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. For a breakdown of what care costs in Manassas and how families pay, see our home care cost guide for Manassas.
- 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.
How to Qualify for Medicaid Home Care in Northern Virginia: Step by Step
- Check financial eligibility. Virginia Medicaid uses income and asset limits set by the state. Your local Department of Social Services (DSS) office can review your situation, or you can screen online at CommonHelp (commonhelp.virginia.gov).
- Submit your Medicaid application. Apply online at CommonHelp or in person at your local DSS office. Gathering proof of income, assets, and identity ahead of time helps avoid delays.
- Complete the functional assessment. A state screener conducts an in-home evaluation to confirm your loved one needs help with Activities of Daily Living such as bathing, dressing, toileting, or mobility.
- Enroll with a managed care organization (MCO). Once approved, most Northern Virginia members are enrolled in the CCC Plus Waiver through an MCO such as Aetna, Anthem, Humana, or Sentara, which authorizes your home care hours.
- Choose CareLiving as your home care agency. You have the right to select your own Medicaid-approved provider. We coordinate directly with your MCO, and care can often begin within 24–48 hours of authorization. Get started here.
Don’t Qualify for Medicaid? You Still Have Options
Many Northern Virginia families don’t meet Medicaid’s income limits but still need dependable support at home. CareLiving also serves private pay families across Northern Virginia — the same nurse-supervised caregivers and personalized care plans, from a few hours a week to 24-hour and live-in care. We also work with long-term care insurance. Review our home care costs guide and payment options, or call 571-599-7467 for a free in-home assessment.