How to Pay for In-Home Care
How to Pay for Home Care in Oregon
Jump to a state to see its Medicaid programs, waivers, and other ways to help pay for in-home care.
Oregon families typically start by screening for Medicaid in-home services, which can be delivered through consumer-employed Homecare Workers, the Independent Choices Program (a cash benefit that expressly allows a relative to be hired as an employee provider), in-home care agencies, and, starting in 2026, Agency with Choice. Those with very high care needs should also check the Spousal Pay Program, which has much stricter criteria than ordinary family-provider rules, and APD Agency with Choice, expected to launch in July 2026 as a shared-employment model. Oregon Project Independence (OPI) is state funded with no income or asset limit and a sliding fee, while OPI-M is Medicaid funded with higher financial limits, free approved services, and no estate recovery; both help people remain at home. People with intellectual/developmental disabilities can use ODDS in-home supports through Personal Support Workers or agency models, and the Children's Extraordinary Needs Program can pay eligible parents or guardians up to 20 hours a week (capacity expanded to 230 children as of July 2026). Families should also screen PACE where available, the Family Caregiver Support Program, Medicare Savings Programs, OHP transportation, food/energy/phone assistance, property-tax relief, Paid Leave Oregon, and Veteran benefits.
Updated August 2026
Reviewed by Valerie VanBooven, RN, BSN
Oregon Medicaid LTSS / APD
Medicaid In-Home Services
YesHelps pay for: Long-term services and supports delivered in the person's home, including help with ADLs/IADLs and related supports authorized through APD/AAA.
Who qualifies: Must meet Oregon Medicaid long-term-services financial and functional eligibility and have authorized in-home needs; service plan and provider requirements apply.
How to start: Call ADRC or the local APD/AAA office for a long-term-care screening and application.
Good to know: Family caregiver payment: Depends on provider model and relationship rules
Shift Services
YesHelps pay for: Authorized in-home services delivered in extended/shift arrangements for people whose assessed needs support that model.
Who qualifies: Must meet Oregon Medicaid long-term-services financial and functional eligibility and have authorized in-home needs; service plan and provider requirements apply. Shift-service criteria and service-plan authorization apply.
How to start: Ask the case manager whether assessed needs qualify for shift services.
Good to know: Family caregiver payment: Depends on provider relationship and authorization rules
Community Transportation
IndirectHelps pay for: Authorized transportation that supports covered community-based long-term-care needs and service-plan goals.
Who qualifies: Must meet Oregon Medicaid long-term-services financial and functional eligibility and have authorized in-home needs; service plan and provider requirements apply. Transportation must be authorized under applicable APD rules and not duplicate another payer.
How to start: Ask the case manager whether community transportation is available in the plan.
Good to know: Family caregiver payment: No routine caregiver wage
Consumer-Directed / APD
Consumer-Employer / Homecare Worker (HCW)
YesHelps pay for: The individual chooses, hires, trains, supervises and schedules a Homecare Worker; the state handles payment and key administrative functions.
Who qualifies: Must meet Oregon Medicaid long-term-services financial and functional eligibility and have authorized in-home needs; service plan and provider requirements apply. A paid worker must enroll and satisfy Homecare Worker requirements.
How to start: Ask the case manager for the Consumer-Employer/Homecare Worker option.
Good to know: Family caregiver payment: Often yes for qualified relatives; spouse rules are separate
Participant-Directed / APD
Independent Choices Program (ICP)
YesHelps pay for: A Medicaid in-home cash benefit used under an approved service plan and budget to hire workers and purchase approved supports.
Who qualifies: Must meet Oregon Medicaid long-term-services financial and functional eligibility and have authorized in-home needs; service plan and provider requirements apply. Participant must meet ICP management, banking, budget, employer and EVV requirements.
How to start: Ask the APD/AAA case manager to screen for ICP and build a service budget.
Good to know: Family caregiver payment: Yes - a participant's relative may be an employee provider; representative cannot also be the worker
Paid Family Caregiver / APD
Independent Choices Relative Employee Provider
YesHelps pay for: Uses the ICP cash benefit to employ a qualifying relative for authorized ADL/IADL assistance.
Who qualifies: The participant must qualify for ICP; employee provider must meet background/employment requirements and services must stay within the approved budget.
How to start: Tell the case manager which relative is proposed and complete ICP employee-provider enrollment.
Good to know: Family caregiver payment: Yes - expressly permitted for a relative under ICP; the representative cannot also be the paid provider
Paid Spouse / APD
Spousal Pay Program
YesHelps pay for: Pays an enrolled spouse as a Homecare Worker for authorized in-home services when the recipient has exceptionally high needs.
Who qualifies: Requires Medicaid in-home eligibility, full assistance in at least 4 of 6 ADLs, a debilitating medical condition, nursing-facility risk, needs beyond customary spousal duties, and annual approval. The spouse cannot be the representative.
How to start: Ask the APD/AAA case manager for a Spousal Pay eligibility determination.
Good to know: Family caregiver payment: Yes - spouse only when strict Spousal Pay criteria are met
Shared-Employment / APD
Agency with Choice (AwC)
YesHelps pay for: New in-home model where the individual directs care and chooses/trains workers while an agency handles hiring, payroll, paperwork and background checks.
Who qualifies: Must meet Oregon Medicaid long-term-services financial and functional eligibility and have authorized in-home needs; service plan and provider requirements apply. APD expected this option to launch in July 2026; availability depends on contracted agency implementation.
How to start: Ask the case manager whether Agency with Choice is active and available in the service area.
Good to know: Family caregiver payment: Potentially - chosen worker must satisfy agency and program rules
Agency-Directed / APD
In-Home Care Agency Option
YesHelps pay for: An in-home care agency hires, trains, manages and pays the direct care worker for the Medicaid member.
Who qualifies: Must meet Oregon Medicaid long-term-services financial and functional eligibility and have authorized in-home needs; service plan and provider requirements apply. Agency must be authorized and available.
How to start: Ask the case manager for authorized in-home care agency choices.
Good to know: Family caregiver payment: Generally not a direct family-employment model; agency hiring rules control
Oregon Medicaid HCBS
K Plan / Community First Choice
YesHelps pay for: Oregon's 1915(k) Community First Choice state-plan authority supports home- and community-based attendant services and related supports.
Who qualifies: Medicaid eligibility plus functional/service criteria for the applicable APD or ODDS program; K Plan services are authorized through the person-centered plan.
How to start: Apply for Medicaid LTSS or I/DD services and ask which approved K Plan services fit the assessment.
Good to know: Family caregiver payment: Depends on service/provider rules
K Plan / APD-ODDS
Attendant Care
YesHelps pay for: Hands-on and cueing assistance with personal care and daily activities needed to live safely in the community.
Who qualifies: Must be an authorized need in the person-centered service plan and delivered by an eligible provider.
How to start: Request attendant-care needs during assessment/service planning.
Good to know: Family caregiver payment: Often possible through consumer-directed provider models; relationship rules vary
K Plan / ODDS
Skills Training
YesHelps pay for: Support worker assists with daily tasks while teaching or maintaining skills for greater independence.
Who qualifies: Must be eligible for Oregon I/DD services and Medicaid-funded supports; the Oregon Needs Assessment and Individual Support Plan determine authorized services/hours.
How to start: Apply through the local Community Developmental Disabilities Program (CDDP); then work with the services coordinator/personal agent.
Good to know: Family caregiver payment: Potentially - qualified family member may serve under applicable PSW/provider rules
Relief Care
YesHelps pay for: Temporary support that gives the person's usual family or unpaid caregiver a break.
Who qualifies: Must be eligible for Oregon I/DD services and Medicaid-funded supports; the Oregon Needs Assessment and Individual Support Plan determine authorized services/hours.
How to start: Apply through the local Community Developmental Disabilities Program (CDDP); then work with the services coordinator/personal agent.
Good to know: Family caregiver payment: No - service is designed to relieve the usual caregiver, whether that caregiver is paid or unpaid
Oregon Medicaid LTSS
Emergency Response System
IndirectHelps pay for: Emergency-response technology can support safe independent living and reduce the need for constant in-person monitoring.
Who qualifies: Must be an authorized covered need under the applicable Medicaid LTSS plan.
How to start: Ask the case manager whether an emergency response system is covered in the plan.
Good to know: Family caregiver payment: No
Medicaid Home-Delivered Meals
IndirectHelps pay for: Authorized home-delivered meals can reduce meal-preparation burden and help support community living.
Who qualifies: Coverage depends on the person's LTSS program and service-plan authorization; cannot duplicate another payer.
How to start: Ask the case manager whether home-delivered meals are available.
Good to know: Family caregiver payment: No
Assistive Devices / Technology
IndirectHelps pay for: Approved devices or technology that increase independence and substitute for or supplement hands-on assistance.
Who qualifies: Must relate to assessed needs and satisfy the applicable Medicaid program's coverage and authorization rules.
How to start: Document the functional need during assessment and request authorization.
Good to know: Family caregiver payment: No caregiver wage
Home Modifications / Accessibility Supports
IndirectHelps pay for: Approved environmental changes can improve access and safety and reduce caregiving burden.
Who qualifies: Availability depends on the person's specific Medicaid authority/program and approved service plan.
How to start: Ask the case manager which home-modification benefit applies.
Good to know: Family caregiver payment: No
APD 1915(c) Waiver
Community Transition Services
IndirectHelps pay for: One-time setup supports for eligible people transitioning from an institution or provider-operated setting to in-home/community living.
Who qualifies: Must qualify under the APD Aged and Physically Disabled waiver and meet transition-service requirements.
How to start: Engage the APD case manager before discharge or move.
Good to know: Family caregiver payment: No direct family wage
Housing Support Services
IndirectHelps pay for: Supports to help eligible Medicaid LTSS recipients find or maintain housing needed for successful in-home/community living.
Who qualifies: Must qualify under the APD waiver and have an authorized housing-support need.
How to start: Ask the APD case manager whether housing support is available in the service plan.
Good to know: Family caregiver payment: No
State-Funded In-Home Support
Oregon Project Independence (OPI)
YesHelps pay for: Limited in-home services for adults who need help to remain at home and are not using Medicaid long-term-care benefits.
Who qualifies: No income or asset limit; participants generally pay part of the cost on a sliding scale. Local waiting lists and priority rules may apply.
How to start: Call or visit the local APD/AAA office.
Good to know: Family caregiver payment: Depends on local/provider rules; do not assume spouse payment
OPI Service
OPI Personal Care
YesHelps pay for: Help with bathing, dressing, mobility and other personal-care needs to remain at home.
Who qualifies: Must qualify for OPI and have the service authorized; availability/funding can vary locally.
How to start: Request personal-care needs during OPI assessment.
Good to know: Family caregiver payment: Depends on local/provider rules
OPI Housekeeping / Chore Services
YesHelps pay for: Housekeeping and chore assistance can reduce the daily-living burden that otherwise requires privately paid help.
Who qualifies: Must qualify for OPI and have the service authorized; local funding and service availability apply.
How to start: Request housekeeping/chore needs during OPI assessment.
Good to know: Family caregiver payment: Depends on provider rules
OPI Meals / Transportation Supports
IndirectHelps pay for: Home-delivered meals and transportation can reduce the amount of purchased in-home assistance a household needs.
Who qualifies: Must qualify for OPI and have the support authorized; services vary by local area.
How to start: Ask the local OPI program which meal and transportation supports are available.
Good to know: Family caregiver payment: No routine family wage
OPI Assistive Technology
IndirectHelps pay for: Approved technology or devices can support independence and reduce hands-on care needs.
Who qualifies: Must qualify for OPI and have the item/service approved within local program rules and funding.
How to start: Ask the OPI case manager about assistive-technology options.
Good to know: Family caregiver payment: No
OPI / Aging Network
OPI Support for Unpaid Family Caregivers
IndirectHelps pay for: OPI can include supports that reduce the burden on unpaid family caregivers and help sustain care at home.
Who qualifies: OPI eligibility plus local service/funding rules apply.
How to start: Ask the OPI case manager and local Family Caregiver Support Program about caregiver supports.
Good to know: Family caregiver payment: Usually support/respite rather than a wage
Medicaid Expansion / APD
Oregon Project Independence - Medicaid (OPI-M)
YesHelps pay for: Medicaid-funded in-home support for adults with limited income/resources who need help to stay at home but may not qualify for traditional Medicaid LTSS.
Who qualifies: Age 18+; income at or below 400% FPL and limited resources under OPI-M rules; functional criteria apply. Services are free if eligible and there is no estate recovery.
How to start: Apply through the local APD/AAA office; ask specifically for OPI-M screening.
Good to know: Family caregiver payment: Potentially under OPI-M provider rules; ICP and Spousal Pay cannot be received concurrently with OPI-M
OPI-M Service
OPI-M Personal Care / Housekeeping
YesHelps pay for: Help with bathing, eating, walking, housekeeping and meal preparation to support remaining at home.
Who qualifies: Must qualify for OPI-M and have the service authorized; paid support supplements unmet needs and does not automatically replace willing natural supports.
How to start: Request these needs during OPI-M assessment.
Good to know: Family caregiver payment: Potentially subject to OPI-M provider rules
OPI-M Adult Day Services
Indirect / YesHelps pay for: Daytime supervision, activities and support that can reduce the number of in-home paid-care hours needed.
Who qualifies: Must qualify for OPI-M and have adult-day services authorized.
How to start: Ask the OPI-M case manager whether adult day services are appropriate and available.
Good to know: Family caregiver payment: No direct family wage
OPI-M Home Modifications / Assistive Technology
IndirectHelps pay for: Home accessibility changes and technology can reduce hands-on assistance and improve safety.
Who qualifies: Must qualify for OPI-M and have the item/modification tied to assessed need and approved under program rules.
How to start: Document the need with the case manager and request authorization before purchase/work.
Good to know: Family caregiver payment: No
OPI-M Supports for Unpaid Caregivers
IndirectHelps pay for: Services that support unpaid caregivers can help sustain an at-home care plan and delay more intensive paid care.
Who qualifies: Must qualify for OPI-M; available supports and authorization depend on assessment and program rules.
How to start: Ask the OPI-M case manager what unpaid-caregiver supports are available.
Good to know: Family caregiver payment: Support rather than a direct caregiver wage
Medicaid State Plan
State Plan Personal Care (SPPC)
YesHelps pay for: Personal-care assistance for eligible Medicaid recipients who need help with covered daily activities.
Who qualifies: Must meet SPPC eligibility, assessment and authorization requirements; service-plan and exception rules apply.
How to start: Ask the local APD/AAA office whether SPPC is the correct personal-care route.
Good to know: Family caregiver payment: Provider/relationship rules are program-specific; confirm before relying on family payment
Integrated Long-Term Care
PACE - Program of All-Inclusive Care for the Elderly
YesHelps pay for: Integrated Medicare/Medicaid medical and long-term-care model that can include home care, personal care, therapies, transportation and other supports needed to remain in the community.
Who qualifies: Generally age 55+, nursing-facility level of care, residence in a PACE service area and ability to live safely in the community at enrollment.
How to start: Ask ADRC or a local PACE organization to confirm service area and eligibility.
Good to know: Family caregiver payment: No routine direct family wage; provider arrangements follow the PACE organization
Oregon Health Plan
OHP Home Health Care
Yes - skilled/medicalHelps pay for: Covered home health services, including medically necessary skilled services delivered at home under OHP benefit and authorization rules.
Who qualifies: Must be an eligible OHP member and meet medical-necessity, benefit-package and provider/authorization requirements.
How to start: Ask the treating clinician and OHP/CCO about home-health authorization.
Good to know: Family caregiver payment: No routine family wage
Medicaid Transportation
OHP Non-Emergent Medical Transportation (NEMT)
IndirectHelps pay for: Rides to covered care and, when pre-approved, help with eligible travel costs such as gas, meals and lodging.
Who qualifies: Available to qualifying OHP benefit groups; travel reimbursement must be approved by the local ride service before the trip.
How to start: Call the local CCO/open-card ride service before the appointment; OHP can help identify the brokerage.
Good to know: Family caregiver payment: No caregiver wage; approved travel reimbursement may offset family transportation cost
Medicaid Eligibility Path
Employed Persons with Disabilities (EPD)
Indirect / Yes if LTSS authorizedHelps pay for: Helps eligible working people with disabilities retain Medicaid coverage, including coverage for long-term services.
Who qualifies: Must meet EPD disability, work, income/resource and program requirements; LTSS still requires separate functional/service authorization.
How to start: Apply for medical benefits and ask ODHS about EPD and long-term-service eligibility.
Good to know: Family caregiver payment: Depends on the underlying LTSS provider model
ODDS Medicaid HCBS
I/DD In-Home Supports
YesHelps pay for: Home/community supports for eligible children and adults with intellectual/developmental disabilities living at home.
Who qualifies: Must be eligible for Oregon I/DD services and Medicaid-funded supports; the Oregon Needs Assessment and Individual Support Plan determine authorized services/hours.
How to start: Apply through the local Community Developmental Disabilities Program (CDDP); then work with the services coordinator/personal agent.
Good to know: Family caregiver payment: Often yes through eligible PSW/provider arrangements; parent/spouse rules depend on program
Participant-Directed / ODDS
Personal Support Worker (PSW) Self-Directed Model
YesHelps pay for: The individual/family recruits and manages a Personal Support Worker for authorized attendant care, skills training and relief care.
Who qualifies: Must be eligible for Oregon I/DD services and Medicaid-funded supports; the Oregon Needs Assessment and Individual Support Plan determine authorized services/hours. PSW must pass required enrollment/background/orientation steps.
How to start: Tell the services coordinator/personal agent you want to manage PSWs directly.
Good to know: Family caregiver payment: Potentially - someone already known to the person may be hired if eligible; legally responsible caregiver rules can differ
Shared-Employment / ODDS
Employer Model Agency (EMA)
YesHelps pay for: Hybrid ODDS in-home model: the person chooses/trains workers while an agency handles hiring, payroll, paperwork and background checks.
Who qualifies: Available as an ODDS in-home provider model beginning Jan. 1, 2026; individual must have authorized I/DD in-home services.
How to start: Ask the services coordinator/personal agent for Employer Model Agency options.
Good to know: Family caregiver payment: Potentially, subject to agency and ODDS provider rules
Agency-Directed / ODDS
Standard Model Agency
YesHelps pay for: Agency hires, trains and supervises support workers while the person directs goals and the support they receive.
Who qualifies: Must be eligible for Oregon I/DD services and Medicaid-funded supports; the Oregon Needs Assessment and Individual Support Plan determine authorized services/hours.
How to start: Apply through the local Community Developmental Disabilities Program (CDDP); then work with the services coordinator/personal agent.
Good to know: Family caregiver payment: Generally agency employment rules control
ODDS In-Home Service
Hourly Attendant Care
YesHelps pay for: Paid support with dressing, bathing, eating, toileting, mobility, meals, cleaning, laundry, shopping, communication and other authorized tasks.
Who qualifies: Must be eligible for Oregon I/DD services and Medicaid-funded supports; the Oregon Needs Assessment and Individual Support Plan determine authorized services/hours.
How to start: Apply through the local Community Developmental Disabilities Program (CDDP); then work with the services coordinator/personal agent.
Good to know: Family caregiver payment: Potentially through eligible PSW/agency provider rules
Hourly Skills Training
YesHelps pay for: Paid support that combines assistance with teaching/maintaining daily-living skills and independence.
Who qualifies: Must be eligible for Oregon I/DD services and Medicaid-funded supports; the Oregon Needs Assessment and Individual Support Plan determine authorized services/hours.
How to start: Apply through the local Community Developmental Disabilities Program (CDDP); then work with the services coordinator/personal agent.
Good to know: Family caregiver payment: Potentially through eligible PSW/agency provider rules
Relief Care
YesHelps pay for: Daily relief support that gives the usual family/friend caregiver a break; the usual caregiver may be paid or unpaid.
Who qualifies: Must be eligible for Oregon I/DD services and Medicaid-funded supports; the Oregon Needs Assessment and Individual Support Plan determine authorized services/hours.
How to start: Apply through the local Community Developmental Disabilities Program (CDDP); then work with the services coordinator/personal agent.
Good to know: Family caregiver payment: No - a different worker provides the relief period
Paid Parent / ODDS
Children's Extraordinary Needs Program (CEN)
YesHelps pay for: Pays eligible parents or guardians to provide authorized care to a child with extraordinary medical or behavioral needs.
Who qualifies: Child must be under 18, meet the program's I/DD or specified CIIS pathway and be in Oregon Needs Assessment service group 5m or 5b. Capacity is limited; 230 children at a time beginning July 1, 2026, with a waitlist.
How to start: Ask the child's services coordinator about the CEN waitlist and eligibility.
Good to know: Family caregiver payment: Yes - eligible parent/guardian can be paid up to 20 hours per week
ODDS Children
CIIS Intensive Behavior Program
Yes / IndirectHelps pay for: Intensive in-home case management and supports for eligible children with significant behavior-related disability needs.
Who qualifies: Child must meet CIIS program criteria; Intensive Behavior referrals first require county developmental-disability eligibility.
How to start: Work through the CDDP/services coordinator for referral and application steps.
Good to know: Family caregiver payment: Parent payment is not automatic; CEN is the separate paid-parent route when criteria are met
CIIS Medically Involved Program
Yes / IndirectHelps pay for: Flexible family-centered in-home supports for eligible children with significant medical/disability needs.
Who qualifies: Must meet CIIS Medically Involved criteria and Medicaid/program requirements.
How to start: Ask the services coordinator about CIIS Medically Involved screening.
Good to know: Family caregiver payment: Parent payment is not automatic; CEN may apply for qualifying children
CIIS Medically Fragile Program
Yes / IndirectHelps pay for: Intensive in-home services/case management for children with complex, medically fragile needs who qualify under program criteria.
Who qualifies: Must meet CIIS Medically Fragile criteria and Medicaid/program requirements.
How to start: Ask the services coordinator about CIIS Medically Fragile screening.
Good to know: Family caregiver payment: Parent payment is not automatic; CEN may apply for qualifying children
ODDS In-Home Support
Nursing Services
Yes - skilledHelps pay for: Authorized nursing supports can address disability-related medical needs in the home and support safe community living.
Who qualifies: Must be eligible for Oregon I/DD services and Medicaid-funded supports; the Oregon Needs Assessment and Individual Support Plan determine authorized services/hours. Nursing must be medically necessary/authorized under the ISP.
How to start: Ask the services coordinator to evaluate nursing needs and coverage.
Good to know: Family caregiver payment: Only if the relative is independently qualified/enrolled under applicable nursing/provider rules
Assistive Technology / Other Technology Supports
IndirectHelps pay for: Technology that meets assessed disability-related needs can improve independence and reduce hands-on care burden.
Who qualifies: Must be eligible for Oregon I/DD services and Medicaid-funded supports; the Oregon Needs Assessment and Individual Support Plan determine authorized services/hours. Item/service must be included and authorized in the ISP.
How to start: Ask the services coordinator to document the need and applicable funding authority.
Good to know: Family caregiver payment: No caregiver wage
Community Transportation
IndirectHelps pay for: Transportation support can help eligible adults access community activities and services without relying entirely on family transportation.
Who qualifies: Must be eligible for Oregon I/DD services and Medicaid-funded supports; the Oregon Needs Assessment and Individual Support Plan determine authorized services/hours. Community transportation is generally an adult support and must be authorized in the ISP.
How to start: Ask the services coordinator/personal agent about transportation options.
Good to know: Family caregiver payment: No routine caregiver wage
Caregiver Support / Aging Network
Family Caregiver Support Program
IndirectHelps pay for: Information, counseling, support groups, training, respite and supplemental services can reduce unpaid-caregiver burden and purchased-care needs.
Who qualifies: Serves qualifying caregivers, including people caring for an adult age 60+ who needs in-home care and certain caregivers of people with Alzheimer's/related disorders.
How to start: Call ADRC and ask for the local Family Caregiver Support Program.
Good to know: Family caregiver payment: Usually not a caregiver wage; respite and supplemental help depend on local funding
Medicare Cost Offset
Medicare Savings Programs (QMB / SLMB / QI-SMF / QDWI)
IndirectHelps pay for: May pay Medicare premiums and, for some categories, deductibles/co-insurance, freeing household funds for home care.
Who qualifies: Must have Medicare Part A and meet the applicable Oregon income/program limits. Limits are updated periodically.
How to start: Apply through ODHS/ONE or call ADRC; SHIBA can provide free counseling.
Good to know: Family caregiver payment: No
Medicare Navigation
SHIBA - Senior Health Insurance Benefits Assistance
IndirectHelps pay for: Free Medicare counseling can help identify premium, drug and coverage savings that preserve funds for caregiving.
Who qualifies: Available statewide to people who need Medicare information/counseling.
How to start: Call SHIBA or use a local counseling site.
Good to know: Family caregiver payment: No
Medicare
Medicare Home Health
Yes - limited/skilledHelps pay for: Intermittent skilled nursing, therapy and certain home health aide services for eligible homebound beneficiaries.
Who qualifies: Must meet Medicare home-health eligibility, including qualifying skilled need, certification and plan-of-care requirements.
How to start: Ask the treating clinician and a Medicare-certified home health agency.
Good to know: Family caregiver payment: No routine family wage
Medicare Hospice
YesHelps pay for: Interdisciplinary end-of-life care can include nursing, aides, equipment, medications and respite related to the terminal illness.
Who qualifies: Medicare hospice eligibility/election and plan-of-care requirements apply.
How to start: Ask the clinician/hospice for evaluation and compare Medicare-certified providers.
Good to know: Family caregiver payment: No direct family wage
Prescription Cost Offset
Medicare Part D Extra Help
IndirectHelps pay for: Reduces Part D premiums, deductibles and prescription costs, preserving funds for caregiving.
Who qualifies: Medicare beneficiary meeting Extra Help criteria; some people qualify automatically.
How to start: Apply through Social Security or ask SHIBA for help.
Good to know: Family caregiver payment: No
Oregon Prescription Drug Program / ArrayRx
IndirectHelps pay for: State-sponsored prescription discount card can reduce the cost of FDA-approved medications at participating pharmacies.
Who qualifies: Discount program terms and participating pharmacies apply; it is not insurance.
How to start: Enroll/use the ArrayRx discount card and compare prices at participating pharmacies.
Good to know: Family caregiver payment: No
Food Cost Offset
SNAP Food Benefits
IndirectHelps pay for: Monthly food assistance can reduce grocery costs and free household funds for home care.
Who qualifies: Household eligibility rules apply; Oregon updates benefit/eligibility guidance as federal rules change.
How to start: Apply through benefits.oregon.gov or call ONE Customer Service.
Good to know: Family caregiver payment: No
Energy / Home Cost Offset
LIHEAP / Oregon Energy Assistance Programs
IndirectHelps pay for: Utility-bill assistance paid to utilities on behalf of eligible households can reduce housing costs and protect the home environment.
Who qualifies: Income, utility and local-provider rules apply; funding and application windows can be limited.
How to start: Contact the local community action/energy assistance provider listed by Oregon Housing and Community Services.
Good to know: Family caregiver payment: No
Communications Cost Offset
Oregon Lifeline
IndirectHelps pay for: Federal/state program providing discounted or free phone or high-speed internet service to qualifying low-income Oregon households.
Who qualifies: Must meet Oregon Lifeline income or qualifying-program rules and use a participating provider.
How to start: Apply through Oregon Lifeline or a participating service provider.
Good to know: Family caregiver payment: No
Property Tax Cost Offset
Senior and Disabled Property Tax Deferral
IndirectHelps pay for: Oregon can pay county property taxes for qualifying senior or disabled homeowners; deferred taxes become a state lien and accrue interest.
Who qualifies: For 2026 the household income limit is $70,000; age/disability, ownership, residence, equity/RMV and other rules apply. A lien and repayment obligation remain.
How to start: File with the county assessor by the regular or late filing deadline.
Good to know: Family caregiver payment: No
Veteran Property Tax Offset
Disabled Veteran or Surviving Spouse Property Tax Exemption
IndirectHelps pay for: Qualifying disabled Veterans or surviving spouses/domestic partners can exempt part of a homestead's assessed value from property tax.
Who qualifies: Oregon generally requires qualifying Veteran disability status; ODVA notes eligibility can include VA/Armed Forces certification of 40% or more disability. County filing rules apply.
How to start: Contact the county assessor or a Veteran Service Officer for the current claim form and certification requirements.
Good to know: Family caregiver payment: No
Income Replacement for Caregivers
Paid Leave Oregon - Family Leave
IndirectHelps pay for: Temporary paid leave can replace some wages while an eligible worker takes time away from work to care for a family member with a serious health condition.
Who qualifies: Worker must meet Paid Leave Oregon eligibility and qualifying family-leave/event requirements; employer equivalent-plan rules can apply.
How to start: Apply through Paid Leave Oregon or the employer's approved equivalent plan.
Good to know: Family caregiver payment: Not a caregiver wage from Medicaid; wage-replacement benefit to the worker
Veteran Emergency Cost Offset
Oregon Veterans' Emergency Financial Assistance Program (OVEFAP)
IndirectHelps pay for: Emergency financial assistance for eligible Veterans and immediate family can help stabilize urgent household needs and preserve resources for care.
Who qualifies: Eligibility, emergency-need documentation, funding and approved expense rules apply; awards are not guaranteed.
How to start: Work with an Oregon Veteran Service Officer or review the ODVA grant application process.
Good to know: Family caregiver payment: No routine caregiver wage
Insurance
Long-Term Care Insurance
Yes - if policy covers itHelps pay for: Existing long-term care insurance may reimburse covered home-care, personal-care or related long-term-care services depending on the policy.
Who qualifies: Benefit triggers, elimination periods, daily/monthly limits, provider requirements and exclusions are policy-specific.
How to start: Request the policy's home-care benefit summary and start a claim before services begin when possible.
Good to know: Family caregiver payment: May reimburse family-provided care only if the policy expressly permits it
Private Pay
Personal Savings / Family Cost Sharing / Private Home Care
YesHelps pay for: Household income, savings or shared family contributions can pay for private-duty personal care when public programs do not cover enough hours or the person is not eligible.
Who qualifies: Private-pay rates, minimum shifts, employment status, taxes and agency contracts vary. Screen public benefits first to avoid unnecessary out-of-pocket spending.
How to start: Compare licensed/qualified providers or direct-hire options and build a written care budget.
Good to know: Family caregiver payment: Yes if privately arranged and lawful; employment/tax rules apply when hiring directly
VA Benefits
VA Homemaker & Home Health Aide
YesHelps pay for: Personal care and help with daily activities delivered through VA-authorized home health aide agencies.
Who qualifies: Veteran must be enrolled/eligible for VA health care and clinically need the service; authorization and local availability apply. Ask the VA primary care team/social worker for a Geriatrics and Extended Care assessment.
How to start: Ask the VA social worker or care team about VA Homemaker & Home Health Aide.
Good to know: Family caregiver payment: No routine direct family wage
Veteran-Directed Care (VDC)
YesHelps pay for: Participant-directed budget for personal care and supports, giving the Veteran substantial choice/control over workers.
Who qualifies: Veteran needs nursing-home-level services or significant ADL support and must be served by a participating VDC program; local availability matters. Ask the VA social worker whether VDC is available through the local VA/aging-network partnership.
How to start: Ask the VA social worker or care team about Veteran-Directed Care (VDC).
Good to know: Family caregiver payment: Often yes - family/friends may potentially be hired subject to VDC, fiscal/employer and local program rules
VA Skilled Home Health Care
Yes - skilledHelps pay for: Short-term/intermittent skilled nursing, therapy and other clinical home-health services authorized by VA.
Who qualifies: Clinical need, VA authorization and participating provider requirements apply. Ask the VA care team for home-health referral/authorization.
How to start: Ask the VA social worker or care team about VA Skilled Home Health Care.
Good to know: Family caregiver payment: Only if a relative is independently qualified/enrolled under applicable provider rules
VA Respite Care
YesHelps pay for: Short-term in-home, adult-day or facility respite to relieve a family caregiver.
Who qualifies: Veteran must meet clinical eligibility and authorization criteria; modality/availability varies. Ask the VA care team or Caregiver Support Program about respite.
How to start: Ask the VA social worker or care team about VA Respite Care.
Good to know: Family caregiver payment: No - benefit is designed to give the caregiver relief
VA Adult Day Health Care
Indirect / YesHelps pay for: Daytime health, rehabilitation, social and supervision services that can reduce home-care hours.
Who qualifies: VA clinical eligibility, authorization and local program availability apply. Ask the VA social worker/primary care team about adult day health.
How to start: Ask the VA social worker or care team about VA Adult Day Health Care.
Good to know: Family caregiver payment: No direct family wage
VA Home Based Primary Care
Yes - medical careHelps pay for: Interdisciplinary primary care delivered at home for Veterans whose medical needs make clinic-based care difficult.
Who qualifies: Clinical complexity/homebound need and local HBPC program eligibility apply. Ask the VA primary care team for HBPC screening.
How to start: Ask the VA social worker or care team about VA Home Based Primary Care.
Good to know: Family caregiver payment: No direct family wage
Program of Comprehensive Assistance for Family Caregivers (PCAFC)
IndirectHelps pay for: Caregiver education/support and, for eligible Primary Family Caregivers, a monthly stipend plus other benefits.
Who qualifies: Veteran and caregiver must meet current PCAFC eligibility, service-connection/care-needs and application requirements. Apply jointly through VA caregiver benefits; local Caregiver Support team can help.
How to start: Ask the VA social worker or care team about Program of Comprehensive Assistance for Family Caregivers (PCAFC).
Good to know: Family caregiver payment: Yes - monthly stipend for an approved Primary Family Caregiver
Program of General Caregiver Support Services (PGCSS)
IndirectHelps pay for: Coaching, training, peer support, referrals and caregiver resources for eligible Veteran caregivers.
Who qualifies: Generally available to caregivers of Veterans enrolled in VA health care; program-specific participation rules apply. Contact the local VA Caregiver Support Program.
How to start: Ask the VA social worker or care team about Program of General Caregiver Support Services (PGCSS).
Good to know: Family caregiver payment: No stipend under PGCSS
VA Pension Aid & Attendance / Housebound
Yes - cash can offset careHelps pay for: Increased monthly VA pension for qualifying Veterans/survivors who need help with daily activities, are housebound or meet specified criteria; funds can help pay for care.
Who qualifies: Must first qualify for VA Pension/survivors pension and satisfy Aid & Attendance or Housebound criteria. File with VA or work with an accredited Veteran Service Officer.
How to start: Ask the VA social worker or care team about VA Pension Aid & Attendance / Housebound.
Good to know: Family caregiver payment: Can be used toward privately arranged care subject to pension rules; not a VA caregiver wage
VA Community Care Network - Oregon Region 4
Yes when authorizedHelps pay for: Authorized community providers can deliver VA-approved services when Community Care eligibility/authorization applies.
Who qualifies: Oregon is in VA Community Care Network Region 4; TriWest administers Regions 4 and 5. Community Care generally requires VA referral/authorization for non-emergency care. Work through the VA care team/community care office before scheduling non-emergency services.
How to start: Ask the VA social worker or care team about VA Community Care Network - Oregon Region 4.
Good to know: Family caregiver payment: Provider relationship rules depend on the specific authorized benefit
Oregon Department of Veterans' Affairs - VSO / Claims Help
IndirectHelps pay for: Accredited Veteran Service Officers help with VA claims, pension, Aid & Attendance and Oregon Veteran benefits.
Who qualifies: Veteran/dependent eligibility depends on the specific federal or state benefit. Use the ODVA county services directory to find a local accredited VSO.
How to start: Ask the VA social worker or care team about Oregon Department of Veterans' Affairs - VSO / Claims Help.
Good to know: Family caregiver payment: No caregiver wage
Oregon Veterans' Emergency Financial Assistance Program
IndirectHelps pay for: Emergency assistance for eligible Veterans and immediate family facing urgent financial need; can stabilize housing/utilities/other approved needs while care is arranged.
Who qualifies: Program-specific emergency-need, Veteran/family, documentation and funding rules apply; awards are not guaranteed. Apply through ODVA, preferably with help from a local Veteran Service Officer.
How to start: Ask the VA social worker or care team about Oregon Veterans' Emergency Financial Assistance Program.
Good to know: Family caregiver payment: No caregiver wage
Where Oregon Families Can Start
Not sure where to begin? Match your situation to a contact below.
Best statewide starting point for long-term care, APD/AAA offices, OPI/OPI-M, caregiver support and local aging/disability resources.
Aging and Disability Resource Connection (ADRC)
Apply for or manage Oregon Health Plan, food and other state benefits; request help with Medicaid eligibility.
ONE Customer Service / Benefits
Medicaid in-home-services assessment, service planning, Homecare Worker options, Spousal Pay, ICP and OPI/OPI-M.
Local APD / Area Agency on Aging
Help finding/enrolling Homecare Workers or Personal Support Workers and understanding consumer-employer responsibilities.
Oregon Home Care Commission / Employer Resource Connection
Fiscal/EVV support after ICP enrollment; case manager handles program screening and budget authorization.
Independent Choices Program / Acumen
Ask whether the new shared-employment in-home option is active/available and how referral works.
Agency with Choice - APD
Screen for state-funded OPI or Medicaid-funded OPI-M and compare cost/eligibility differences.
Oregon Project Independence / OPI-M
Apply for I/DD eligibility and start ODDS in-home supports for a child or adult.
Community Developmental Disabilities Program (CDDP)
Ask about PSWs, Employer Model Agencies, Children's Extraordinary Needs paid-parent program and CIIS.
ODDS In-Home / CEN / CIIS
Find the local ride brokerage and arrange pre-approved rides or eligible travel reimbursement.
OHP Non-Emergent Medical Transportation
Free Medicare counseling, Medicare Savings Program and Part D/Extra Help navigation.
SHIBA - Medicare Counseling
Start VA caregiver/home-care questions and get accredited help with pension, Aid & Attendance and state Veteran benefits.
VA / Oregon Department of Veterans' Affairs
Before You Rely on Any Payment Source
Planning Point
Why It Matters
Start with ADRC for aging/physical-disability long-term care
ADRC at 855-673-2372 can route families to the local APD/AAA office for Medicaid LTSS, OPI, OPI-M, caregiver support and other local services. Starting there reduces the risk of applying to the wrong program.
OPI and OPI-M are different programs
OPI is state funded, has no income or asset limit and usually uses a sliding participant fee; OPI-M is Medicaid funded, has much higher financial limits than traditional Medicaid, has no service fee if eligible and has no estate recovery. Local OPI waiting lists can still affect access.
OPI-M cannot be stacked with every Medicaid in-home model
OAR 411-014-0020 excludes concurrent Spousal Pay, Independent Choices and shift services, among other listed programs. Do not assume an OPI-M enrollee can add ICP or the Spousal Pay Program on top.
Independent Choices is Oregon's strongest general family-hire route
ICP rules expressly allow a participant's relative to be an employee provider. A representative cannot also be the paid employee provider, and the participant/representative must comply with budget, payroll, banking, EVV and employer responsibilities.
Spousal Pay is a high-threshold specialty program
The Spousal Pay Program requires full assistance in at least four of six ADLs plus a debilitating medical condition, nursing-facility risk and needs beyond customary spousal duties. The spouse must be the principal paid provider, meet HCW enrollment rules and cannot be the representative.
APD now has four in-home provider models
With the 2026 Agency with Choice rollout, APD describes four choices: Consumer Employer/Homecare Worker, Independent Choices, in-home care agencies and Agency with Choice. AwC was expected to launch in July 2026; confirm that the contracted option is operational in the member's area.
ODDS Employer Model Agency began in 2026
ODDS calls its Agency with Choice model the Employer Model Agency and planned it as a Jan. 1, 2026 in-home provider option alongside PSW self-direction and Standard Model Agencies. Ask the services coordinator which models are available locally.
The paid-parent CEN program is capacity-limited
Children's Extraordinary Needs can pay an eligible parent/guardian up to 20 hours per week, but the program has a waitlist. Capacity expanded to 230 children at a time beginning July 1, 2026, so qualifying for the service group does not guarantee immediate enrollment.
PACE is service-area limited
PACE requires age 55+, nursing-facility level of care and residence in a participating service area. Oregon has PACE only in selected counties/parts of counties, so verify the current ZIP/service boundary before relying on it.
APD waiver renewals are a 2026 watch item
Oregon's APD Aged and Physically Disabled 1915(c) waiver and related 1915(b)(4) waiver are approved through Dec. 31, 2026, and renewal applications were being processed for 2027-2031. Verify final CMS approval/rules for services starting in 2027.
OHP transportation reimbursement usually needs advance approval
OHP NEMT can cover rides and some travel costs such as gas, meals and lodging, but travel-cost reimbursement must generally be approved by the local ride service before the trip.
Use Veteran benefits as a separate funding layer
Oregon is in VA Community Care Network Region 4, administered by TriWest. VA home care, Veteran-Directed Care, PCAFC, Aid & Attendance, ODVA VSO help and Oregon Veteran tax/emergency benefits each have separate eligibility and authorization systems and may layer with state/federal benefits subject to payer rules.
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 Oregon to help you navigate the application process.
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