How to Pay for In-Home Care
How to Pay for Home Care in Delaware
Jump to a state to see its Medicaid programs, waivers, and other ways to help pay for in-home care.
This directory lists Delaware-specific and federal payment sources that can pay for, reimburse, offset, or help plan for home care. Some are direct payment sources; others are indirect supports that reduce the amount of private home care a family must buy. Delaware's strongest state-specific pathways include the Diamond State Health Plan Plus (DSHP-Plus) managed long-term services and supports, the DDDS Lifespan Waiver with self-direction, pediatric disability pathways like CCADP, caregiver respite and support through DDDS and DSAAPD, Medicaid for Workers with Disabilities, and various cost-offset programs, and VA benefits are broken out because they can be one of the strongest payment pathways for eligible Delaware veterans and surviving spouses.
Updated August 2026
Reviewed by Valerie VanBooven, RN, BSN
Delaware Medicaid / LTSS
Diamond State Health Plan Plus (DSHP-Plus)
YesHelps pay for: Mandatory Medicaid managed-care LTSS for eligible Delaware residents who are elderly or physically disabled; HCBS can help prevent or delay nursing-facility placement.
Who qualifies: Medicaid financial eligibility plus LTSS/functional criteria and program enrollment.
How to start: Start with Long-Term Care Medicaid screening and ask about DSHP-Plus HCBS.
Good to know: Family caregiver payment: Service-specific; consumer-direction rules apply
Delaware Medicaid / DSHP-Plus
DSHP-Plus Personal Care / Attendant Services
YesHelps pay for: Authorized hands-on assistance with ADLs and related daily tasks in the home/community.
Who qualifies: DSHP-Plus enrollment, assessed need and service-plan authorization.
How to start: Ask the MCO/care manager to assess personal-care needs and consumer-direction options.
Good to know: Family caregiver payment: Potentially through consumer direction; verify worker relationship rules
Delaware Medicaid / Self-Direction
DSHP-Plus Consumer Direction
YesHelps pay for: Support for consumer direction lets eligible members exercise more control over authorized personal-care/attendant services.
Who qualifies: DSHP-Plus eligibility, authorized personal care and ability to self-direct or use a representative.
How to start: Tell the MCO/care manager you want consumer-directed attendant services.
Good to know: Family caregiver payment: Potentially; confirm current rules before hiring family
Delaware Medicaid / Respite
DSHP-Plus Respite
Yes - respiteHelps pay for: Respite can give an unpaid caregiver a temporary break; Delaware’s DDDS comparison lists up to 14 days per year under DSHP-Plus.
Who qualifies: DSHP-Plus authorization and assessed caregiver/respite need.
How to start: Request respite through the MCO/care manager before arranging care.
Good to know: Family caregiver payment: Self-directed respite may allow participant-selected worker; verify relationship rules
Delaware Medicaid / Day Services
DSHP-Plus Adult Day Services
Offsets home-care hoursHelps pay for: Supervised daytime health/support services can reduce the number of paid or unpaid home-care hours needed during the day.
Who qualifies: DSHP-Plus enrollment, assessed need and service authorization.
How to start: Ask the care manager about adult day services in the plan.
Good to know: Family caregiver payment: No direct family wage
Delaware Medicaid / Nutrition
DSHP-Plus Home-Delivered Meals
Offsets care costHelps pay for: Authorized home meal delivery can reduce meal-preparation burden and help support community living.
Who qualifies: DSHP-Plus enrollment, assessed need and service-plan authorization.
How to start: Ask the care manager whether meals are appropriate and covered.
Good to know: Family caregiver payment: No
Delaware Medicaid / Safety
DSHP-Plus Personal Emergency Response System (PERS)
Offsets care costHelps pay for: Emergency-response technology can reduce supervision burden and support safe community living.
Who qualifies: DSHP-Plus enrollment and service-plan authorization.
How to start: Ask the care manager about PERS eligibility.
Good to know: Family caregiver payment: No
Delaware Medicaid / Home Mods
DSHP-Plus Minor Home Modifications
Offsets care costHelps pay for: Accessibility/safety modifications when authorized; DDDS comparison lists $6,000 per project, $10,000 per year and $20,000 lifetime.
Who qualifies: Must be authorized as necessary under the DSHP-Plus service plan and comply with limits.
How to start: Obtain care-manager approval before work begins.
Good to know: Family caregiver payment: No
Delaware Medicaid / Transition
DSHP-Plus Community Transition Services
Offsets care/setup costHelps pay for: One-time transition supports for eligible members moving from an institution to the community; DDDS comparison lists up to $2,500 for each move.
Who qualifies: Program enrollment, qualifying transition and prior authorization.
How to start: Coordinate through the transition/care-management team before the move.
Good to know: Family caregiver payment: No
Nursing Home Transition Program
Offsets care/setup costHelps pay for: Transition planning and HCBS can help eligible Medicaid members move from institutional settings back to the community when safe and feasible.
Who qualifies: Medicaid/LTSS eligibility, institutional status and safe community plan.
How to start: Ask facility discharge staff and Medicaid care management about community transition.
Good to know: Family caregiver payment: No direct family wage
Delaware Medicaid / ABI
DSHP-Plus ABI Day / Cognitive Services
Offsets care costHelps pay for: Day habilitation and cognitive services for qualifying members with acquired brain injury can support community living and reduce caregiver burden.
Who qualifies: DSHP-Plus eligibility, ABI-related need and service authorization.
How to start: Ask the MCO/care manager about ABI-specific HCBS.
Good to know: Family caregiver payment: No direct family wage
Delaware Medicaid / HCBS
Home & Community-Based Long-Term Services and Supports
YesHelps pay for: Delaware Medicaid HCBS can provide alternatives to institutional care, including personal care and other supports based on assessed need.
Who qualifies: Must meet Medicaid financial rules and applicable level-of-care/functional criteria.
How to start: Contact Long-Term Care Medicaid for screening.
Good to know: Family caregiver payment: Program/service-specific
Delaware Medicaid / Eligibility
Long-Term Care Medicaid / Miller Trust Planning
Enables LTSS coverageHelps pay for: For applicants over the Medicaid LTSS income cap, a qualified income trust (Miller Trust) may be required; asset and spousal rules also matter.
Who qualifies: Current Delaware LTSS financial and functional eligibility rules; trust must be correctly established/used.
How to start: Contact LTC Medicaid before moving income/assets or creating a trust.
Good to know: Family caregiver payment: No
Delaware DDDS / Medicaid
DDDS Lifespan Waiver
YesHelps pay for: 1915(c) HCBS waiver for eligible people with intellectual/developmental disabilities, supporting services across the lifespan.
Who qualifies: DDDS eligibility, Medicaid/waiver criteria, assessed need and available authorization.
How to start: Apply for DDDS services and ask which waiver pathway fits.
Good to know: Family caregiver payment: Some services may be self-directed
Delaware DDDS / Self-Direction
Lifespan Waiver Personal Care - Self-Directed
YesHelps pay for: Personal care/attendant services may be consumer-directed so the participant/family can identify who provides authorized care.
Who qualifies: Lifespan Waiver enrollment and authorized personal-care service; personal care and respite share a $2,700 annual limit shown by DDDS.
How to start: Ask the DDDS navigator about self-directed personal care and fiscal/employer supports.
Good to know: Family caregiver payment: Potentially; verify caregiver relationship/employment rules
Agency With Choice
YesHelps pay for: Easterseals Agency With Choice supports eligible DDDS participants who self-direct services while the agency handles employer/payroll functions.
Who qualifies: Must use an eligible self-directed DDDS service and complete worker/enrollment requirements.
How to start: Ask DDDS/Easterseals whether Agency With Choice fits the authorized plan.
Good to know: Family caregiver payment: Can support participant-selected workers subject to program rules
Delaware DDDS / Respite
Lifespan Waiver Medicaid Respite - Self-Directed
Yes - respiteHelps pay for: Medicaid respite can be self-directed, allowing the service recipient/family to identify the respite provider, subject to authorization and program rules.
Who qualifies: Age 18+ and enrolled in Lifespan Waiver for Medicaid-funded DDDS respite; avoid duplication of respite services.
How to start: Coordinate with DDDS Community Navigator before arranging respite.
Good to know: Family caregiver payment: Potentially; verify relationship restrictions
Delaware DDDS / State Funds
DDDS State-Funded Respite
Yes - respiteHelps pay for: Non-waiver respite for eligible DDDS recipients without respite funding through Lifespan or DSHP-Plus; gives primary caregivers a temporary break.
Who qualifies: Age 4+, DDDS preliminary/full eligibility, and no duplicate Medicaid respite funding; request limits and funding availability apply.
How to start: Request through DDDS at least two weeks ahead when possible.
Good to know: Family caregiver payment: Provider-of-choice/reimbursement model; caregiver rules apply
Delaware DDDS / Supported Living
Lifespan Waiver Supported Living
Yes / supports community livingHelps pay for: Individualized supports in a home leased/owned by the participant; DDDS comparison lists up to 40 hours per week.
Who qualifies: Lifespan Waiver eligibility, assessed need and service authorization.
How to start: Discuss supported living with the DDDS Community Navigator.
Good to know: Family caregiver payment: Provider model; not automatically family pay
Delaware DDDS / Residential
Shared Living / Residential Habilitation
Residential alternativeHelps pay for: Residential habilitation/shared-living models can provide daily support in community settings, including approved caregiver arrangements.
Who qualifies: DDDS/waiver eligibility, assessed residential support need and provider/program rules.
How to start: Ask DDDS about shared-living or residential habilitation options.
Good to know: Family caregiver payment: May include approved caregiver/provider arrangements
Delaware DDDS / Home Mods
Lifespan Waiver Home & Vehicle Modifications
Offsets care costHelps pay for: Accessibility modifications can support remaining at home; DDDS comparison lists a combined $6,000 limit every five years for home and vehicle modifications.
Who qualifies: Lifespan Waiver authorization, documented need and combined service limits.
How to start: Get DDDS approval before purchasing or modifying.
Good to know: Family caregiver payment: No
Delaware DDDS / Equipment
Specialized DME / Assistive Technology
Offsets care costHelps pay for: Specialized equipment and assistive technology can reduce hands-on assistance and support independence; service limits vary by item/program.
Who qualifies: Lifespan Waiver eligibility, assessed need and prior authorization; DDDS comparison lists an AT maximum for qualifying service.
How to start: Ask DDDS to assess technology/equipment needs before purchase.
Good to know: Family caregiver payment: No
Delaware DDDS / Transition
Lifespan Waiver Community Transition Services
Offsets care/setup costHelps pay for: One-time supports for eligible participants transitioning to community living; DDDS comparison lists up to $4,000 every 10 years.
Who qualifies: Qualifying transition, waiver enrollment and prior authorization.
How to start: Coordinate with DDDS before the move or purchase.
Good to know: Family caregiver payment: No
Delaware DDDS / Employment
Pathways to Employment Personal Care / Supports
Can support personal assistanceHelps pay for: Medicaid HCBS employment pathway for eligible young adults with disabilities; may include supports needed to work and participate in the community.
Who qualifies: Program targets eligible Medicaid members with disabilities who meet age/program criteria and employment goals.
How to start: Ask DDDS/DSAAPD about Pathways to Employment eligibility and service plan.
Good to know: Family caregiver payment: Self-direction may apply to authorized services
Delaware Medicaid / Pediatrics
Pediatric Self-Directed Attendant Care (SDAC)
YesHelps pay for: Self-directed attendant care gives qualifying children with medical complexity a pathway for authorized hands-on supports at home.
Who qualifies: Child Medicaid eligibility, medical/functional criteria and approved service plan.
How to start: Ask the child’s Medicaid MCO/care team about SDAC assessment.
Good to know: Family caregiver payment: Participant/family directs worker; caregiver eligibility rules must be confirmed
Pediatric Medicaid Respite
Yes - respiteHelps pay for: Respite benefit for qualifying children with medical complexity can give primary caregivers temporary relief.
Who qualifies: Medicaid eligibility, qualifying pediatric need, authorization and no duplicate respite.
How to start: Request through the child’s MCO/care coordinator and confirm worker restrictions.
Good to know: Family caregiver payment: Service may be self-directed; primary caregiver/legal-guardian restrictions apply
Community Alternative Disability Program (CCADP)
Enables Medicaid/home servicesHelps pay for: Medicaid pathway for severely disabled children who meet institutional level-of-care criteria; parental income/resources are disregarded for the child’s eligibility test.
Who qualifies: Child must meet disability/level-of-care and individual financial rules, including program income/resource limits.
How to start: Apply through Long-Term Care Medicaid and request CCADP review.
Good to know: Family caregiver payment: Service-specific
Delaware Behavioral Health / Medicaid
PROMISE Personal Care
YesHelps pay for: PROMISE can provide personal care and other community supports for eligible adults with significant behavioral-health needs.
Who qualifies: Adult Medicaid eligibility, qualifying behavioral-health condition and PROMISE program criteria.
How to start: Ask DSAMH/Medicaid care team for PROMISE screening.
Good to know: Family caregiver payment: Program/provider rules apply
PROMISE Homemaker / Chore
Offsets care costHelps pay for: Homemaker/chore supports can help with household tasks that otherwise increase caregiver workload.
Who qualifies: PROMISE eligibility and service-plan authorization.
How to start: Ask the PROMISE care team whether homemaker/chore service is clinically appropriate.
Good to know: Family caregiver payment: No direct family wage
PROMISE Community Residential Supports
Residential/community supportHelps pay for: Community residential supports can help eligible adults remain in less institutional settings with structured assistance.
Who qualifies: PROMISE eligibility, assessed need and authorization.
How to start: Ask the PROMISE team about residential/community support options.
Good to know: Family caregiver payment: No direct family wage
Delaware Medicaid / Working Disabled
Medicaid for Workers with Disabilities (MWD)
Enables Medicaid servicesHelps pay for: Full Medicaid for eligible working people with disabilities; can preserve access to covered medical/home services while employed.
Who qualifies: Age 16-64, employed and paying FICA, SSA-defined disability; 2026 countable income up to 275% FPL. No resource test and no premium under current rules.
How to start: Apply through DMMA/LTC benefits office using the MWD application.
Good to know: Family caregiver payment: Service-specific
Delaware Aging / State & Federal
DSAAPD In-Home Support / Aging Services
May pay/arrange supportHelps pay for: Aging/disability network services can connect eligible residents to in-home supports and local programs that help them remain independent.
Who qualifies: Eligibility and funding vary by service; many programs prioritize need and community-living goals.
How to start: Call ADRC for screening and referral.
Good to know: Family caregiver payment: Program-specific
Delaware Aging / Home Mods
DSAAPD Home Modification Support
Offsets care costHelps pay for: Home accessibility/safety modifications may be available to help older adults and adults with physical disabilities remain safely at home.
Who qualifies: Program-specific functional, residence and funding criteria apply.
How to start: Call ADRC before starting work to determine eligibility and approved process.
Good to know: Family caregiver payment: No
Delaware Aging / Nutrition
DSAAPD Home-Delivered Meals
Offsets care costHelps pay for: Meals delivered to qualifying homebound residents can reduce meal-preparation workload and nutrition-related care burden.
Who qualifies: Generally based on age/disability, homebound status and need; provider rules apply.
How to start: Call ADRC or county meal provider for screening.
Good to know: Family caregiver payment: No
Delaware Aging / Day Services
DSAAPD Community-Based Day Programs
Offsets home-care hoursHelps pay for: Day programs provide supervision, activities and supports outside the home, potentially reducing paid or unpaid daytime care hours.
Who qualifies: Program-specific age/disability, need and funding criteria.
How to start: Call ADRC for local day-program options.
Good to know: Family caregiver payment: No
Delaware Caregiver / Respite
Lifespan Respite Voucher
Yes - respiteHelps pay for: Easterseals Lifespan Respite provides a $500 voucher for one care recipient to eligible unpaid Delaware caregivers caring for older adults/seniors.
Who qualifies: Delaware residency, unpaid caregiver and program eligibility; cannot duplicate other respite funding. Funding availability applies.
How to start: Contact Easterseals Lifespan Respite and complete the voucher process before relying on funds.
Good to know: Family caregiver payment: Can pay approved respite provider, not the primary caregiver as an ongoing wage
Delaware Caregiver Support
National Family Caregiver Support / DSAAPD
May offset care costHelps pay for: Caregiver counseling, training, respite navigation and supplemental services can reduce out-of-pocket burden and caregiver burnout.
Who qualifies: Caregiver/care-recipient age and relationship rules vary by service and Older Americans Act funding.
How to start: Call ADRC for caregiver-program screening.
Good to know: Family caregiver payment: Usually no direct wage
Caregiver Resource Center / DelaCARES Resources
Offsets care burdenHelps pay for: Education, assistive-technology information, support groups and resource navigation can reduce caregiving burden and help locate respite.
Who qualifies: Generally available to Delaware caregivers; specific grants/services have separate eligibility.
How to start: Use DSAAPD/Easterseals caregiver resources and ask about current grant availability.
Good to know: Family caregiver payment: No direct wage
Delaware Navigation
Aging & Disability Resource Center (ADRC)
Navigation / cost avoidanceHelps pay for: No-wrong-door statewide information and referral for aging, disability, LTSS, caregiver, meals, transportation and community resources.
Who qualifies: Open statewide; individual referred programs have their own eligibility.
How to start: Call for benefits screening and local referrals.
Good to know: Family caregiver payment: No
Delaware Medicaid / Home Health
Medicaid Home Health Services
Yes - skilled/home healthHelps pay for: Medicaid may cover medically necessary home-health services for eligible members, including skilled services under plan and authorization rules.
Who qualifies: Medicaid eligibility, medical necessity, covered service and provider/authorization requirements.
How to start: Ask the Medicaid MCO/clinician for home-health assessment/referral.
Good to know: Family caregiver payment: No direct family wage
Delaware Medicaid / Hospice
Medicaid Hospice
Yes - hospiceHelps pay for: Hospice can cover palliative/end-of-life services, supplies and interdisciplinary support for eligible Medicaid members who elect hospice.
Who qualifies: Medicaid eligibility plus hospice clinical/election requirements.
How to start: Ask clinician/MCO for hospice evaluation and covered-provider options.
Good to know: Family caregiver payment: No direct family wage
Delaware Medicaid / Transportation
Medicaid Non-Emergency Medical Transportation (Modivcare)
Offsets care/transport costHelps pay for: Transportation to covered medical services can reduce out-of-pocket ride costs when the member has no other transportation.
Who qualifies: Fully eligible Delaware Medicaid/DHCP client; trip must be to a covered service and transportation need verified.
How to start: Reserve generally at least 3 days before a scheduled appointment.
Good to know: Family caregiver payment: No
Delaware Prescription Assistance
Delaware Prescription Assistance Program (DPAP)
Offsets household costHelps pay for: State assistance can cover qualifying prescription costs and Medicare Part D premiums, preserving cash for home care.
Who qualifies: Age 65+ or qualifying SSDI status; current income/cost rules apply. Annual benefit limit applies.
How to start: Apply through Delaware Medicaid/DPAP.
Good to know: Family caregiver payment: No
Medicare Savings
Qualified Medicare Beneficiary (QMB)
Offsets household costHelps pay for: Pays Medicare Part A/B premiums and Medicare cost sharing for eligible low-income Medicare beneficiaries.
Who qualifies: 2026 Delaware countable income limit shown as 100% FPL; resource/Medicare rules apply.
How to start: Apply through Delaware Medicaid and ask DMAB for screening help.
Good to know: Family caregiver payment: No
Specified Low-Income Medicare Beneficiary (SLMB)
Offsets household costHelps pay for: Pays Medicare Part B premium for eligible beneficiaries, freeing monthly cash for care.
Who qualifies: 2026 Delaware countable income limit shown as 120% FPL; resource/Medicare rules apply.
How to start: Apply through Delaware Medicaid; DMAB can help screen.
Good to know: Family caregiver payment: No
Qualifying Individual (QI-1)
Offsets household costHelps pay for: Pays Medicare Part B premium for qualifying beneficiaries; funding and eligibility rules apply.
Who qualifies: 2026 Delaware countable income limit shown as 135% FPL; resource/Medicare rules apply.
How to start: Apply through Delaware Medicaid; reapply as required.
Good to know: Family caregiver payment: No
Qualified Disabled and Working Individual (QDWI)
Offsets household costHelps pay for: May pay Medicare Part A premium for certain disabled working beneficiaries who lost premium-free Part A.
Who qualifies: 2026 Delaware income table lists QDWI at 200% FPL; Medicare and resource rules apply.
How to start: Ask Delaware Medicaid/DMAB for eligibility screening.
Good to know: Family caregiver payment: No
Medicare / Prescription
Medicare Part D Extra Help
Offsets household costHelps pay for: Federal subsidy reduces Part D premiums, deductibles and prescription copays for eligible people with limited income/resources.
Who qualifies: Medicare eligibility and Extra Help financial rules; some Medicaid/MSP recipients qualify automatically.
How to start: Apply through Social Security or ask DMAB for screening help.
Good to know: Family caregiver payment: No
Medicare / Home Health
Medicare Home Health Benefit
Yes - limited skilled benefitHelps pay for: Medicare can cover intermittent skilled nursing, therapy and certain home health aide services when statutory home-health requirements are met.
Who qualifies: Must meet Medicare home-health eligibility, including homebound/skilled-care requirements and certified agency use.
How to start: Ask the treating clinician for a home-health plan/referral.
Good to know: Family caregiver payment: No
Medicare / Caregiver Support
Medicare Caregiver Training Services
Offsets care costHelps pay for: Medicare may cover caregiver training when needed to help with a beneficiary’s treatment plan, reducing paid instruction/training costs.
Who qualifies: Must meet Medicare coverage requirements and be ordered/provided as part of covered care.
How to start: Ask the Medicare clinician or home-health provider about covered caregiver training.
Good to know: Family caregiver payment: No wage
Medicare / Dementia
GUIDE Dementia Care Model
May offset dementia-care costHelps pay for: Participating GUIDE providers can coordinate dementia care and offer caregiver support; eligible beneficiaries may also receive respite services through the model.
Who qualifies: Traditional Medicare beneficiary with dementia and participating GUIDE provider/model eligibility.
How to start: Find a participating GUIDE provider and request assessment.
Good to know: Family caregiver payment: No direct caregiver wage
Medicare / Hospice
Medicare Hospice Benefit
Yes - hospice/respiteHelps pay for: Comprehensive hospice benefit can cover end-of-life clinical care, medications/supplies related to terminal illness and limited respite.
Who qualifies: Medicare hospice eligibility, physician certification and beneficiary election.
How to start: Request hospice evaluation through clinician/provider.
Good to know: Family caregiver payment: No
Medicare Advantage
Medicare Advantage Supplemental Benefits
Sometimes / plan-specificHelps pay for: Some MA plans offer in-home support, meals, transportation or caregiver-related supplemental benefits beyond Original Medicare.
Who qualifies: Must be enrolled in a plan offering the benefit and meet plan criteria; benefits change by plan/year.
How to start: Review Evidence of Coverage or call the plan; DMAB can help compare.
Good to know: Family caregiver payment: Usually no direct family wage
Delaware Employment / Caregiving
Delaware Paid Leave - Family Caregiver Leave
Offsets lost wagesHelps pay for: Wage replacement for eligible employees who take qualifying leave to care for a parent, spouse or child with a serious health condition.
Who qualifies: Generally same employer at least 12 months and 1,250 hours; up to 6 weeks every 24 months for family caregiving, subject to program rules.
How to start: File through LaborFirst/employer process and provide required certification.
Good to know: Family caregiver payment: Pays employee wage replacement, not caregiver-service wages
Food Assistance
Supplemental Nutrition Assistance Program (SNAP)
Offsets household costHelps pay for: Monthly food assistance can reduce grocery spending and preserve cash for caregiving/home-care expenses.
Who qualifies: Household income/resource and program rules; amounts vary by household circumstances.
How to start: Apply through Delaware ASSIST/DSS.
Good to know: Family caregiver payment: No
Energy Assistance
Delaware Energy Assistance Program / LIHEAP
Offsets household costHelps pay for: Heating, crisis and seasonal utility assistance can reduce energy costs and preserve cash for care.
Who qualifies: Income and program-season rules; Delaware uses current state/federal income guidelines and funding availability.
How to start: Apply through the designated county/community provider.
Good to know: Family caregiver payment: No
Weatherization
Weatherization Assistance
Offsets household costHelps pay for: Energy-efficiency improvements can lower recurring utility costs for qualifying low-income households.
Who qualifies: Income, dwelling and program rules; funding/contractor availability applies.
How to start: Ask DEAP/DNREC about weatherization intake and eligibility.
Good to know: Family caregiver payment: No
Delaware Property Tax
Senior School Property Tax Credit
Offsets household costHelps pay for: Eligible homeowners age 65+ can receive 50% of school property taxes, up to $500, freeing cash for care.
Who qualifies: Principal residence and age/residency rules apply; longer Delaware residency requirement applies to newer domiciliaries.
How to start: Apply with the county by the annual deadline and verify current qualification period.
Good to know: Family caregiver payment: No
Delaware Veterans / Property Tax
Disabled Veterans School Tax Credit
Offsets household costHelps pay for: Qualified disabled veterans may receive up to 100% credit against non-vocational school district property taxes on the primary residence.
Who qualifies: Generally qualifying 100% service-connected permanent/total disability or TDIU and Delaware domicile rules; cannot combine with senior school tax credit.
How to start: Apply through county/Delaware Finance with required veteran documentation.
Good to know: Family caregiver payment: No
Transportation
DART Reduced Fare
Offsets transportation costHelps pay for: Reduced transit fares for qualifying riders age 65+ and people with disabilities can lower routine transportation costs.
Who qualifies: Age/disability verification and DART reduced-fare rules.
How to start: Apply for the appropriate reduced-fare identification/program.
Good to know: Family caregiver payment: No
DART Paratransit
Offsets transportation/caregiver burdenHelps pay for: ADA complementary paratransit can provide accessible transportation for eligible people whose disability prevents use of fixed-route service.
Who qualifies: ADA paratransit certification and trip/service-area rules.
How to start: Complete DART ADA paratransit eligibility application before scheduling rides.
Good to know: Family caregiver payment: No
Insurance
Long-Term Care Insurance
Yes / policy-specificHelps pay for: Depending on policy, LTC insurance may reimburse home care, personal care, respite, hospice or adult day services after eligibility/benefit triggers are met.
Who qualifies: Must own a policy with applicable home/community benefits and satisfy benefit triggers, elimination period and limits.
How to start: Request policy/certificate and open a claim before paying long-term providers.
Good to know: Family caregiver payment: Policy-specific
Home Equity
HECM Reverse Mortgage
Cash / indirectHelps pay for: Eligible homeowners age 62+ may convert home equity into cash that can be used for care, while retaining title subject to loan obligations.
Who qualifies: FHA HECM borrower/property rules, counseling, fees and ability to meet taxes/insurance/home obligations.
How to start: Complete HUD-approved counseling and compare alternatives before borrowing.
Good to know: Family caregiver payment: Yes, indirectly
Veterans / Self-Direction
Veteran-Directed Care (VDC)
YesHelps pay for: VA self-directed budget can let eligible Veterans manage personal-care services and hire workers, including family, where VDC is locally available.
Who qualifies: VA enrollment, clinical/community-care criteria and local VDC availability.
How to start: Ask Wilmington VA social work/care team whether VDC is available for the Veteran’s location.
Good to know: Family caregiver payment: Yes, subject to VDC/local worker rules
Veterans / Cash Benefit
VA Aid & Attendance Pension Add-On
Cash / indirectHelps pay for: Additional VA pension payment for qualifying Veterans/survivors who need ADL help or meet other Aid & Attendance criteria; cash can help fund care.
Who qualifies: Must qualify for VA pension plus Aid & Attendance medical and financial requirements.
How to start: Apply through VA or an accredited Delaware Veteran Service Officer.
Good to know: Family caregiver payment: Yes, indirectly
VA Benefits
VA Homemaker & Home Health Aide
YesHelps pay for: VA may authorize a community aide to help an eligible Veteran with ADLs and selected daily tasks.
Who qualifies: VA enrollment/community-care eligibility, clinical need and local availability; copay may apply. Ask VA primary care/social worker for assessment/referral.
How to start: Ask the VA social worker or care team about VA Homemaker & Home Health Aide.
Good to know: Family caregiver payment: No
Veteran-Directed Care
YesHelps pay for: Flexible self-directed budget for eligible Veterans who need personal care; participant can hire workers, including family, subject to local rules.
Who qualifies: Enrolled Veteran, community-care eligibility, clinical criteria and local VDC availability. Ask Wilmington VA social worker whether VDC serves the Veteran’s location.
How to start: Ask the VA social worker or care team about Veteran-Directed Care.
Good to know: Family caregiver payment: Yes
VA Skilled Home Health
Yes - skilled careHelps pay for: VA may purchase skilled nursing, therapy and related home-health services from authorized community providers.
Who qualifies: Clinical need, VA eligibility/authorization and provider availability. Ask VA care team for skilled-home-health referral.
How to start: Ask the VA social worker or care team about VA Skilled Home Health.
Good to know: Family caregiver payment: No
VA Respite Care
Yes - respiteHelps pay for: VA may provide in-home, adult-day or facility respite to give caregivers a break.
Who qualifies: Enrollment, clinical need and local availability/authorization. Ask VA social worker or Caregiver Support Coordinator.
How to start: Ask the VA social worker or care team about VA Respite Care.
Good to know: Family caregiver payment: No direct wage
VA Aid & Attendance Pension Add-On
Cash / indirectHelps pay for: Additional pension payment for qualifying Veterans/survivors needing ADL help or meeting other A&A criteria.
Who qualifies: Must first qualify for VA pension plus A&A medical/financial criteria. Apply via VA or an accredited representative.
How to start: Ask the VA social worker or care team about VA Aid & Attendance Pension Add-On.
Good to know: Family caregiver payment: Yes, indirectly
PCAFC Caregiver Stipend
Direct caregiver stipendHelps pay for: VA may pay an approved primary family caregiver a monthly stipend and provide training, counseling, respite and other supports.
Who qualifies: Veteran and caregiver must meet PCAFC eligibility and complete VA assessment/enrollment. Apply jointly through VA Caregiver Support.
How to start: Ask the VA social worker or care team about PCAFC Caregiver Stipend.
Good to know: Family caregiver payment: Yes
VA Community Care Network - Region 1
Pays authorized providerHelps pay for: VA-authorized community care can include home health and other approved services. Delaware is in CCN Region 1, administered by Optum.
Who qualifies: VA referral/authorization and community-care eligibility generally apply. Obtain VA authorization before routine community care.
How to start: Ask the VA social worker or care team about VA Community Care Network - Region 1.
Good to know: Family caregiver payment: No
Home Based Primary Care (HBPC)
Home-based clinical careHelps pay for: Interdisciplinary VA primary care delivered in the home for eligible Veterans with complex chronic conditions.
Who qualifies: VA enrollment, clinical need and local program availability. Ask Wilmington VA primary care/social worker about HBPC.
How to start: Ask the VA social worker or care team about Home Based Primary Care (HBPC).
Good to know: Family caregiver payment: No
Medical Foster Home
Residential care alternativeHelps pay for: Private-home residential option paired with VA home-based services for Veterans who need substantial assistance and prefer a small-home setting.
Who qualifies: Clinical suitability, local program availability and private-pay/VA benefit coordination. Ask VA social worker about Medical Foster Home availability.
How to start: Ask the VA social worker or care team about Medical Foster Home.
Good to know: Family caregiver payment: No direct family wage
VA Caregiver Support Program
Support / respite navigationHelps pay for: Coaching, education, peer support, respite navigation and caregiver services; also gateway to PCAFC screening.
Who qualifies: Veteran/caregiver relationship and program-specific criteria vary. Call national line or Wilmington VA Caregiver Support.
How to start: Ask the VA social worker or care team about VA Caregiver Support Program.
Good to know: Family caregiver payment: PCAFC may pay stipend
VA Pension
Cash / indirectHelps pay for: Needs-based monthly pension for qualifying wartime Veterans/survivors; pension income can help fund home care.
Who qualifies: Service, age/disability, income/net-worth and other VA pension rules. Apply through VA or accredited VSO.
How to start: Ask the VA social worker or care team about VA Pension.
Good to know: Family caregiver payment: Yes, indirectly
Delaware Office of Veterans Services / VSOs
Benefits accessHelps pay for: State Veteran Service Officers help Delaware Veterans and families identify and apply for earned federal/state benefits.
Who qualifies: Benefit-specific eligibility applies. Schedule with a county VSO for claims and benefit screening.
How to start: Ask the VA social worker or care team about Delaware Office of Veterans Services / VSOs.
Good to know: Family caregiver payment: No direct wage
Where Delaware Families Can Start
Not sure where to begin? Match your situation to a contact below.
No-wrong-door LTSS navigation, caregiver support, meals, home modifications, day services and local aging/disability resources
Delaware Aging & Disability Resource Center (ADRC)
Medicaid LTSS eligibility, DSHP-Plus and CCADP application/screening questions
Long-Term Care Medicaid Central Intake
General Medicaid, managed-care enrollment and member-service questions
Delaware Medicaid Customer Relations / Managed Care
I/DD eligibility, Lifespan Waiver, self-direction, Pathways and community supports
Division of Developmental Disabilities Services (DDDS)
State-funded and Medicaid respite questions; coordinate before arranging respite
DDDS Respite Unit
$500 Lifespan Respite voucher and caregiver-resource information
Easterseals Lifespan Respite / Caregiver Support
Free Medicare counseling, Medicare Savings/Extra Help screening and plan comparisons
Delaware Medicare Assistance Bureau (DMAB)
Prescription-assistance eligibility/application questions for older or disabled Delaware residents
Delaware Prescription Assistance Program (DPAP)
Schedule covered non-emergency medical rides for eligible Medicaid/DHCP members
Modivcare - Medicaid NEMT
File or manage qualifying family-caregiver leave claims and wage-replacement benefits
Delaware Paid Leave / LaborFirst
Accredited/county VSO assistance with VA pension, Aid & Attendance and other claims
Delaware Office of Veterans Services
PCAFC stipend screening, caregiver support, respite navigation and local coordinator help
VA Caregiver Support / Wilmington VA
Before You Rely on Any Payment Source
Planning Point
Why It Matters
DSHP-Plus and the DDDS Lifespan Waiver are alternatives, not stackable waivers
DDDS states that even when someone meets criteria for both, the person must choose one and cannot receive services from both at the same time. Compare service packages before changing programs.
Consumer direction does not automatically mean every relative can be paid
Both DSHP-Plus and Lifespan support consumer direction, and DDDS respite can be self-directed. Worker enrollment, legally responsible-person rules, age/service rules and the exact family relationship still need verification before promising wages.
DSHP-Plus and Lifespan have materially different service limits
Examples in Delaware’s current comparison: DSHP-Plus respite up to 14 days/year; Lifespan personal care + respite share a $2,700 annual limit; modification and transition limits also differ. Use the member’s actual program.
DDDS state-funded respite is not an open-ended caregiver wage
It is for DDDS-eligible people without duplicate Medicaid respite funding, has request/usage rules and depends on authorization/funding. Coordinate with the DDDS respite team before paying a provider.
The Lifespan Respite voucher is $500, not recurring caregiver payroll
Easterseals currently describes a $500 voucher for one care recipient. It is a short-term respite resource and cannot be treated like an ongoing paid-family-caregiver program.
MWD is unusually favorable for working people with disabilities
For 2026, Delaware lists MWD at 275% FPL ($3,658/month for one person). Current MWD rules have no resource test and no premium, making it worth screening before assuming work disqualifies someone from Medicaid.
Long-Term Care Medicaid still has separate income/asset planning rules
LTSS eligibility is not the same as MWD or regular Medicaid. Applicants above the applicable LTC income standard may need a qualified income trust, and asset/spousal rules can affect eligibility.
Delaware Paid Leave replaces wages; it does not pay for home-care hours
Eligible employees may receive up to 80% of wages, capped at $900/week, with family caregiver leave generally up to 6 weeks every 24 months. Treat this as lost-wage relief, not a caregiver-service reimbursement.
PACE is not yet a current Delaware payment option
As of August 2026, DMMA says it is currently developing PACE in Delaware. Do not present PACE as enrollable until the state announces an operating program and service area.
Property-tax credits have anti-stacking and residency details
The senior school tax credit is 50% up to $500 and has residency rules. The disabled-veteran school tax credit cannot be combined with the senior school tax credit for the same property.
Delaware is in VA Community Care Network Region 1
Optum administers Region 1. Community-care services generally require VA referral/authorization; do not treat a community provider as automatically VA-covered.
Coordinate benefits before changing payroll, ownership, or assets
Medicaid LTSS, self-directed employment, VA benefits, insurance, taxes and home-equity decisions can interact. Verify eligibility and authorization first, especially before hiring relatives, transferring assets or incurring major home-modification costs.
Program rules, income limits, and availability change over time and can vary by county. Confirm current details with the program directly, or ask a home care provider in Delaware to help you navigate the application process.
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