Of these 17.4 million Medicaid enrollees, approximately 5 million receive LTSS through Medicaid.

Related to those preferences, they want to maintain their independence and have control over their own decisions.

The Medicaid program is the largest payer for LTSS, covering 51 percent of national LTSS expenses in 2013.

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Importantly, HCBS are not only the preference of most people, they are cost-effective.

That decision is now pending appeal.

It assessed familiarity, satisfaction, and plan switching.

Health care provider and patient

Mature couple working on family finances at home together. They pay bills, complete income taxes, apply for home loan, investing, or pay off a credit card.

![The mid adult female doctor and her senior adult male patient discuss the home healthcare options listed in the brochure.](https://cdn.aarp.net/content/dam/aarpe/en/home/pri/topics/health/coverage-access/stretching-the-medicaid-dollar/_jcr_content/root/container_main/container_body_main/container_body1/container_body_cf/container_additional_1/container_2123475527/featuredlist/tabItem/eliminating-access-no-cost-preventive-health-services-affect-older-adults3.coreimg.75.932.jpeg/content/dam/aarp/ppi/topics/health/coverage-access/no-cost preventive-health-services-report.jpg)

Navigating the Medicare Coverage Maze: Challenges and Policy Solutions

Woman doing online research