How to Pay for In-Home Care
How to Pay for Home Care in North Carolina
Jump to a state to see its Medicaid programs, waivers, and other ways to help pay for in-home care.
This directory lists North Carolina-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. North Carolina's strongest state-specific pathways include the CAP/DA Waiver, Personal Care Services, Special Assistance In-Home, Home Care Independence, and PACE, and VA benefits are broken out because they can be one of the strongest payment pathways for eligible North Carolina veterans and surviving spouses.
Updated August 2026
Reviewed by Valerie VanBooven, RN, BSN
North Carolina Medicaid / LTSS
CAP/DA Waiver
Direct home-care payerHelps pay for: Medicaid HCBS alternative to institutional care; can authorize a broad package of home- and community-based supports for adults at risk of institutionalization.
Who qualifies: Age 18+; Medicaid eligibility; institutional level-of-care; need for at least one CAP/DA service and an approved service plan.
How to start: Contact NC Medicaid or request a CAP/DA referral/case-management assessment.
Good to know: Family caregiver payment: Sometimes.
CAP/DA In-Home Aide 1
Direct home-care payerHelps pay for: Can fund in-home assistance with home management and selected supportive tasks when included in the approved CAP/DA plan.
Who qualifies: CAP/DA eligibility and assessed need; service must be authorized in the plan.
How to start: Ask the CAP/DA case manager about in-home aide services.
Good to know: Family caregiver payment: Sometimes.
CAP/DA In-Home Aide 2
Direct home-care payerHelps pay for: Can fund more hands-on in-home assistance with personal care and daily activities when authorized.
Who qualifies: CAP/DA eligibility and assessed functional need.
How to start: Ask the CAP/DA case manager to include appropriate aide services in the plan.
Good to know: Family caregiver payment: Sometimes.
CAP/DA Personal Assistance
Direct home-care payerHelps pay for: Can pay for personal assistance with ADLs/IADLs and community living tasks under an approved CAP/DA plan.
Who qualifies: CAP/DA eligibility; service authorization and budget rules apply.
How to start: Request personal assistance through the CAP/DA case manager.
Good to know: Family caregiver payment: Yes under consumer direction, subject to rules.
CAP/DA Respite
Direct home-care payerHelps pay for: Can pay for institutional or in-home respite to relieve an unpaid caregiver.
Who qualifies: CAP/DA eligibility and respite authorization in the plan.
How to start: Ask the CAP/DA case manager about respite options.
Good to know: Family caregiver payment: No direct cash to primary caregiver.
CAP/DA Meal Preparation & Delivery
PartialHelps pay for: Can cover meal preparation/delivery as part of an approved HCBS plan.
Who qualifies: CAP/DA eligibility and assessed need.
How to start: Ask the case manager whether meal services can be authorized.
Good to know: Family caregiver payment: No.
CAP/DA Equipment, Modification & Technology
Offsets care costHelps pay for: Can fund qualifying equipment, accessibility modifications and technology that support safe community living.
Who qualifies: CAP/DA eligibility; item/service must be approved as medically/functionally necessary.
How to start: Discuss home-safety and accessibility needs with the CAP/DA case manager.
Good to know: Family caregiver payment: No.
CAP/DA Personal Emergency Response Service
Offsets care costHelps pay for: Can cover an emergency alert system that supports independent living and may reduce paid supervision needs.
Who qualifies: CAP/DA eligibility and plan authorization.
How to start: Ask the CAP/DA case manager about PERS eligibility.
Good to know: Family caregiver payment: No.
CAP/DA Non-Medical Transportation / Chore / Participant Goods
PartialHelps pay for: Can cover certain non-medical transportation, decluttering/garbage-disposal chore services, participant goods/services and other approved supports.
Who qualifies: CAP/DA eligibility; service must be permitted and authorized in the individual plan.
How to start: Ask the CAP/DA case manager which supplemental supports fit the assessed need.
Good to know: Family caregiver payment: No.
North Carolina Medicaid / Self-Direction
CAP/DA Consumer-Directed Services (CAP/Choice)
Direct home-care payerHelps pay for: Lets an eligible beneficiary or representative recruit, hire, supervise and dismiss a personal assistant and set pay within the authorized budget, with financial-management support.
Who qualifies: Must be CAP/DA eligible and able to self-direct or have a qualified representative.
How to start: Tell the CAP/DA case manager you want the consumer-directed option.
Good to know: Family caregiver payment: Yes, subject to program rules.
North Carolina Medicaid / State Plan
Personal Care Services (PCS)
Direct home-care payerHelps pay for: Pays trained aides for hands-on help with eating, dressing, bathing, toileting and mobility in the home for eligible Medicaid beneficiaries.
Who qualifies: NC Medicaid; medical condition/disability/cognitive impairment; assessment must show qualifying unmet ADL needs.
How to start: Request PCS assessment through NC Medicaid / NCLIFTSS.
Good to know: Family caregiver payment: Generally through licensed provider.
North Carolina Medicaid / Medical
Medicaid Home Health
Yes - skilled careHelps pay for: Can cover medically necessary skilled nursing, therapy and qualifying home health services under Medicaid coverage rules.
Who qualifies: NC Medicaid enrollment, medical necessity and provider/authorization requirements.
How to start: Ask the treating clinician and Medicaid plan/provider about home health coverage.
Good to know: Family caregiver payment: No.
North Carolina Medicaid / Integrated Care
PACE
Direct home-care payerHelps pay for: Integrated Medicare/Medicaid program that can arrange home care, personal care, nursing, therapy, meals, transportation and other services needed to keep an eligible participant in the community.
Who qualifies: Age 55+; nursing-facility level of care; live in a PACE service area; able to live safely in community; Medicare/Medicaid/private-pay pathways.
How to start: Contact a NC PACE organization or NC Medicaid for screening.
Good to know: Family caregiver payment: No direct cash.
North Carolina Medicaid / Transition
Money Follows the Person (MFP)
Offsets care costHelps pay for: Can fund one-time transition costs such as security deposits, utility setup, furniture and accessibility changes when moving from an institution to the community.
Who qualifies: Must meet MFP/Medicaid transition criteria.
How to start: Ask the transition coordinator, facility social worker or NC Medicaid about MFP.
Good to know: Family caregiver payment: No.
North Carolina State / Cash Support
State-County Special Assistance In-Home (SAIH)
Indirect cash supportHelps pay for: Provides a cash supplement and case management to some low-income adults at risk of residential placement who can remain safely at home with a care plan.
Who qualifies: Low income; at risk of entering a residential facility; county DSS assessment determines whether needs can be safely met at home.
How to start: Contact the local Department of Social Services.
Good to know: Family caregiver payment: No direct caregiver wage.
North Carolina Aging / Self-Direction
Home Care Independence
Direct home-care payerHelps pay for: Non-Medicaid consumer-directed in-home care program that can let an older adult hire family, friends or others as a personal assistant, with care-adviser and payroll support.
Who qualifies: Age 60+; lives at home; needs personal-care/home-management help; must self-direct or have a representative; not available in every county.
How to start: Use the state provider directory or contact the Division of Aging.
Good to know: Family caregiver payment: Yes, subject to rules.
NC Lifespan Respite Voucher
Yes - respiteHelps pay for: Reimburses eligible unpaid family caregivers for up to $750 in respite services in a calendar year when funds are available.
Who qualifies: NC resident caregiver age 18+; unpaid caregiving; generally cannot already receive ongoing publicly funded respite/in-home services; referral by local professional organization required.
How to start: Ask a local AAA, health system, social-service agency or other professional organization for referral.
Good to know: Family caregiver payment: Caregiver chooses eligible respite worker/provider.
North Carolina Aging / In-Home Services
In-Home Aide - Home Management
Yes / subsidizedHelps pay for: Publicly supported local services can help with housekeeping, cooking, shopping, bill paying and other home-management tasks.
Who qualifies: Eligibility and local funding vary; generally aimed at older adults needing help to remain safely at home.
How to start: Use the FY26 In-Home Aide provider directory or local AAA.
Good to know: Family caregiver payment: No.
In-Home Aide - Personal Care
Yes / subsidizedHelps pay for: Publicly supported local services can provide hands-on ADL assistance for medically stable older adults with significant functional limitations.
Who qualifies: Local program assessment; level II/III personal-care criteria vary by need and funding.
How to start: Contact a local In-Home Aide provider or AAA.
Good to know: Family caregiver payment: No.
North Carolina Aging / Respite
In-Home Aide Respite
Yes / subsidizedHelps pay for: Publicly supported in-home aide services may provide respite to a primary caregiver, including home-management and personal-care tasks.
Who qualifies: Local funding and program assessment apply.
How to start: Contact a local In-Home Aide provider or AAA.
Good to know: Family caregiver payment: No.
North Carolina Aging / Dementia
Project C.A.R.E.
Yes - respiteHelps pay for: Dementia caregiver program offering consultation, education and funds for self-directed respite subject to eligibility and availability.
Who qualifies: For caregivers of people with Alzheimer’s disease or related dementia; regional availability and funding apply.
How to start: Contact the Project C.A.R.E. office serving the county or local AAA.
Good to know: Family caregiver payment: No continuous caregiver wage.
North Carolina Aging / Caregiver Support
Family Caregiver Support Program
Partial / respiteHelps pay for: Can provide short-term respite, counseling, training, service navigation and limited supplemental services to eligible family/informal caregivers.
Who qualifies: Caregiver eligibility depends on age/relationship/care-recipient criteria under the Older Americans Act; local availability varies.
How to start: Contact the local AAA or caregiver-support specialist.
Good to know: Family caregiver payment: No continuous caregiver wage.
North Carolina Aging / Adult Day
Adult Day Services
Offsets care costHelps pay for: Adult day health/day care can provide daytime supervision, meals, activities and health-related supports, reducing paid in-home hours for appropriate participants.
Who qualifies: Eligibility, cost share and local funding vary.
How to start: Contact local AAA/aging provider for adult day options.
Good to know: Family caregiver payment: No.
North Carolina Aging / Nutrition
Home-Delivered Meals
Offsets care costHelps pay for: Provides meals and safety checks to eligible homebound older adults, potentially reducing the number of paid caregiver hours needed for meal preparation.
Who qualifies: Generally age 60+ and frail, homebound or isolated; local program criteria apply.
How to start: Contact the local provider or AAA.
Good to know: Family caregiver payment: No.
Congregate Meals
Offsets care costHelps pay for: Provides nutritious meals in group settings for many adults age 60+, reducing food costs and providing social support.
Who qualifies: Generally age 60+; spouse/disabled-person rules may apply.
How to start: Contact local senior nutrition provider or AAA.
Good to know: Family caregiver payment: No.
North Carolina Aging / Transportation
Transportation Services for Older Adults
Offsets care costHelps pay for: Local aging programs can subsidize general or medical transportation for adults age 60+, reducing caregiver driving hours and transportation spending.
Who qualifies: Age 60+; local provider availability and eligibility rules apply.
How to start: Use the state transportation provider directory or local AAA.
Good to know: Family caregiver payment: No.
North Carolina Aging / Navigation
Area Agencies on Aging (AAAs)
Navigation / cost reductionHelps pay for: Sixteen regional AAAs help locate subsidized in-home services, caregiver support, meals, transportation, legal help and benefits counseling.
Who qualifies: Programs vary by region, funding and eligibility.
How to start: Contact the AAA serving the county.
Good to know: Family caregiver payment: No.
North Carolina Aging / Senior Centers
Senior Centers
Offsets care costHelps pay for: Local senior centers may connect older adults to in-home assistance, meals, insurance counseling, transportation, legal help and other cost-saving programs.
Who qualifies: Local eligibility varies; many services focus on adults age 60+.
How to start: Contact the local senior center or AAA.
Good to know: Family caregiver payment: No.
North Carolina Aging / Home Safety
Housing & Home Improvement Assistance
Offsets care costHelps pay for: Local aging/housing programs may support repairs or modifications that make remaining at home safer and can reduce hands-on assistance needs.
Who qualifies: Local funding, income and housing criteria vary.
How to start: Ask the local AAA about housing/home-improvement programs.
Good to know: Family caregiver payment: No.
North Carolina Nutrition / Income Support
Food and Nutrition Services (FNS)
Offsets household costHelps pay for: SNAP food benefits can reduce grocery spending, freeing household income for caregiving and other home-care costs.
Who qualifies: Income/resource and household rules apply; 2025-26 federal eligibility changes may affect some households.
How to start: Apply through ePASS or local DSS.
Good to know: Family caregiver payment: No.
North Carolina Nutrition / Seniors
Simplified Nutritional Assistance Program
Offsets household costHelps pay for: Simplified food-assistance pathway for qualifying North Carolina residents age 65+ who receive SSI and meet program rules.
Who qualifies: Age 65+, SSI recipient, NC resident, separate food purchasing/preparation and other rules.
How to start: Apply through FNS/local DSS; eligible households may receive a simplified application.
Good to know: Family caregiver payment: No.
North Carolina Energy / Income Support
Low Income Energy Assistance Program (LIEAP)
Offsets household costHelps pay for: One-time vendor payment toward heating costs can preserve cash for home care and medications.
Who qualifies: Income and household requirements; older/disabled households receive an early application period.
How to start: Apply through local DSS/ePASS during the program window.
Good to know: Family caregiver payment: No.
Medicare
Medicare Home Health
Yes - skilled/limited aideHelps pay for: Original Medicare can cover qualifying intermittent skilled nursing, therapy and limited home health aide services when Medicare conditions are met.
Who qualifies: Homebound; skilled need; clinician order/plan of care; Medicare-certified home health agency.
How to start: Ask the clinician for a Medicare home-health evaluation.
Good to know: Family caregiver payment: No.
Caregiver Training Services
Offsets training costHelps pay for: Medicare Part B may cover training for a caregiver when a practitioner determines it is needed for the patient’s treatment plan.
Who qualifies: Must meet Medicare medical-necessity and coverage requirements.
How to start: Ask the treating practitioner whether caregiver training can be ordered.
Good to know: Family caregiver payment: No.
Medicare / Dementia
Medicare GUIDE Model
Partial / respiteHelps pay for: Participating dementia-care organizations provide navigation, caregiver support and qualifying respite for eligible Original Medicare beneficiaries with dementia.
Who qualifies: Original Medicare Parts A/B; dementia; other CMS eligibility rules; must be served by a participating GUIDE organization.
How to start: Find a GUIDE participant serving the ZIP code or call Medicare.
Good to know: Family caregiver payment: No direct stipend.
Medicare Advantage
Supplemental In-Home Benefits
Sometimes / limitedHelps pay for: Some Medicare Advantage plans offer limited in-home supports, meals, transportation or caregiver-related benefits beyond Original Medicare.
Who qualifies: Plan-specific and year-specific; authorization/network rules apply.
How to start: Review the current Evidence of Coverage and call the plan.
Good to know: Family caregiver payment: Usually no.
North Carolina Medicare Counseling
SHIIP
Offsets health costsHelps pay for: Free counseling can help identify Medicare, Medicare Advantage, Medigap, Extra Help and Medicare Savings options that reduce health costs and preserve money for home care.
Who qualifies: Medicare beneficiaries and caregivers; counseling available statewide.
How to start: Call SHIIP or find a counselor in the county.
Good to know: Family caregiver payment: No.
Medicare / Medicaid Cost Sharing
Medicare Savings Programs
Offsets health costsHelps pay for: For qualifying low-income Medicare beneficiaries, Medicaid programs may help pay Medicare premiums and sometimes cost sharing, freeing income for home care.
Who qualifies: Income/resource limits and category rules apply.
How to start: Apply through county DSS / NC Medicaid and ask SHIIP for screening help.
Good to know: Family caregiver payment: No.
Medicare / Prescription Costs
Extra Help (Part D LIS)
Offsets medication costsHelps pay for: Federal Extra Help can reduce Medicare Part D premiums and prescription cost sharing, preserving income for care.
Who qualifies: Income/resource eligibility under Social Security/Medicare rules.
How to start: Apply through Social Security or ask SHIIP for help.
Good to know: Family caregiver payment: No.
Insurance
Traditional Long-Term Care Insurance
Direct home-care payerHelps pay for: Existing policies may reimburse or pay a daily/monthly benefit for qualifying home care after benefit triggers and elimination periods are met.
Who qualifies: Policy terms, ADL/cognitive trigger, elimination period and approved-provider rules apply.
How to start: Request the full policy and open a claim with the insurer.
Good to know: Family caregiver payment: Sometimes, policy-specific.
Hybrid Life + Long-Term Care Policy
Direct home-care payerHelps pay for: Combination policies may accelerate a death benefit or provide a separate LTC pool for qualifying home-care expenses.
Who qualifies: Must own a qualifying policy and meet its benefit trigger.
How to start: Request an in-force illustration and benefits explanation from the carrier.
Good to know: Family caregiver payment: Policy-specific.
Insurance / Life
Accelerated Death Benefit / Chronic Illness Rider
Cash / indirectHelps pay for: Some life policies allow early access to death benefits for terminal/chronic illness and may provide cash that can be used for care.
Who qualifies: Policy-specific diagnosis/ADL rules and limits apply.
How to start: Ask the life insurer for rider and accelerated-benefit terms.
Good to know: Family caregiver payment: Yes, indirectly.
Private Pay
Savings / Retirement Income
Direct home-care payerHelps pay for: Social Security, pensions, IRA/401(k) withdrawals, savings and investments can be used directly for home care.
Who qualifies: No program eligibility, but tax and retirement-sustainability consequences should be considered.
How to start: Build a monthly care budget and compare agency/direct-hire options.
Good to know: Family caregiver payment: Yes.
Direct-Hire Caregiver
Direct home-care payerHelps pay for: Hiring a caregiver directly may reduce hourly cost, but the household may become the employer and owe payroll/tax/insurance obligations.
Who qualifies: Household-employer classification, wage/overtime, workers compensation and tax rules may apply.
How to start: Use a written agreement and payroll process; consult tax/legal help.
Good to know: Family caregiver payment: Yes.
Private Pay / Family
Family Care Agreement
Direct home-care payerHelps pay for: A care recipient can privately compensate a relative under a properly documented personal-care agreement.
Who qualifies: Agreement should be prospective, reasonable and documented; Medicaid transfer rules may matter later.
How to start: Consult an elder-law attorney before significant family payments if Medicaid may be needed.
Good to know: Family caregiver payment: Yes.
Financial Planning
Annuity Income
Cash / indirectHelps pay for: An annuity may convert assets into a predictable income stream that can be used for home-care bills.
Who qualifies: Product liquidity, fees, tax treatment and Medicaid consequences vary.
How to start: Review with a fiduciary adviser and elder-law attorney when Medicaid planning matters.
Good to know: Family caregiver payment: Yes, indirectly.
Home Equity
Home Equity Loan / HELOC
Cash / indirectHelps pay for: Homeowners may borrow against equity to pay current care costs.
Who qualifies: Requires sufficient equity, underwriting and ability to carry debt; variable rates may apply.
How to start: Compare lender terms and assess long-term affordability.
Good to know: Family caregiver payment: Yes, indirectly.
HECM Reverse Mortgage
Cash / indirectHelps pay for: Eligible homeowners age 62+ may access home equity without traditional monthly principal-and-interest payments, subject to occupancy, tax, insurance and maintenance obligations.
Who qualifies: HECM age/property/equity and counseling requirements; loan balance grows over time.
How to start: Speak with a HUD-approved reverse-mortgage counselor before signing.
Good to know: Family caregiver payment: Yes, indirectly.
Tax Strategy
Medical Expense Deduction
Tax offsetHelps pay for: Certain qualified long-term-care or nursing-type expenses may count as itemized medical expenses when IRS requirements are met.
Who qualifies: Qualified care, documentation and AGI threshold rules apply; ordinary household help is not automatically deductible.
How to start: Keep care plans, invoices and task breakdowns; consult tax adviser.
Good to know: Family caregiver payment: No.
Health Savings Account (HSA)
Tax-free funds / indirectHelps pay for: Existing HSA funds can be used tax-free for qualifying medical expenses and certain qualified long-term-care expenses/premiums.
Who qualifies: Expense must be HSA-qualified and not otherwise reimbursed.
How to start: Review HSA rules before paying home-care invoices.
Good to know: Family caregiver payment: No.
Child and Dependent Care Credit
Tax offsetHelps pay for: An employed taxpayer may qualify for a credit for care of a spouse or qualifying dependent who is incapable of self-care when the expense enables work or job search.
Who qualifies: Dependency, work-related expense, provider and other IRS rules apply.
How to start: Review Form 2441 requirements with a tax professional.
Good to know: Family caregiver payment: No.
Property Tax / Cost Offset
NC Elderly or Disabled Homestead Exclusion / Circuit Breaker
Offsets household costHelps pay for: Qualifying homeowners may reduce or defer property taxes, preserving household cash for care.
Who qualifies: Age/disability, income, ownership/occupancy and program-specific requirements apply; county assessor administers.
How to start: File the applicable AV-9 form with the county tax office.
Good to know: Family caregiver payment: No.
Veteran Cost Offset
NC Disabled Veteran Property Tax Exclusion
Offsets household costHelps pay for: Qualifying disabled veterans or certain surviving spouses may receive a state property-tax exclusion, preserving cash for care.
Who qualifies: Service-connected permanent and total disability or other statutory qualifying condition; certification required.
How to start: Contact county tax office and use NCDVA-9/AV-9 forms.
Good to know: Family caregiver payment: No.
Workers Compensation
Workers Compensation Home / Attendant Care
Conditional home-care payerHelps pay for: For a qualifying work-related injury, workers-compensation coverage or settlement may pay medically necessary home health or attendant services.
Who qualifies: Must arise from compensable work injury and be medically/legal authorized.
How to start: Ask the workers-comp carrier/attorney about attendant-care coverage.
Good to know: Family caregiver payment: Sometimes, case-specific.
Auto / Liability
Liability or Accident Settlement
Cash / indirectHelps pay for: Settlement proceeds from an accident or injury may be structured or reserved to pay future home-care expenses.
Who qualifies: Depends on claim, settlement terms, liens and tax/legal issues.
How to start: Coordinate with attorney and financial adviser.
Good to know: Family caregiver payment: Yes, indirectly.
Charitable / Community
Disease-Specific or Charitable Grants
Sometimes / limitedHelps pay for: Some nonprofit foundations, faith communities and disease-specific organizations offer limited grants, respite or practical assistance.
Who qualifies: Program-specific diagnosis, geography, income and funding limits apply.
How to start: Ask social worker/AAA and search reputable disease-specific foundations.
Good to know: Family caregiver payment: Usually no.
Cost Reduction
Senior Community Service Employment Program (SCSEP)
Offsets household costHelps pay for: Part-time community-service employment can provide income for eligible low-income adults age 55+, helping offset household and care costs.
Who qualifies: Age 55+ and income/program eligibility rules.
How to start: Ask the local AAA/SCSEP provider about openings.
Good to know: Family caregiver payment: No.
Senior Farmers Market Nutrition / Food Programs
Offsets household costHelps pay for: Seasonal nutrition benefits and other senior food programs can reduce food spending, preserving income for care.
Who qualifies: Program-specific age/income/location rules and seasonal funding.
How to start: Ask the local AAA or nutrition provider.
Good to know: Family caregiver payment: No.
VA Benefits
VA Homemaker & Home Health Aide
Direct home-care payerHelps pay for: VA may pay an authorized 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.
How to start: Ask the VA social worker or primary care team.
Good to know: Family caregiver payment: No.
Veteran-Directed Care
Direct home-care payerHelps pay for: Provides a flexible self-directed budget for eligible Veterans needing personal care; workers may include family or neighbors subject to program rules.
Who qualifies: Enrolled Veteran; community-care eligibility; clinical criteria; local program availability.
How to start: Ask the VA social worker whether VDC is available locally.
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 community providers for eligible Veterans.
Who qualifies: Clinical need, VA eligibility and authorization/local availability.
How to start: Ask the VA care team for skilled home-health assessment/referral.
Good to know: Family caregiver payment: No.
VA Respite Care
Yes - respiteHelps pay for: VA may pay for in-home, adult-day or nursing-home respite for eligible Veterans when caregivers need a break.
Who qualifies: Clinical need, enrollment, availability; community-care eligibility for community providers.
How to start: Ask the VA social worker/caregiver support coordinator.
Good to know: Family caregiver payment: No.
VA Aid & Attendance Pension Add-On
Cash / indirectHelps pay for: Additional monthly VA pension payment for qualifying Veterans/survivors who need help with daily activities or meet other criteria; cash can be used toward care.
Who qualifies: Must first qualify for VA pension plus Aid & Attendance criteria; medical and financial rules apply.
How to start: Use VA or an accredited representative to apply.
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 respite, training, counseling and other supports.
Who qualifies: Veteran and caregiver must meet PCAFC eligibility and complete VA assessment/enrollment.
How to start: Apply jointly through VA Caregiver Support.
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. North Carolina is in CCN Region 1, administered by Optum.
Who qualifies: VA referral/authorization and community-care eligibility generally apply.
How to start: Obtain VA authorization before routine community care; do not assume reimbursement after private hire.
Good to know: Family caregiver payment: No.
Where North Carolina Families Can Start
Not sure where to begin? Match your situation to a contact below.
CAP/DA, PCS, PACE, Medicaid LTSS and benefit questions
NC Medicaid Contact Center
State aging/social-services navigation and local program referrals
NC DHHS Customer Service Center
Local aging services, caregiver support, meals, transportation, in-home services and benefits navigation
North Carolina Area Agencies on Aging
Apply for Medicaid, Special Assistance In-Home, FNS/SNAP, energy assistance and other benefits
Local Department of Social Services
Free Medicare, Medigap, Medicare Savings and Extra Help counseling
NC SHIIP
Application-based respite reimbursement up to $750 when funds are available
NC Lifespan Respite Program
Dementia caregiver consultation, education and self-directed respite funds
Project C.A.R.E.
Integrated home/community and medical care for qualifying adults 55+
NC PACE
Connect to local VA caregiver and home/community services
VA Caregiver Support Line
Assessment for VDC, respite, home health, HHA and CCN
VA Health Care / Social Work
Property-tax forms and state tax information
North Carolina Department of Revenue
Before You Rely on Any Payment Source
Start with NC Medicaid + local AAA/DSS
Call 888-245-0179 for Medicaid LTSS questions and use the local AAA/DSS to screen for non-Medicaid aging programs, Special Assistance In-Home, meals, transportation and caregiver support.
Ask specifically about CAP/DA consumer direction
CAP/DA includes a consumer-directed option that can give a beneficiary or representative employer authority over a personal assistant. Ask the case manager about worker eligibility and financial-management rules.
Do not overlook Special Assistance In-Home
SAIH is a cash supplement for some low-income adults at risk of residential placement. It is different from Medicaid personal care and should be screened through county DSS.
Home Care Independence is non-Medicaid and not statewide
It can allow an adult age 60+ to hire family, friends or others, but local provider availability is limited. Ask the AAA/state provider directory whether it exists in the county.
NC Lifespan Respite is limited but flexible
When funds are available, eligible unpaid caregivers can receive up to $750 in reimbursement for respite. A professional organization must submit the referral/application.
Project C.A.R.E. is valuable for dementia caregivers
It can provide self-directed respite funds and dementia-specific consultation but does not pay a caregiver for continuous ongoing care.
Do not confuse Medicare with long-term custodial care
Original Medicare may cover qualifying intermittent skilled home health, but not ongoing personal care when that is the only need.
GUIDE is not a cash allowance
GUIDE provides dementia care management and qualifying respite through participating organizations; respite is not unrestricted cash paid to the family.
VA CCN requires authorization
North Carolina is VA CCN Region 1 (Optum). Families should obtain VA referral/authorization before using community providers except where separate urgent/emergency rules apply.
Aid & Attendance is a pension add-on
The Veteran or survivor must qualify for VA pension and the additional Aid & Attendance criteria. It is not a stand-alone insurance policy.
Property-tax relief can preserve care dollars
North Carolina offers elderly/disabled homestead relief, a circuit-breaker option and a disabled-veteran exclusion. County tax offices administer the applications.
Document family caregiver payments
If a relative is paid privately, use a written prospective care agreement and good records, especially if Medicaid eligibility may be needed later.
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 North Carolina to help you navigate the application process.
← Back to How to Pay for In-Home CareHome Care Providers in North Carolina
These providers serve families in North Carolina and can help you apply what you've learned above to your specific situation.
A Better Solution In Home Care – Raleigh, NC
Serving North Carolina
A Better Solution In Home Care – Raleigh, NC provides home care services in the Raleigh area.
Communities Served
Raleigh
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Affordable Family Care Services NC – Chapel Hill, NC
Serving North Carolina
Remain independent and safe at home with Affordable Family Care Services. Family owned and operated with 24-Hour On-Call services and our caregiver match program means we will always be there for your family. We specialize in 24-Hour Home Care, Alzheimer’s Home Care, Personal Care at Home, Post Surgery Care, Senior Home Care and Companion Care at Home. Fill out a get started form today and one of our staff members will reach out to get your services started.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Raleigh, Charlotte, Greensboro and surrounding areas
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Affordable Family Care Services NC – Gastonia, NC
Serving North Carolina
Affordable Family Care Services NC provides home care services in Gastonia, NC and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Raleigh, Charlotte, Greensboro and surrounding areas
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Affordable Family Care Services NC – Greensboro, NC
Serving North Carolina
Affordable Family Care Services NC provides home care services in Greensboro, NC and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Raleigh, Charlotte, Greensboro and surrounding areas
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Affordable Family Care Services NC – Raleigh, NC
Serving North Carolina
Affordable Family Care Services NC provides home care services in Raleigh, NC and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Raleigh, Charlotte, Greensboro and surrounding areas
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Affordable Family Care Services NC – Southern Pines, NC
Serving North Carolina
Affordable Family Care Services NC provides home care services in Southern Pines, NC and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Raleigh, Charlotte, Greensboro and surrounding areas
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East Carolina Home Care
Serving North Carolina
East Carolina Home Care provides home care services in Greenville, NC and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Greenville
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Tender Hearted Home Care – Asheboro, NC
Serving North Carolina
Tender Hearted Home Care provides home care services in Asheboro, NC and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Greensboro, Salisbury, Lexington and surrounding areas
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Tender Hearted Home Care – Salisbury, NC
Serving North Carolina
Tender Hearted Home Care provides home care services in Salisbury, NC and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Greensboro, Salisbury, Lexington and surrounding areas
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Tender Hearted Home Care – Statesville, NC
Serving North Carolina
Tender Hearted Home Care provides home care services in Statesville, NC and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Greensboro, Salisbury, Lexington and surrounding areas
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