Government Programs That Pay In-Home Caregivers Explained

Four major government programs fund in-home care in the United States:

• Medicaid
• Medicare
• Veterans Affairs (VA) programs
• PACE (Program of All-Inclusive Care for the Elderly)

For veterans, the VA has specific programs that pay for ongoing in-home care by a designated caregiver. But for those who are not veterans, Medicaid is the only insurance that compensates family members or friends to provide long-term caregiving services in a person's home. The other programs fund care services delivered by licensed agencies or coordinated care programs.

Medicaid

Medicaid is the primary program that pays family caregivers and is the main focus of this website.

Each state runs its own Medicaid long-term care programs.

In Virginia, caregivers are paid through the CCC Plus Waiver using the Consumer Directed care model.

Under this model, the person receiving care or their representative chooses the caregiver. That caregiver can be any adult, including a family member or friend.

Learn more: What Is Medicaid and How Does It Help Caregivers

Medicare

Medicare does not pay family members to provide in-home care.

Medicare covers short-term skilled care at home, such as:

• Physical therapy
• Nursing care
• Wound treatment

This care must follow a hospitalization or qualifying medical event and must be delivered by a licensed home health agency.

Once the approved period of care ends, Medicare coverage stops.

Medicare does not cover long-term personal care, such as bathing, dressing, or meal preparation (unless these services are provided in conjunction with a specific in-home treatment plan).

For a comparison of the two programs, see: Medicare vs. Medicaid — What Caregivers Need to Know

Veterans Affairs (VA) Programs

The U.S. Department of Veterans Affairs offers two programs relevant to family caregivers.

Program of Comprehensive Assistance for Family Caregivers (PCAFC)

This program pays a monthly stipend to a designated family caregiver of a qualifying veteran with a serious injury or illness.

The caregiver must complete VA training and be formally designated as the veteran's primary caregiver.

Aid and Attendance

This program increases a veteran's monthly pension benefit to help pay for in-home care.

It does not pay a family caregiver directly, but the veteran can use the additional income to pay a caregiver.

VA programs operate separately from Virginia Medicaid, and each has its own eligibility rules.

For official information on these programs, see: VA Aid and Attendance program details.

PACE

PACE (Program of All-Inclusive Care for the Elderly) is a Medicare and Medicaid program for adults 55 and older who require nursing-facility-level care but wish to live at home.

PACE provides coordinated care through a PACE center and medical care team.

PACE does not pay family members as caregivers. Instead, services are delivered through the PACE program's staff and care network.