TABLE OF CONTENTS
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.
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 Health 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.
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.
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.
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.
You must also meet other requirements for Medicaid, including:
Virginia provides several options for residents interested in applying for Medicaid.
What Information You Will Need
To qualify for Medicaid, you will also need to supply the following with your application:
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.
|Cover Virginia Call Center
|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
|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
|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.
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:
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.
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.
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.
|Virginia Energy Assistance Program
|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 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
|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)
|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 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.
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.
|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.
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.