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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.
|Home Health Care
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:
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:
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:
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.
|West Virginia State Health Insurance Assistance Program (SHIP)
|SHIP is a statewide program that provides information about various Medicaid benefits, Medicare plans and other reduced-fee health care programs for people of limited financial means. Contact your County Aging Provider or Aging and Disability Center to find a counselor near you.
|Department of Health and Human Services
|Contact the Department of Health and Human Services if you have questions about Medicaid enrollment, waiver programs or what to expect after you apply. You can also call this number if you need to change information on your application after you’ve submitted it.
|Legal Aid of West Virginia
|Through this organization, seniors can get help with applications, denials and appeals for Medicaid and other kinds of government benefits. Residents must be low-income to qualify for free legal aid.
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.
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.
|Provided by the West Virginia Bureau of Senior Services, Lighthouse is an in-home care program for people who don’t qualify for Medicaid due to income or assets. Services you can get include personal care, light housekeeping, mobility assistance, grocery shopping and meal preparation. You can receive up to 60 hours of care per month depending on your needs. To qualify, you must be aged 60+, medically eligible and financially eligible according to a sliding-fee schedule.
|Area Agencies on Aging
|West Virginia has four Area Agencies on Aging to serve the needs of older adults. The AAAs administer Take Me Home, a program that helps seniors transition from a nursing home, hospital or assisted living facility back to their own home. Other services may include rent assistance, emergency utility bill payments, benefits counseling, transportation and adult day care.
|Meals on Wheels
|This program provides hot and nutritious home-delivered meals up to five days per week. To qualify, you must be unable to cook your own food or to leave your home to have meals in a congregate setting. You must also not have anyone else available to prepare food for you. Meals could be low-cost or free depending on income.
|Property Tax Exemptions
|West Virginia offers a $20,000 exemption on the assessed value of property for homeowners who are 65+ and/or totally blind or disabled. To qualify, the property must be your primary residence. You must also have been a resident of West Virginia for at least two consecutive years prior to your application and lived in the residence for at least six months.
|West Virginia Weatherization Assistance Program
|WAP helps low-income households reduce their utility bills by providing modifications to improve their home’s energy efficiency. Improvements can include maintenance of HVAC systems, insulation of attics and walls, furnace repairs and weatherstripping for windows and doors. Your household income must be lower than the maximum amount to qualify.
|Appalachia Service Project
|The Appalachia Service Project performs free home repairs for families with limited financial means. Seniors can request repairs to roofs, siding, drywall, floors and any other areas of the home. Volunteers can also build wheelchair ramps, handrails and other modifications to help make your home safer to navigate.
|West Virginia Free Legal Answers
|Offered by the American Bar Association, this service provides free virtual legal advice on a number of civil topics. Seniors can ask questions about financial issues, housing, bankruptcy, employment, family law and more. If your issue is more complex than can be answered in one question, its website has information about other low-cost and free legal services that may be able to help you.
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.
|What Types of Care Can Be Provided?
|Home care agencies can provide nonclinical services, such as companionship, housekeeping, meal preparation and help with activities of daily living. Home health care agencies can provide both nonclinical and clinical services, including skilled nursing, physical therapy and the maintenance of chronic illnesses or disabilities.
|Are Care Plans Required?
|Providers must develop a written plan of care based on an assessment of each patient’s needs. The plan should outline services to be provided, goals of treatment and the duration and frequency of provider visits.
|Can Home Care Providers Assist with Medication Management?
|Home care workers can assist a patient with the self-administration of prescribed medications that don’t require the skills of a licensed medical professional to be administered safely.
|Are There Special Requirements for Screening Home Care Aides?
|Home care aides must undergo a criminal background check through the state’s screening tool, WV CARES.
|Are Home Care Aides Required to Undergo Special Training?
|All staff must be trained to perform care duties in accordance with their job description. Home health aides must complete 75 hours of training, 16 of which are supervised clinical hours, plus 12 hours of continuing education per year.
|Does Medicaid Cover Home Care in West Virginia?
|West Virginia Medicaid covers home care through its Personal Care Program and Aged and Disabled Waiver.
|How Do I Report Abuse of Myself or a Loved One?
|To report abuse, contact Adult Protective Services at (800) 352-6513. This hotline is open 24 hours per day, seven days a week. You can also report abuse to the long-term care ombudsman at (800) 834-0598.
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.