Does Iowa Pay for Home Health Care?

Iowa’s Medicaid program pays for home health care through the Home Health Services (HHS) Home and Community-Based Services (HCBS) waiver. It pays for up to five visits per week from skilled nursing professionals, 28 hours per week from a home health aide and visits as per medical need from social services personnel and relevant therapists. The care must be conducted by a Medicare-certified home health agency.

A senior deemed to have an appropriate medical need by a physician (who must then review the case every 60 days to determine if HHS is still necessary) is eligible for home health care. Since HHS is a Medicaid program, the senior must also satisfy Medicaid’s qualifying criteria. These include being a U.S. citizen (or legal resident) aged 65 and older who lives in Iowa and is medically in need of care.

Applicants must also satisfy financial guidelines. These vary greatly as there are many variables to consider, such as the differences between single and married applicants and if they have dependents. For example, a single applicant applying for HHS in 2023 can’t have an income exceeding $2,742 per month and countable assets of more than $2,000. Almost all income is counted, including Social Security, veterans benefits and pension payments. Countable assets include cash, stocks, bonds and real estate that isn’t the applicant’s primary home. Assets not counted include personal belongings and one car.

Seniors typically prefer receiving home health care services because they can remain in familiar surroundings and don’t have restricted visits from friends and family. Home health care is primarily a medical service, such as nurses applying injections and monitoring intravenous equipment, therapists conducting speech, occupational or physical treatments and physicians visiting as per need. It can also be a nonmedical service, with caregivers providing assistance during the senior’s recuperation period. This can include helping them with activities of daily living, such as bathing and dressing, but also attending to the home, including light housekeeping, shopping for groceries and other needs.

Nursing home care is typically restricted to seniors who require 24/7 supervision from medical professionals. Consequently, the senior will reside in a facility that has a greater range of medical equipment than can be installed in a person’s home. Staff will include registered and licensed nurses and the staff-to-resident ratio will be much smaller than other residential care options, such as assisted living. Rooms are homier than in a hospital, and some facilities allow residents to furnish them with personal belongings. Meals are served three times daily, either in a communal dining room or in the resident’s room, depending on their level of medical care.