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My friend needs 24 hour aides.

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Medicaid does pay for in-home care, but not generally 24 hours. At that point it is more cost-effective for them to pay for a care center. Is your friend on Medicaid? If so, the case manager can explain options to your friend, and you can be present.
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Yes, Medicade will pay for home health. You might want to check Assisted Living, it's not a nursing home, but has staff that will help your friend with daily needs.
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