I. What You Should Expect to Pay for Home Care in Virginia

In Virginia, seniors pay an average of $4,767 per month for in-home care and $4,954 per month for home health care, according to the 2021 Genworth Cost of Care Survey. It’s important to understand the differences between in-home care and home health care when comparing costs. In-home care usually refers to light housekeeping, personal care and assistance with activities of daily living. Home health services are more complex and must be performed by a nurse or other licensed health professional.

The Cost of Home Care and Home Health Care in Nearby States

Virginia has home care costs below the national average, but it’s one of the most expensive states in the region. Maryland has slightly higher prices, with a monthly average of $5,148 for both care types. With average monthly costs of $4,767 for both care types, Kentucky is right in line with Virginia. North Carolina is slightly less expensive, as both care types have average monthly costs of $4,385. West Virginia has the lowest prices — $3,527 per month for in-home care and $3,575 for home health services. The national average is $4,957 for in-home care and $5,148 for home health care.

Home Care Home Health Care
Virginia $4,767 $4,954
National $4,957 $5,148
Maryland $5,148 $5,148
West Virginia $3,527 $3,527
North Carolina $4,385 $4,385
Kentucky $4,767 $4,767

The Cost of Home Care vs. Other Types of Care

Virginia has several options for senior care, including home care, nursing home care, assisted living and adult day care. With average monthly costs of $8,213, nursing home care is the most expensive, followed by assisted living at an average of $5,250 per month. The only option more affordable than home care is adult day care, which has an average monthly cost of $1,690.

II. Can Medicaid Help You Pay for Home Care in Virginia?

Virginia’s traditional Medicaid program provides limited coverage for home health care. For service coverage, it must be considered medically necessary. That means you must use the service to treat a specific condition. Virginia Medicaid doesn’t cover in-home care directly, but the state has a Medicaid waiver program that may cover in-home care for seniors who need it.

Home Care Waiver Programs in Virginia

Commonwealth Coordinated Care Plus (CCC Plus) Waiver

The CCC Plus Waiver program covers services provided in homes and community settings, allowing eligible enrollees to avoid moving to nursing homes and other institutions. This waiver combines the features of three previous Medicaid waivers, giving participants access to home care services, assistive technology, care coordination and more. Depending on the participant’s needs, the CCC Plus Waiver may cover personal care, private-duty nursing, adult day care, home modifications and other services to help them maintain their independence and prevent health-related complications.

To qualify for the CCC Plus Waiver, an applicant must be at least 65 years old and have a demonstrated medical need. Eligible Medicaid participants should contact a local Virginia Department of Social Services office to inquire about transitioning to the CCC Plus Waiver program.

How to Know if You're Eligible for Medicaid in Virginia

Virginia has limited funding available for its Medicaid program, limiting enrollment to residents who meet stringent financial eligibility criteria. For 2022, individual applicants must not exceed $10,872 per year in income. The income limit for married couples is a bit higher: $14,652 per year. Medicaid enrollees must also demonstrate that they have limited financial resources. The 2022 asset limit is $2,000 for individuals and $3,000 for married couples; Medicaid doesn’t count personal property, one vehicle, home furnishings and the applicant’s primary residence toward this limit.

2022 Medicaid Income Limits for Seniors in Virginia
Income Limits* Asset Limits
Single Person $10,872 $2,000
Two-Person Household $14,652 $3,000

*Per year

You must also meet other requirements for Medicaid, including:

  • Virginia residency
  • U.S. citizenship, permanent residency, U.S. national or legal alien

How to Apply for Medicaid in Virginia

Virginia provides several options for residents interested in applying for Medicaid.

  • Online: Use the CommonHelp website to fill out an online application
  • By mail/in person: Download the Medicaid application online and mail or drop off completed applications to a local Department of Social Services office
  • Phone: Call (833) 522-5582; the Cover Virginia Call Center is open weekdays from 8 a.m. to 7 p.m. and Saturdays from 9 a.m. to noon

What Information You Will Need

To qualify for Medicaid, you will also need to supply the following with your application:

  • Proof of residency
  • Proof of citizenship
  • Income documents, such as pay stubs, W-2s and tax returns
  • Financial documents, such as bank statements
  • Current insurance policy number

How to Get Help Applying for Medicaid

If you need help filling out your Medicaid application or have questions about your eligibility, consult one of the resources below.

Contact Area Served Services Provided
Cover Virginia Call Center (833) 522-5582 Entire State Cover Virginia has trained staff members on hand six days a week to answer questions and help residents complete the Medicaid application process.
Legal Services of Northern Virginia (703) 778-6800 Northern Virginia (Arlington, Loudon, Fairfax and Prince William Counties) Legal Services of North Virginia provides free legal assistance to residents of four Virginia counties, along with the cities of Alexandria, Leesburg, Manassas and Falls Church. Experienced volunteers are available to answer questions about Medicaid denials or help current enrollees resolve problems related to their Medicaid services.
Virginia Health Care Foundation Medicaid Application Assistance Contact local application assistance site Entire State The Virginia Health Care Foundation operates Project Connect, a program that gives participants access to free one-on-one Medicaid application assistance. Help is available in both English and Spanish.

III. Can You Use Medicare to Pay for Home Care in Virginia?

Medicare doesn’t pay for non-medical home care, but it can cover the cost of the medical version of home care, called “Home Healthcare” in some situations. In order to be eligible, you need to be homebound and have a referral from your doctor for the specific type of medical care that is needed. There are also other restrictions that apply.

Below is an overview of some of the services typically covered by Medicare for those who are eligible:

  • Physical Therapy: Physical therapy is used to help patients recover from injuries (broken bones, knee injuries, etc.), and to treat ongoing conditions such as arthritis. Additionally, physical therapy is often provided in the home to help seniors recover from surgeries and procedures, such as a knee or hip replacement.
  • Nursing Care: Licensed nurses can provide a number of medical services (such as wound care, changing feeding tubes, etc.) for those who need medical care, but don’t need to stay in a hospital full-time.
  • Occupational Therapy: Occupational therapy is designed to help seniors regain or maintain the ability to accomplish normal, daily tasks, such as bathing, dressing, eating, etc., and providers can travel to your home if needed.
  • Speech Therapy: Seniors can lose the ability to adequately communicate for many reasons, and speech therapists are there to help seniors regain the ability to communicate using a variety of means. Additionally, speech therapists help to keep seniors independent by modifying diets and teaching special techniques to swallow safely.

As mentioned above, home care is distinctly different from home healthcare, but there is some overlap – so while Medicare doesn’t cover non-medical home care, there are personal care services that may be covered in special circumstances – such as an occupational therapist helping with eating or dressing.

Read our guide to Medicare and Home Care Coverage for more information.

IV. Other Financial Assistance Options for Home Care in Virginia

While the above programs can be a great way to make home care affordable for many people, they are not the right solution for everyone. Thankfully, there are other ways to make home care more affordable for you and your family. For more information about your other options, read our section on Other Ways to Pay for this guide.

V. Free Resources for Aging in Place in Virginia

Medicaid helps Virginia seniors maintain their health and independence, but the state also has resources to help with legal issues, home energy and other matters. Consult the resources below if you need additional assistance to remain in your home.

Contact Area Served Services Provided
Virginia Energy Assistance Program (833) 829-2767 Entire State The Virginia Energy Assistance Program offers crisis, fuel and cooling assistance. Applicants may also qualify for weatherization assistance to increase energy efficiency and lower heating and cooling costs.
VALegalAid.org (866) 534-5243 Entire State VALegalAid.org connects consumers with free legal assistance from organizations located throughout Virginia. The site also has a self-help library, giving users access to accurate information on elder law, consumer law, debtors’ rights, housing and other legal issues.
Office for Aging Services (804) 662-9333 Entire State The Office for Aging Services works with Area Agencies on Aging, nonprofit organizations and other government agencies to help Virginia’s seniors live as independently as possible. Staff members may provide referrals for adult day care, case management, personal care and other services.
Emergency Home and Accessibility Repair Program (EHARP) (804) 371-7000 Entire State EHARP helps low-income Virginians by providing funds to make emergency repairs or modify homes to make them more accessible for disabled occupants. Recipients can use funds to install wheelchair ramps, replace unsafe plumbing components or address structural/electrical hazards.
Virginia Tax (804) 367-8031 Entire State Virginia Tax offers a homestead exemption, allowing eligible homeowners to exempt a certain amount of a home’s value from property taxes. Veterans living in Virginia may also qualify for additional tax benefits through Virginia Tax or county taxation agencies.


VI. Vaccination Requirements & COVID-19 Rules for Home Care Aides in Virginia

Any home health agency that works with clients on Medicaid or Medicare must comply with the COVID-19 vaccination rules established by the Centers for Medicare & Medicaid Services (CMS). Under the final mandate, which was issued on January 28, 2022, all covered agencies in Virginia must require full COVID-19 vaccination of their employees as of February 28, 2022. Personal attendants and other in-home care providers don’t have to comply with this rule.

The CMS rule is in effect as of April 2022, but it may update vaccination guidelines at any time. Your local Area Agency on Aging can provide up-to-date information on vaccine requirements for home care workers. Virginia residents should also know that home care agencies can implement requirements stricter than the ones imposed by CMS. If you have questions about vaccination or personal protection equipment (PPE) rules, contact your preferred agency for more information.

VII. Rules and Regulations for Home Care Providers in Virginia

The Virginia Department of Health enforces the requirements outlined in Chapter 381 of the Virginia Administrative Code, which covers home care organization licensing.

What Types of Care Can Be Provided? Home care agencies can offer a wide range of services to clients, including personal care, assistance with activities of daily living, meal preparation and light housekeeping. Licensed health professionals can provide services within their designated scope of practice. For example, a registered nurse may perform skilled nursing care in a client’s home.
Are Care Plans Required? Under Virginia law, a registered nurse must prepare a care plan for each client. The plan must include an overview of the patient’s health status, including any functional limitations or rehabilitation requirements. It should also contain a list of provided services.
Can Home Care Providers Assist with Medication Management? State law permits home care aides to remind clients to take their medications or assist with the self-administration of medications.
Are There Special Requirements for Screening Home Care Aides? Home care agencies must conduct a criminal background check within 30 days of a new employee’s hire date. Until the agency has completed the background check, the employee cannot have unsupervised contact with the agency’s clients.
Are Home Care Aides Required to Undergo Special Training? All home care aides must complete a nurse aide training program or pass the Virginia Nurse Aide Competency Test. All aides must also undergo annual training to refresh their knowledge and skills.
Does Medicaid Cover Home Care in Virginia? Yes. Traditional Medicaid covers home health services ordered by a health care professional and considered medically necessary to treat a specific health condition. Virginia’s CCC Plus Waiver pays for home health services, personal care and other types of home care to help seniors avoid living in institutional settings.
How Do I Report Abuse of Myself or a Loved One? Anyone who suspects that an older adult has experienced abuse should contact Adult Protective Services at (888) 832-3858.


VIII. How to Find a Home Care Provider in Virginia

Whether you are looking for yourself or a loved one, finding a quality home care provider can be a stressful process. To help you overcome this challenge, we’ve created a helpful checklist below that can help guide you through the process of both determining your needs, and finding a home care agency that will be the best fit for you and your family.

Download PDF Here

Learn More About Home Care in Virginia’s Top Cities