First Choice: CFC is another Maryland Medicaid waiver for people who might need nursing care but want to stay at home. Benefits include assistive technology and accessibility adaptations (meaning home modifications). For more, click here.

Massachusetts

 

– Frail Elder waiver: Massachusetts Medicaid (MassHealth) offers an HCBS waiver for eligible people who need nursing-level care but want to stay living at home, with benefits including a home environmental assessment and home modifications. For more, click here.

– Moving Forward Plan waivers: Another MassHealth program of HCBS waivers for people who need nursing-level care, similar to the Frail Elder waiver above, MFP waivers offer benefits including home accessibility adaptations. For more, click here.

Michigan

 

– MI Choice waiver: Self-directed care is an option under the Michigan Choice Medicaid Waiver program, so there is some flexibility in choosing providers. Benefits include home and vehicle modifications for people at risk of nursing home placement. For more, click here.

– Michigan Health Link: Intended to keep recipients in their own homes, Michigan Medicaid’s Health Link waiver provides coverage for assistive technology and home modifications to people who are eligible for both Medicaid and Medicare. This waiver is area-specific, and residents in certain counties in Michigan are not covered. For more, click here.

Minnesota

 

– Elderly Waiver: Minnesota Medicaid’s Elderly Waiver is an HCBS waiver for people who need nursing-home level care but want to stay home, with benefits including home and vehicle modifications. Consumer direction is an option under this waiver. For more, click here.

– Consumer Support Grants: Minnesota Medicaid’s Consumer Support Grants are a special program offering grant funds to eligible recipients who can self-direct their care. Among the benefits the money can be spent on are home and vehicle modifications. For more, click here.

Mississippi

 

– Independent Living (IL) Waiver: For people who might otherwise need to move into a nursing home, IL waivers (also called HCBS waivers) under Mississippi Medicaid offer benefits including home modifications and specialized medical equipment. For more, click here.
Montana

 

– Big Sky Medicaid Waiver: This HSBC waiver under Montana Medicaid is for those who need nursing-level care, and offers benefits including home modifications. Recipients may self-direct their care. For more, click here.
Nebraska

 

– Aged and Disabled Waiver: Designed to keep someone who needs nursing-level care in their own home, this HCBS waiver available under Nebraska Medicaid offers home and vehicle modifications among its benefits. For more, click here.
Nevada

 

– Home and Community Based Waiver for Persons with Physical Disabilities (HCBW-PD): Provided by Nevada Medicaid for people who need nursing-level care, this waiver has flexibility under consumer direction and can be used to pay for home modifications. For more, click here.
New Hampshire

 

– Choices For Independence: The New Hampshire Medicaid Choices for Independence waiver is an HCBS program for people who need nursing-home level care but want to stay at home. Benefits include home and vehicle modifications. For more, click here.
New Jersey

 

– Managed Long Term Services and Supports (MLTSS): New Jersey Medicaid’s NJ FamilyCare program provides services through MLTSS to people who want to stay at home despite needing nursing-level care. Benefits including home and vehicle modifications. For more, click here.
New Mexico

 

– Centennial Care Community Benefit: New Mexico Medicaid is called Centennial Care, and the program that provides home and vehicle modifications to people who might need nursing care, but want to live at home, is called Community Benefit. For more, click here.
New York

 

– Managed Long Term Care (MLTC) waiver: New York Medicaid’s MLTC waiver is an HCBS waiver that helps people who might need nursing-level care stay in their homes. Among the benefits are home modifications. For more, click here.
North Carolina

 

– Community Alternative Program for Disabled Adults (CAP/DA): North Carolina’s HCBS waiver CAP/DA is meant to help residents avoid moving into a nursing home, and among the benefits are assistive technology and minor home modifications. For more, click here.
North Dakota

 

– Home and Community Based Services (HCBS) waiver: North Dakota’s HCBS waiver program (also called the Aged and Disabled waiver) is designed to help people who require nursing-level care but want to stay in their own homes. Consumer direction gives recipients flexibility for how they select providers, and limited environmental home modifications are among the benefits. For more, click here.
Ohio

 

– MyCare Ohio Plan: For people who are enrolled in both Medicare and Medicaid, the MyCare Ohio Plan (MCOP), or Integrated Care Delivery System (ICDS), covers costs including home modifications. Self-directed care is an option under this program, but unfortunately it is not available in every county in Ohio. For more, click here.

– PASSPORT waiver: This Ohio Medicaid waiver (Pre-Admission Screening System Providing Options and Resources Today) is for people who need nursing-level care but want to live at home. Self-directed care is an option with this waiver, and benefits include home modifications. For more, click here.

Oklahoma

 

– Oklahoma ADvantage: This Oklahoma Medicaid waiver is for seniors who need nursing-level care but want to remain at home. Self direction is an option through the associated program Consumer-Directed Personal Assistance Services and Supports (CD-PASS). Home modifications are among the many services covered by ADvantage. For more, click here.
Oregon

 

– Oregon K Plan: Also known as the Community First Choice (CFC) Option, Oregon Medicaid’s K Plan is not a waiver, and anyone who is eligible receives services including home modifications up to $5,000. For more, click here.
Pennsylvania

 

– Services My Way (SMW): Pennsylvania SMW recipients receive benefits through a Cash & Counseling model that lets them self-direct care and services including home modifications. A nursing-home level of care must be required. For more, click here.

– Community HealthChoices (CHC): This Pennsylvania Medicaid program provides benefits for eligible people who need nursing-level care but want to stay at home. Among the costs covered are assistive technology and home and vehicle modifications. For more, click here.

Rhode Island

 

– Global Consumer Choice Compact Waiver: This Rhode Island Medicaid waiver is for people who need nursing-level care but want to stay in their homes. Self direction is an option, and benefits include vehicle and home modifications. This waiver combines others that were previously available, including the Personal Choice Program (PCP). For more, click here.
South Carolina

 

– Community Choices Waiver: Also called the Elderly and Disabled Waiver, this program under SC Medicaid (also called Healthy Connections) is for those who need nursing care but want to live at home. Among the benefits is coverage for home modifications. For more, click here.
South Dakota

 

– HOPE waiver: South Carolina Medicaid’s HOPE waiver (for Home and Community-Based Options and Person-Centered Excellence) is for people who need full-time nursing care but want to remain at home. Home modifications are among the benefits. For more, click here.
Tennessee

 

– TennCare CHOICES: This Tennessee Medicaid program is for people who are at risk of needing to move into a nursing home. Assistive technology and home modifications up to $15,000 are among the benefits. For more, click here.
Texas

 

– STAR+PLUS: Texas Medicaid’s STAR+PLUS waiver helps nursing-home eligible recipients stay in their own homes by offering benefits including coverage for environmental adaptive aids and home modifications. For more, click here.
Utah

 

– Utah Medicaid Aging Waiver: Utah’s Home and Community Based Services (HCBS) waiver is for people who need a high level of care but want to remain at home. It allows for consumer direction, and benefits include home modifications and durable medical equipment. For more, click here.

– New Choices Waiver (NCW): This Utah Medicaid waiver covers needs, including home modifications, for people who want to move out of a nursing home and back into their own place of residence. For more, click here.

Vermont

 

– Global Commitment to Health waiver: This waiver program under Vermont Medicaid (known as Green Mountain Care) is for people who might need nursing-level care but want to stay at home. Assistive technology and home modifications are among the benefits. For more, click here.

– Choices For Care Moderate Needs Group: Available for Medicaid and non-Medicaid residents in Vermont who need nursing care but want to stay home, CFC MNG offers funds for a variety of services including home modifications. For more, click here.

Virginia

 

– Commonwealth Coordinated Care Plus (CCC+): Virginia’s CCC Plus is an HCBS Medicaid waiver that merges the state’s previous waiver programs for disabled and aged older adults (Assisted Technology and the Elderly or Disabled with Consumer Direction) into one benefits package that covers costs including home and vehicle modifications valued at up to $5,000. For more, click here.
Washington

 

– New Freedom waiver: For people in King and Pierce counties who need nursing-level care but want to live at home, the New Freedom (NF) Medicaid waiver provides a budget to cover costs including home and vehicle modifications. For more, click here.

– Washington Medicaid Alternative Care (MAC): Designed to help caregivers who serve the elderly in private homes, Washington Medicaid’s MAC program provides benefits including home modifications and basic repairs, as well as assistive technology. For more, click here.

– COPES Medicaid waiver: Washington Medicaid’s Community Options Program Entry System (COPES) waiver is for people who need services to stay in their home rather than move into a nursing home. Benefits include home and vehicle modifications. For more, click here.

Wisconsin

 

– Include, Respect, I Self-Direct (IRIS) Medicaid waiver: IRIS is a Home and Community Based Services waiver under Wisconsin Medicaid for eligible residents who need nursing-home care but want to stay living in their own homes. Consumer direction is part of the IRIS waiver, and benefits include assistive technology and home modifications. For more, click here.

– Family Care: The Wisconsin Medicaid Family Care and Family Care Partnership managed-care programs are designed to help people who need high-level care stay in their homes. Benefits are self-directed and can include assistive technology and home modifications. For more, click here.

 

Eligibility Requirements for Medicaid Home Modifications

The eligibility criteria for home modifications depends on the specific Medicaid program under which the benefit is offered. In addition, eligibility is state-specific, and application specific. To learn the specific eligibility criteria for any Medicaid program, use our Medicaid Eligibility Requirements Finder.

For home modifications specifically, in additional to being financially and medically eligible for the Medicaid program through which home modifications are offered, they will be an additional requirement that the individual must have a specific need for the modification that is being requested. In many cases, Medicaid-funded, home modifications are approved on a case-by-case basis.