83% of Boomers Want Care at Home. The 34-Month Medicaid Wait She Read About May Not Even Apply to the List She’s On
She put her name on a Medicaid home care waiting list years ago and told her family the plan was set, but the list she joined may have no idea she exists yet, and the clock she thinks is running…
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Consider a retired schoolteacher in her seventies. Years before she expects to need help bathing, cooking or managing her pills, she puts her name on her state’s Medicaid home care waiting list. Over Sunday dinner, she tells her kids she’s “on the list.” In her mind, that settles it. Nobody has looked at her bank statements, and nobody has checked whether she needs care. She read that the wait runs 34 months, so she figures her time is already running.
Plenty of people share her goal. The insurer’s annual survey studies how Americans plan their finances. In its 2026 Planning and Progress Study, Northwestern Mutual found that 83% of Boomers would prefer in-home care if a health event required long-term support. The problem is that the list she’s on may be a different kind of list from the ones behind that 34-month figure.
Medicaid’s Home Care “Waiting List” Can Mean 2 Different Things
Medicaid is the program run by Washington and the states that pays long-term care bills for people with limited income and assets. Medicare is different. Most people get this health coverage from the federal government at 65, and it doesn’t pay for ongoing custodial help at home. Families mix the two up all the time, and that confusion is exactly what leads to plans like hers.
States often provide specialized Medicaid home care through waivers, programs that can cap how many people receive services. When more people want a waiver than there are open slots, a waiting or interest list can form.
KFF, the health policy research group, surveys state Medicaid officials every year about these home care programs and finds that some waiting lists include only people the state has already found eligible. Others include people whose eligibility nobody has determined, and some states call those interest lists or referral lists, which share a name but mean very different things.
Why the 34-Month Average Can Mislead
KFF reports that people on waiting or interest lists who eventually got services in 2026 had waited 34 months on average. That one national number combines both kinds of lists.
The split between them is big. In 2026, 32 states screened people for eligibility on at least one waiver list. Eight states (Alaska, Florida, Iowa, New Mexico, Oklahoma, Oregon, South Carolina and Texas) screened no one on any list, yet those eight states accounted for 56% of everyone waiting nationwide. In other words, more than half of the people on the lists lived in states where getting on one did not mean anyone had established their eligibility.
The average has one more catch. Most people on these lists are waiting for programs that serve people with intellectual or developmental disabilities. That makes the 34-month national average a shaky guide to how long an older adult like her might actually wait.
Getting to the Top of an Interest List Only Starts the Real Process
On an unscreened list, hearing her name called is just the starting gun. Only then might she face the full financial application. She may also need a level-of-care assessment to show she needs the kind of help the program covers, and possibly a spend-down of savings to get under her state’s limits.
If her income or assets turn out to be too high, reaching the top of the list still doesn’t guarantee services. Her years in line may have moved her closer to an opening without settling whether she can actually take it. Her family may also find that her house, her IRA or a recent gift to a grandchild matters in ways nobody had looked at.
A screened list works differently. The state has already put her through some form of eligibility review before adding her, so her place on the list carries more weight. The family also has a better chance of learning about eligibility problems before her name reaches the top.
2 Questions Worth Getting in Writing
Families can clear this up by putting two questions to the state Medicaid agency or the office that runs the waiver:
- Is this a screened waiting list or an unscreened interest list?
- Has anyone reviewed her finances or her care needs yet?
If the answers are “unscreened” and “no,” the family knows her place on the list isn’t an approval for services. The real work of gathering financial records and finding out the state’s rules still lies ahead. Getting those answers in an email or letter helps, because a friendly phone call won’t count for much when her name comes up years from now.
Timing matters too. A parent who’s healthy today has room to sort out paperwork, records and family decisions calmly. Once she’s had a fall or a hospital stay, that same work gets done in a hurry.
Starting in 2027, States Have to Show Their Work
More transparency is on the way. KFF notes that starting in 2027, states will have to report whether the people on their waiting lists have been screened for eligibility. That should make the national numbers easier to read.
Until then, being on the list can feel like a plan. For her family, the question that matters most is whether the list knows anything about her yet.
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Gerelyn Terzo is the author of dividend investing handbook "Dividend Investing Strategies: How to Have Your Cake & Eat It Too." A veteran financial journalist, she covers agri-finance for outlets like Global AgInvesting and the broader stock market and personal finance for 24/7 Wall Street. She began at CNBC and later helped launch Fox Business in New York. Gerelyn currently resides in Woodland Park, Colorado and dabbles in nature photography as a hobby.
