<h1>Medicaid Home Care in Virginia (CCC Plus Waiver)</h1> - Home Care

Medicaid Home Care in Virginia (CCC Plus Waiver)

For families who need in-home care but face financial constraints, Virginia Medicaid may be able to help cover the cost.

Through the Commonwealth Coordinated Care Plus (CCC Plus) Waiver, eligible Virginians can receive home care services that allow them to remain in their own homes rather than moving to a facility.

When families start exploring in-home care, one of the first questions is whether Medicaid can help cover the cost. Below is a straightforward breakdown of how Virginia Medicaid works for home care, what it covers, and how to access it in Northern Virginia.

What Does Virginia Medicaid Cover for Home Care?

  • Personal Care Services

    The CCC Plus Waiver covers hands-on personal care — help with bathing, dressing, grooming, toileting, and mobility. This is the most common home care service covered under the waiver. Learn more about our Personal Care services.

  • Companion Care

    Medicaid may also cover companion care — assistance with meal preparation, light housekeeping, errands, and transportation — for eligible individuals. Coverage depends on your individual care plan developed with your managed care organization.

  • Specialized and Skilled Care

    For individuals with conditions such as Parkinson's, dementia, stroke recovery, or other complex medical needs, Medicaid may cover skilled nursing visits and specialized personal care services when medically documented.

  • Respite Care

    The CCC Plus Waiver includes coverage for respite care, giving family caregivers temporary relief while a professional caregiver steps in. This is especially valuable for families managing dementia, Alzheimer's, or other high-need conditions.

  • Overnight and Continuous Care

    For individuals with significant care needs, Medicaid waiver plans can authorize more intensive support, including overnight care, based on the level of need determined during your assessment.

How Does Virginia Medicaid Work for Home Care?

Navigating Medicaid can feel overwhelming, but understanding the basics makes the process much more manageable. Here’s what families need to know:

  • Financial Eligibility: To qualify for Virginia Medicaid, your loved one must meet income and asset limits set by the state. Eligibility is determined by your local Department of Social Services (DSS) office. Income thresholds vary depending on whether the individual is applying as an aged, blind, or disabled adult.
  • Functional Eligibility: Beyond finances, your loved one must also demonstrate a functional need for care — meaning they require help with Activities of Daily Living (ADLs) such as bathing, dressing, toileting, or mobility. A state assessor will conduct an in-home evaluation to determine the level of care needed.
  • CCC Plus Managed Care: Once approved, most Northern Virginia Medicaid recipients are enrolled in the CCC Plus Waiver, which is administered through a managed care organization (MCO) such as Aetna, Anthem, or Optima. Your MCO coordinates your loved one’s care plan and authorizes services.
  • Choosing a Home Care Agency: After enrollment, your loved one has the right to choose their home care provider. CareLiving is an approved Medicaid home care agency in Virginia. We work directly with MCOs to coordinate care authorization and services.
  • How to Apply: Apply for Medicaid through your local Virginia DSS office or online at CommonHelp (commonhelp.virginia.gov). Once Medicaid is approved, contact us and we can help guide the next steps for getting care started under your managed care plan. Get Started and we’ll walk you through the process.

Virginia Medicaid Home Care — Frequently Asked Questions

Yes. Through the Commonwealth Coordinated Care Plus (CCC Plus) Waiver, Virginia Medicaid covers in-home personal care, companion care, respite care, and specialized care services for eligible individuals. CareLiving is a Virginia Medicaid-certified provider enrolled in the CCC Plus Waiver program.

The CCC Plus Waiver is Virginia’s Medicaid managed long-term services and supports program. It allows eligible individuals — including seniors and adults with disabilities — to receive home and community-based care instead of moving to a nursing facility. Services are coordinated through a managed care organization (MCO) such as Aetna, Anthem, Humana, or Sentara Health.

You can apply for Virginia Medicaid through your local Department of Social Services (DSS) office or online at CommonHelp (commonhelp.virginia.gov). Once approved, you will be connected with a managed care organization that will conduct a care assessment and authorize home care services. Contact us and we can help guide you through next steps.

Eligibility is based on two criteria: financial eligibility (income and asset limits set by the state) and functional eligibility (demonstrated need for help with Activities of Daily Living such as bathing, dressing, or mobility). A state assessor will conduct an in-home evaluation to determine level of care need. Your local DSS office can review financial eligibility.

Long-term care insurance is a private policy purchased in advance that reimburses for covered care costs up to a set benefit amount. Medicaid is a government program for individuals who meet income and asset eligibility requirements. Some families use both — Medicaid for ongoing care coverage and long-term care insurance to bridge gaps or cover additional costs. Learn more about Long-Term Care Insurance for Home Care.

Yes. Once enrolled in the CCC Plus Waiver, you have the right to select your own Medicaid-approved home care provider. CareLiving is an enrolled Virginia Medicaid home care agency serving Northern Virginia. We coordinate directly with your managed care organization to authorize and begin services.

The timeline varies depending on your local DSS office and managed care organization. Financial eligibility review can take several weeks, followed by a functional assessment to determine care needs. We recommend starting the process as early as possible. Contact us and we’ll help you understand where you are in the process and what to expect next.

Home Care

Ready to Use Virginia Medicaid for Home Care?

Navigating Medicaid and the CCC Plus Waiver doesn’t have to be overwhelming. Our team will help you understand your eligibility, coordinate with your managed care organization, and build a care plan that works for your family.

Get Started Today or call us at 571-599-7467.

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