How to Pay for Home Care in Pennsylvania: Waivers, VA Benefits & More

Pennsylvania families typically pay for home care one of five ways: the Community HealthChoices (CHC) Medicaid waiver, the OPTIONS program through their county's Area Agency on Aging, VA Aid & Attendance for veterans and surviving spouses, long-term care insurance, or private pay. Which route fits depends on your parent's age, health, finances, and military history, and many families end up combining more than one.

If you're trying to figure out how to pay for home care in PA, you're probably also discovering how confusing the system is. Program names sound alike. Eligibility rules overlap. And nobody hands you a map.

This guide walks through each option in plain language, with links to the official sources so you can verify details and current numbers yourself. One note before we start: Golden Hour Home Care provides non-medical home care, which is help with daily living like personal care, meals, housekeeping, and companionship. Some funding programs cover that kind of care, and some only cover skilled medical care. We'll flag the difference as we go.

Does Medicaid pay for home care in Pennsylvania?

Yes, through Community HealthChoices (CHC). CHC is Pennsylvania's Medicaid managed-care program for long-term services and supports. Its whole purpose is to help older adults and people with physical disabilities stay in their homes and communities instead of moving to a facility.

According to the Pennsylvania Department of Human Services, you may qualify for CHC if you're 21 or older and either receive both Medicare and Medicaid, or receive long-term supports through Medicaid because you need help with everyday personal tasks.

For families researching non-medical care, here's the key point: CHC can cover in-home personal assistance for eligible participants. That's the same category of hands-on help with bathing, dressing, meals, and daily routines that a home care agency provides.

How do you apply for CHC?

You can apply online through COMPASS at compass.dhs.pa.gov, or get help from your county assistance office. Dauphin, Lebanon, and Cumberland counties each have one. Financial and clinical eligibility rules are detailed, and the financial limits change over time, so go by what the state tells you rather than numbers you find on older websites.

Fair warning: the process takes patience. Applications involve both a financial review and a clinical determination of whether your parent needs a nursing-facility level of care. Starting early beats starting in a crisis.

What is the PA OPTIONS program?

The OPTIONS program is often the best first stop for families whose parent doesn't qualify for Medicaid. It's run by the Pennsylvania Department of Aging through your local Area Agency on Aging (AAA), and it serves Pennsylvanians age 60 and older whose physical or mental condition affects their ability to manage daily needs.

Two things make OPTIONS worth a phone call. First, per the Pennsylvania Department of Aging, there's no income requirement to participate. Depending on income, your parent may contribute toward services on a sliding co-payment scale, but income alone won't disqualify them. Second, the services line up well with non-medical home care: help with daily living activities, care management, home-delivered meals, and adult day services, with some AAAs offering extras like housekeeping support and home modifications.

To apply, contact the Area Agency on Aging for your parent's county. If you're not sure where to start, the Department of Aging's office in Harrisburg can point you to the right AAA. Expect an in-home assessment before services begin, and be aware that some counties have waiting lists.

Can VA benefits help pay for home care?

If your parent is a wartime veteran or the surviving spouse of one, look at VA Aid & Attendance. It's an increased monthly pension amount added to a qualifying VA pension, and it exists precisely for people who need help with daily life.

According to the U.S. Department of Veterans Affairs, you may qualify for Aid & Attendance if you need help performing daily functions such as bathing, eating, or dressing, are bedridden, are a patient in a nursing home, or meet specific vision-impairment criteria. You'll need evidence like a doctor's report, and VA Form 21-2680, which your parent's doctor completes. One rule to know: a veteran or surviving spouse can't receive Aid & Attendance and Housebound benefits at the same time.

Because Aid & Attendance arrives as an increased pension payment rather than a payment to a specific provider, families commonly use it to help cover non-medical home care hours. Benefit amounts and pension eligibility rules change yearly, so check the current figures at va.gov or ask your county's Veterans Affairs office before building a budget around it.

What about Medicare?

This surprises a lot of families, so let's be direct: Medicare generally does not pay for ongoing non-medical home care. Per Medicare.gov, the home health benefit covers skilled services like part-time nursing and therapy under specific conditions, but it excludes personal or custodial care when that's the only care needed, homemaker services, and 24-hour care at home.

So if your mom needs a nurse for wound care after surgery, Medicare may cover that for a period. If she needs someone to help her bathe, cook, and stay safe day to day, Medicare won't be the payer. That's the gap the other options in this article exist to fill.

Does long-term care insurance cover home care?

Usually yes, and home care is often exactly what these policies were bought for. Most long-term care policies pay benefits once the policyholder can't perform a certain number of activities of daily living, like bathing, dressing, or toileting, and non-medical home care typically qualifies as a covered service.

The catch is that every policy is different. Look for the elimination period (how many days of care before benefits start), the daily or monthly benefit cap, and whether the policy requires care from a licensed agency. If your parent has a policy tucked in a filing cabinet, dig it out and call the insurer before you need it. Ask specifically what documentation they require and whether care must come from a licensed agency, so you know exactly what to line up before care starts.

What does private pay look like?

Many Central PA families simply pay out of pocket, especially early on when a parent needs a handful of hours a week rather than daily care. Private pay has real advantages: no eligibility process, no waiting list, and care can start within days.

Home care is also more flexible than most families expect. You pay for the hours you use, so a few mornings a week of personal care and meal help costs a fraction of what full-time care or a facility does. For actual local rates, see our guide to home care costs in Harrisburg, and for how home care compares financially to a facility move, read our home care vs. assisted living comparison.

Families splitting duties with a paid caregiver should also know about respite care, which many use on a private-pay basis a few hours at a time.

How to pay for home care in PA: a simple starting checklist

Here's the order we suggest to Harrisburg-area families:

1. Call your county's Area Agency on Aging. Ask about OPTIONS and request an assessment. Dauphin, Lebanon, and Cumberland counties each have their own AAA.
2. Check Medicaid eligibility for CHC through COMPASS or your county assistance office, especially if your parent has limited income and assets or already has both Medicare and Medicaid.
3. Ask about military service. Even one qualifying period of wartime service can open the door to Aid & Attendance for a veteran or surviving spouse.
4. Hunt for a long-term care policy. Check files, ask the financial advisor, call the insurer.
5. Price out private pay for the hours actually needed. Many families start small while applications are pending.

You don't have to sort this out alone. Whether your family is in Harrisburg, Lebanon County, or Cumberland County, we've walked beside families through every one of these funding routes.

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Not sure which option fits your family? Golden Hour Home Care offers a free in-home consultation across Dauphin, Lebanon, and Cumberland counties. We'll assess what kind of help your parent needs, build a personalized care plan, and talk honestly about how families like yours usually pay for it. Call (717) 219-8542 or reach out online — we're available 7 days a week, including evenings and holidays.

Frequently asked questions

Does Medicaid pay for non-medical home care in Pennsylvania?−

Yes, for people who qualify. Community HealthChoices (CHC) is Pennsylvania's Medicaid managed-care program for adults 21 and older who need long-term services and supports. For eligible participants, it can cover in-home personal assistance, the kind of hands-on, non-medical help home care agencies provide. Apply through COMPASS at compass.dhs.pa.gov or your county assistance office.

Do I have to be low-income to get help from the PA OPTIONS program?+

No. The OPTIONS program, run through your county's Area Agency on Aging, has no income requirement for Pennsylvanians age 60 and older. Depending on income, you may contribute toward the cost of services on a sliding co-payment scale. It's often the first program to check for a parent who doesn't qualify for Medicaid.

Can a surviving spouse of a veteran get Aid & Attendance?+

Yes. VA Aid & Attendance is an increased monthly pension amount available to qualifying veterans and surviving spouses who need help with daily activities like bathing, eating, or dressing, are bedridden, or meet certain vision criteria. You'll need a doctor's report and VA Form 21-2680. Details and current benefit amounts are at va.gov.

Does Medicare pay for home care?+

Not for ongoing non-medical care. Medicare's home health benefit covers skilled services like nursing and therapy under specific conditions, but it does not pay for personal or custodial care when that's the only care needed, homemaker services, or 24-hour home care. Most families cover non-medical home care through Medicaid CHC, OPTIONS, VA benefits, insurance, or private pay.

Where should a Harrisburg-area family start?+

Start with two phone calls. Call your county's Area Agency on Aging (Dauphin, Lebanon, and Cumberland counties each have one) to ask about OPTIONS and a needs assessment. Then call Golden Hour Home Care at (717) 219-8542 for a free in-home consultation. We'll help you understand what care is needed and which funding routes are worth pursuing.