Home Care in West Virginia

According to the Genworth 2021 Cost of Care Survey, you can expect to pay an average of $3,527 per month in West Virginia. This price includes help with your activities of daily living, personal care and companionship plus other nonclinical services. Home health care, which provides skilled nursing services, costs a bit more at $3,575.

At just $3,527 per month, home care in West Virginia is cheaper than all other surrounding states by approximately $1,400, making it a great option for budget-minded seniors. Both Pennsylvania and Ohio are tied with the national average of $4,957. Virginia and Kentucky are slightly cheaper with prices averaging $4,767.

Home health care prices are very low as well. West Virginia’s average is $3,575, $1,573 less than the national average of $5,148. Pennsylvania and Virginia have similar prices of $4,957 and $4,954, respectively. In Ohio, home health care costs $5,053, and in Kentucky, prices average $4,767.

If you haven’t decided whether home care is right for you, there are a few other options to choose from. Adult day care centers operate during normal business hours and are the cheapest choice at $1,083 monthly. Assisted living costs $4,160 and provides 24/7 supervision in a community-based setting. Nursing homes offer the highest level of supervision along with medical services, but it’s the most expensive solution, averaging $11,619 for a semiprivate room.

In West Virginia, regular Medicaid pays for in-home personal care and nonmedical supportive services to help seniors remain in their homes. The state also covers home care through two Medicaid programs: the Aged and Disabled Waiver and the Personal Care Program. For both programs, you’ll need to demonstrate medical and financial need to qualify.

Medicaid Aged and Disabled Waiver

The Medicaid Aged and Disabled Waiver provides community services and in-home care for people who meet financial and medical eligibility requirements. If accepted, you’ll work with a case management agency to develop a care plan based on your needs and preferences. You’ll also receive a monthly stipend that can be used to hire caregivers and purchase services of your choice. The program provides assistance with personal care, environmental maintenance and nutritional support as well as transportation to activities and services in your community.

To qualify for the Aged and Disabled Waiver, you’ll need to:

• Be certified for a nursing home level of care
• Be able to safely receive needed services in your home
• Receive a functional assessment by a medical professional
• Meet financial criteria as determined by the Department of Health and Human Services

To apply, you’ll need to complete a Medical Necessity Evaluation Request with your physician. You can fax the form to (866) 212-5053 or mail it to the following address:

1007 Bullitt St., Suite 200
Charleston, WV 25301

Medicaid Personal Care Program

The Medicaid Personal Care Program provides hands-on, nonmedical services through direct-care staff who come to your home. You’ll receive help with personal hygiene, feeding, dressing, nutrition, light housekeeping, mobility and other needs. The program does not cover skilled nursing services, such as wound care, injections or medication administration.

To qualify, you will need to:

• Require help with at least three activities of daily living, such as grooming, bathing and dressing
• Be a Medicaid member with a current West Virginia State Medicaid card
• Meet financial and medical eligibility requirements

To apply, you and your physician must complete the Medical Necessity Evaluation Request form for the Personal Care program. Fax your application to (844) 794-6729, or mail it to the following address:

1007 Bullitt Street, Suite 200
Charleston, WV 25301

In West Virginia, the income limit for regular Medicaid is $10,080 per year ($841 per month) for one person and $15,132 annually ($1,261 per month) for a married couple. The state also has limits on the value of your assets, including investments, pension funds, checking accounts and real estate that isn’t your primary residence. The limit is $2,000 per single person and $3,000 per married couple.

You can apply for Medicaid via the West Virginia PATH portal. You’ll need to register for an account and complete a screening questionnaire before applying for services. Alternatively, print and complete a paper application, then mail it to your local DHHS field office, or visit an office to apply in person. To apply by phone, call (877) 716-1212.

What Information You Will Need

DHHS verifies all information on your application to determine your eligibility for Medicaid. You may be asked to provide:

• Financial information about income, assets, medical expenses and utility costs
• Information about Medicare or other health coverage you have
• A copy of your driver’s license or other government-issued ID
• Your Social Security number
• Information about other people in your household

How to Get Help Applying for Medicaid

If you need help navigating the West Virginia Medicaid application, there are a number of resources available to you. These programs and services will answer your questions and walk you through the application process at no cost to you.

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.

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.

If you’d like to live at home for as long as possible, you’ll find many useful resources and programs throughout West Virginia that can help. You could qualify for home-delivered meals, property tax relief, environmental modifications and other assistance that can make it easier for you to safely age in place.

On January 14, 2022, the Centers for Medicare & Medicaid Services (CMS) issued a memo to address COVID-19 vaccination requirements for home care workers in West Virginia. Per this memo, all home care employees who work for a Medicare- and/or Medicaid-certified provider are required to be fully vaccinated against SARS-CoV-2 unless exempt.

This rule doesn’t apply to agencies that aren’t Medicare- or Medicaid-certified, but each provider may have its own rules for vaccination. These regulations are current as of April 2022, but rules are subject to change, so consult your local Area Agency on Aging if you’re concerned about the vaccination status of workers entering your home.

In West Virginia, home care providers are regulated by the Department of Health & Human Resources. It also oversees home health care agencies that provide both clinical and nonclinical services. These regulations outline rules that providers must follow regarding care plans, medication administration, staff training and reporting abuse.

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 West Virginia’s Top Cities

• Boca Raton
• Bradenton
• Cape Coral
• Clearwater
• Delray Beach
• Jacksonville
• Kissimmee
• Melbourne
• Miami
• Miami-Dade County
• Naples
• Orlando
• Ormond Beach
• Pensacola
• Pompano Beach
• Sarasota
• Tampa
• The Villages
• West Palm Beach
• Winter Park