How to Get a Social Worker for Adults: Medicaid, Medicare, and Private

To get a social worker for an adult, the fastest route depends on the situation: dial 211 for a general referral to local services, call the Eldercare Locator at 1-800-677-1116 if the person is 60 or older, contact Adult Protective Services if you suspect abuse or neglect, ask the hospital’s social work department if the adult is a current patient, go through the local VA medical center for a veteran, or use Medicaid or Medicare to access case managers and licensed therapists. Each of these pathways is free to start, and most will assign a professional after a needs assessment.

Match the Type of Social Worker to the Situation

“Social worker” covers several jobs that barely overlap. Picking the right one saves weeks.

Case managers coordinate services for people dealing with aging, disability, or chronic illness. They assess needs, connect you with programs, and follow up.
Licensed clinical social workers (LCSWs) diagnose and treat mental health conditions through therapy. Medicare, Medicaid, and most private insurance cover their services.
Medical social workers work in hospitals and rehab facilities, arranging post-discharge care and helping families handle the non-medical side of illness. Federal rules expect hospitals to involve a registered nurse, social worker, or other qualified professional in discharge planning.¹
Adult Protective Services workers investigate reports of abuse, neglect, or exploitation of vulnerable adults and arrange emergency help.²

Someone with depression needs an LCSW. An 80-year-old who can’t manage daily tasks needs a case manager. A family worried an elder is being scammed needs APS. If the adult is being discharged from a hospital, ask the hospital directly.

When You’re Not Sure Where to Start: Dial 211

211 is a free national helpline that connects callers to a local referral specialist. The specialist searches a database of public and private health and human service agencies, matches the need to available programs, and either transfers the call or provides contact information. The service reaches about 99 percent of the U.S. population and operates in all 50 states, D.C., and Puerto Rico.³

The 211 operator won’t assign a social worker on the spot. What they will do is point you to the agency that will, which is exactly what you need if the situation involves several problems at once. One call can generate referrals for mental health care, housing help, and utility assistance together.

For an Adult Over 60: Eldercare Locator and the Area Agency on Aging

Adults 60 and older have a dedicated network funded by the Older Americans Act. Roughly 620 Area Agencies on Aging (AAAs) operate across the country. They provide or arrange case management, in-home supportive services, nutrition programs, transportation, legal assistance, and caregiver support.⁴ The case managers at these agencies do the work most people picture when they think of a social worker: home visit, assessment, care plan, referrals, and follow-up.

To find your local AAA, call the Eldercare Locator at 1-800-677-1116 or visit eldercare.acl.gov. The line is run by the Administration for Community Living and also helps with information on paying for care.⁵ You don’t need to be in crisis. The line exists to help before things become an emergency.

To Report Abuse, Neglect, or Financial Exploitation

Adult Protective Services handles cases where an adult is being harmed, neglected, or financially exploited. Under the Elder Justice Act, APS programs receive reports, investigate, develop case plans, and arrange medical, legal, housing, law enforcement, or other emergency services as needed.²

There is no single national APS number. Each state runs its own program, and some states route reports through county offices. To find the right number, call the Eldercare Locator at 1-800-677-1116 or check the Department of Justice’s Elder Justice Initiative online.⁶ For financial scams targeting older adults specifically, the National Elder Fraud Hotline is 1-833-372-8311.

Anyone can file a report. You don’t need proof, just a reasonable concern. APS investigates and, if the person needs protection, assigns a social worker to build a safety plan and connect them to ongoing services. If there is immediate danger, call 911 first.

For a Veteran

The Veterans Health Administration employs social workers as part of its care teams at VA medical facilities. VA social workers help veterans handle daily-life challenges and connect them to services. Post-9/11 veterans can request case management at any point during their care and receive it for as long as they need it.⁷

Contact your nearest VA medical center and ask for the social work department. If you don’t know where to start, the main VA health benefits line at 1-877-222-8387 can locate services. Veterans transitioning from active duty may also meet with a VA Liaison who explains VA healthcare benefits and helps plan the move into VA care.

Through Medicaid: Case Management and Home-Based Services

Medicaid is the largest funder of long-term services for adults with low income and significant care needs. Several Medicaid mechanisms put a social worker or case manager on your team.

Home and Community-Based Services Waivers

States can operate HCBS waivers that pay for care in the home or community instead of in a nursing facility. These waivers cover case management, personal care aides, homemaker services, adult day programs, respite care, and other supports.⁸ To qualify, a person generally must need the level of care that a nursing facility provides and meet the state’s Medicaid financial rules. Each state runs its own waivers, so the services, eligibility, and application process vary. Your state Medicaid office or local AAA can tell you which waivers exist and whether you qualify. Waiting lists are common, so apply early.

Targeted Case Management

Federal law also allows states to offer case management as a standard Medicaid benefit outside a waiver. Under this authority, case management means services that help eligible people gain access to needed medical, social, educational, and other services, including needs assessment, care planning, and referral.⁹ States often target this benefit to specific populations such as people with chronic mental illness or developmental disabilities.

Self-Directed Services and Supports Brokers

Some Medicaid programs let participants direct their own care: hire their own aides, set the schedule, and control how the Medicaid budget is spent. Every person who chooses self-direction has access to a supports broker or consultant, a professional who functions like a social worker, helping identify staff and resources and serving as a liaison to the program.¹⁰ The supports broker takes direction from you, not the program.

Through Medicare: A Clinical Social Worker for Mental Health

Medicare Part B covers outpatient mental health services from licensed clinical social workers. Under federal law, “clinical social worker services” means services for the diagnosis and treatment of mental illness performed by a clinical social worker authorized to practice under state law.¹¹ Covered services include individual and group psychotherapy, plus family counseling when the main purpose is to support the patient’s treatment.¹²

After the Part B deductible, you pay 20 percent of the Medicare-approved amount per visit.¹³ Annual depression screenings cost nothing when the provider accepts assignment.¹² A Medigap or Medicare Advantage plan may lower your share further.

One boundary matters here. Medicare covers LCSWs for mental health treatment, not the case management or care coordination that a non-clinical social worker provides. For that kind of help, older adults on Medicare typically go through the Area Agency on Aging, or through Medicaid if they qualify for both.

Hiring a Social Worker Privately

When public programs don’t fit because of wait lists, eligibility gaps, or a preference for more personal attention, private practitioners are an option. The two most common are LCSWs in private therapy practice and geriatric care managers, now formally called Aging Life Care Professionals.

For therapy, LCSWs in private practice accept most insurance, including Medicare and Medicaid in many states. Find one through your insurance company’s provider directory, a referral from your primary care doctor, or your state’s license verification database.

Geriatric care managers handle the non-therapy side: assessing an older adult’s living situation, coordinating medical care, managing transitions between settings, and overseeing in-home aides. They typically hold degrees in social work, nursing, or gerontology. Initial assessments commonly run between several hundred and two thousand dollars, with hourly rates that vary by region and complexity. The Aging Life Care Association maintains a searchable directory at aginglifecare.org.¹⁴ Most private geriatric care management is not covered by insurance, so plan to pay out of pocket.

What Happens at the First Meeting

Whatever pathway you use, the process almost always starts with a needs assessment. A social worker or case manager talks with the adult, and with family if the adult wants them there, about daily life: what they can handle alone, where they’re struggling, what their goals are, and what supports already exist. The conversation looks for strengths as well as gaps.

For Medicaid case management, federal law spells out what the assessment must do: identify medical, social, educational, and other service needs and produce a care plan with concrete goals and actions.⁹ HCBS waiver services must follow an individualized and person-centered plan of care.⁸ The person receiving services is supposed to drive the plan.

After the plan is set, the case manager arranges services, checks in periodically, and revises the plan as things change. If an aide isn’t showing up, the day program isn’t working, or health shifts, tell the case manager. The plan evolves with the person.

If You’re Denied Services or Put on a Waiting List

A denial doesn’t end the conversation. If a government agency denies a request for services, you have the right to ask for the reason in writing. Medicaid and Social Security programs run formal appeal processes, and the denial letter itself explains how to challenge the decision. Social Security offers several appeal levels and lets you have an attorney or other qualified person help at any stage.¹⁵

For aging services through an AAA, ask to speak with a supervisor if the assessment missed something. Bring documentation: medical records, a letter from the doctor, a list of daily tasks the adult can no longer manage safely. Agencies have limited funding and often prioritize the most urgent cases, and a well-documented request is harder to dismiss. If the problem is a Medicaid waiver wait list rather than a denial, ask to be placed on the list immediately and ask about interim services that may be available while waiting.

Quick Reference: Numbers to Call

211: free referral to local social services in all 50 states, D.C., and Puerto Rico.³
Eldercare Locator, 1-800-677-1116: connects adults 60 and older with Area Agencies on Aging. Website: eldercare.acl.gov.¹⁶
Adult Protective Services: no national number; call the Eldercare Locator or your state’s APS line to report abuse, neglect, or exploitation.
National Elder Fraud Hotline, 1-833-372-8311: financial scams and exploitation of older adults.⁶
VA Health Benefits, 1-877-222-8387: for veterans seeking social work or case management through the VA.
State Medicaid office: for HCBS waivers and case management, through the state’s health and human services website.
988 Suicide and Crisis Lifeline: call or text for an immediate mental health crisis.

1
Centers for Medicare & Medicaid Services. Hospital Discharge Planning Worksheet
2
Social Security Administration. Social Security Act Section 2011
3
Federal Communications Commission. Dial 211 for Essential Community Services
4
Office of the Law Revision Counsel. 42 USC 3026 – Area Plans
5
National Institute on Aging. Services for Older Adults Living at Home
6
U.S. Department of Justice. Find Help or Report Abuse
7
U.S. Department of Veterans Affairs. Care Management and Social Work
8
Medicaid.gov. Home and Community-Based Services 1915(c)
9
Office of the Law Revision Counsel. 42 USC 1396n – Compliance With State Plan or Waiver Provisions
10
Medicaid.gov. Self-Directed Services
11
Office of the Law Revision Counsel. 42 USC 1395x – Definitions
12
Medicare.gov. Mental Health Care (Outpatient)
13
Medicare.gov. Medicare and You 2026
14
Aging Life Care Association. ALCA Find an Expert
15
Social Security Administration. Appeal a Decision We Made
16
Eldercare Locator. Eldercare Locator Home