How to Pay for Home Care in Pennsylvania

Private pay from income, savings, investments, pensions, Social Security, or family contributions

Best fit: Families who need flexible, immediate care hours without waiting for program approval.

Helps pay for: Non-medical home care, personal care, companion care, dementia supervision, respite, transportation, homemaker help.

Who qualifies: Anyone with available personal funds. Family members may contribute directly or through a documented care agreement.

How to start: Compare licensed Pennsylvania home care agencies/registries or direct-hire arrangements; build a written schedule and budget.

Good to know: CareScout reported a 2025 Pennsylvania median annual cost of $77,792 for a non-medical caregiver based on 44 hours/week. Actual rates vary by locality and care needs.

Directly hired caregiver with household-employer payroll compliance

Best fit: Families who want to hire and supervise a caregiver directly.

Helps pay for: Wages for a private caregiver, companion, driver, health aide, or household worker.

Who qualifies: Family must evaluate worker classification, payroll taxes, wage/overtime rules, workers compensation and backup coverage.

How to start: Use a written agreement and review IRS household-employer rules plus Pennsylvania labor/tax requirements.

Good to know: A directly hired caregiver may be a household employee. Do not assume a cash-paid worker is an independent contractor.

Traditional long-term care insurance

Best fit: People who bought coverage before needing substantial care.

Helps pay for: Home care, personal care, respite and other covered long-term services, subject to the policy.

Who qualifies: Policyholder must meet the policy benefit trigger, elimination period, provider rules, benefit limits and claim requirements.

How to start: Request the full policy and current benefit statement; open a claim with the insurer.

Good to know: Coverage varies widely; verify whether agency-only, licensed-provider or informal caregiver restrictions apply.

Pennsylvania Long-Term Care Partnership policy

Best fit: People planning ahead who want private LTC coverage with potential Medicaid asset-disregard protection.

Helps pay for: Covered long-term care benefits; qualifying benefits may protect an equivalent amount of assets if Medicaid is later needed.

Who qualifies: Must be a Partnership-qualified policy and later satisfy Medicaid eligibility rules.

How to start: Ask insurer and Pennsylvania Insurance Department whether the policy is Partnership-qualified.

Good to know: A standard LTC policy is not automatically Partnership-qualified. Rules affect Medicaid planning and estate protection.

Hybrid life/LTC policy, chronic-illness rider, accelerated death benefit, life settlement or viatical settlement

Best fit: People with existing life insurance or combination coverage.

Helps pay for: May generate cash or reimbursement for qualifying care depending on policy terms.

Who qualifies: Depends on policy, health status, benefit trigger and transaction rules.

How to start: Ask insurer for an in-force illustration showing the effect on cash value and death benefit; seek tax/legal advice before a settlement.

Good to know: Using benefits can reduce death benefits or create tax/Medicaid consequences.

Reverse mortgage / Home Equity Conversion Mortgage (HECM)

Best fit: Homeowners age 62+ with sufficient equity who intend to remain in the home.

Helps pay for: Loan proceeds can be used for home care or other expenses.

Who qualifies: Borrower must meet HECM requirements and continue taxes, insurance and property obligations.

How to start: Use HUD-approved counseling before choosing a lender.

Good to know: Loan balance grows over time and home equity declines.

HELOC, home-equity loan, sale of home, downsizing, or renting part of the home

Best fit: Homeowners who can safely use housing equity to fund care.

Helps pay for: Private home care and related living costs.

Who qualifies: Depends on equity, credit, housing market and household needs.

How to start: Compare financing costs and effects on long-term housing security.

Good to know: Debt secured by the home can create foreclosure risk; sale/downsizing may affect Medicaid planning.

Social Security, pensions, retirement withdrawals, SSI/SSDI and family contributions

Best fit: Households using recurring income to fund part of a care plan.

Helps pay for: Any privately purchased home-care expense.

Who qualifies: Depends on benefit eligibility and available household income.

How to start: Build a monthly care budget and preserve an emergency reserve.

Good to know: These are not special home-care benefits; they are income sources that can be allocated toward care.

PA ABLE account for eligible people with disabilities

Best fit: Eligible people with qualifying disabilities who need to preserve means-tested benefits while saving for disability expenses.

Helps pay for: Qualified disability expenses may include housing, transportation, health, assistive technology and other disability-related costs that can free other income for care.

Who qualifies: Must meet federal ABLE disability eligibility rules.

How to start: Review PA ABLE eligibility and qualified-expense rules.

Good to know: Pennsylvania allows a deduction for contributions to PA ABLE accounts; withdrawals must meet qualified-disability-expense rules.

HSA, FSA/HRA, federal medical-expense deduction and dependent-care credit

Best fit: Families with eligible accounts or qualifying medical/dependent-care expenses.

Helps pay for: Qualified medical or long-term-care expenses; tax savings can offset overall care costs.

Who qualifies: Federal definitions and documentation rules apply; ordinary companionship/housekeeping does not automatically qualify.

How to start: Keep care plans, invoices, timesheets and proof of payment; consult a tax professional.

Good to know: Do not double-count the same expense for tax-free reimbursement and a deduction/credit.

Pennsylvania deduction for Health Savings Account contributions

Best fit: Pennsylvania taxpayers contributing to qualifying HSA accounts.

Helps pay for: Reduces Pennsylvania taxable income; HSA funds may later pay qualifying medical expenses under federal rules.

Who qualifies: Must meet applicable HSA rules.

How to start: Review PA personal income tax deductions and federal HSA requirements.

Good to know: This does not make ordinary non-medical home care tax-deductible; expense qualification is separate.

Original Medicare home health benefit

Best fit: Homebound Medicare beneficiaries who need qualifying intermittent skilled nursing or therapy.

Helps pay for: Skilled nursing, therapy, medical social services and limited home health aide care when linked to qualifying skilled care.

Who qualifies: Provider order, homebound status, Medicare-certified agency and other Medicare conditions must be met.

How to start: Ask the treating clinician for a home-health assessment/order and use a Medicare-certified agency.

Good to know: Does not cover 24-hour care, routine homemaker services, meal delivery, or personal care when that is the only need.

Medicare Advantage plan home health and supplemental benefits

Best fit: Medicare Advantage members whose plan offers relevant benefits.

Helps pay for: Medicare-covered home health plus possible supplemental in-home supports, meals, transportation or care management.

Who qualifies: Plan-specific, county-specific and subject to authorization/network rules.

How to start: Review current Evidence of Coverage and call the plan before scheduling services.

Good to know: Benefits change annually and should not be assumed from advertising.

Medicare GUIDE dementia-care model

Best fit: Original Medicare beneficiaries with dementia who align to a participating GUIDE organization.

Helps pay for: Dementia care navigation, caregiver education, 24/7 support and qualifying respite services.

Who qualifies: Must meet CMS GUIDE eligibility; Medicare Advantage and PACE enrollees are generally not eligible.

How to start: Search the CMS GUIDE participant list or call 1-800-MEDICARE.

Good to know: Respite is arranged through the GUIDE participant and is subject to an annual cap; it is not a cash caregiver stipend.

Medicare caregiver training services

Best fit: Medicare patients whose caregivers need training to carry out the treatment plan.

Helps pay for: Training in transfers, medication support, wound prevention, condition management and similar skills.

Who qualifies: Treating clinician must determine training is necessary; Part B rules apply.

How to start: Ask the clinician whether caregiver-training billing is appropriate.

Good to know: Helps caregivers provide safer care but does not pay the caregiver a wage.

Medical Assistance home health services

Best fit: Pennsylvania Medicaid beneficiaries who meet medical-necessity and program rules.

Helps pay for: Home health nursing, therapy and other covered services.

Who qualifies: Medical Assistance eligibility and authorization requirements apply.

How to start: Apply through COMPASS/County Assistance Office or call the DHS Consumer Service Center.

Good to know: Home health is different from ongoing custodial personal care.

Community HealthChoices (CHC) HCBS — personal assistance, home health, transportation and LTSS

Best fit: Adults 21+ who are dual-eligible or receive Medicaid LTSS because they need help with everyday personal tasks.

Helps pay for: Personal assistance services, participant-directed supports, home health, transportation and other authorized HCBS.

Who qualifies: Must meet Medicaid/CHC and functional eligibility requirements; service plan and authorization apply.

How to start: Apply for long-term care/HCBS through PA DHS/Independent Enrollment Broker; CHC participant call center can assist.

Good to know: CHC is Pennsylvania managed long-term services and supports; covered hours/services depend on assessed need and authorization.

CHC participant-directed Personal Assistance Services and Community Supports

Best fit: Eligible CHC participants who want more control over who provides approved services.

Helps pay for: Authorized personal assistance and participant-directed community supports; participants may recruit/manage workers within program rules.

Who qualifies: CHC participant must be approved for the relevant service and follow financial-management/EVV rules.

How to start: Ask CHC service coordinator about participant direction, Employer Authority or Agency with Choice.

Good to know: Some family members may be allowed as workers depending on the service and relationship; confirm current rules before assuming payment.

LIFE (Living Independence for the Elderly) — Pennsylvania PACE program

Best fit: Adults 55+ in a LIFE service area who meet nursing-facility level of care and can live safely in the community.

Helps pay for: In-home supportive care, personal care, nursing, therapies, meals, transportation, prescriptions and comprehensive medical care.

Who qualifies: Age 55+, service area, nursing-facility level of care, safe community living; Medicaid financial eligibility or private-pay option.

How to start: Call the Independent Enrollment Broker or a local LIFE provider.

Good to know: LIFE is Pennsylvania’s PACE program. Enrollment changes how Medicare/Medicaid services are delivered.

Act 150 Attendant Care Program

Best fit: Pennsylvania residents with physical disabilities who need skilled-nursing-facility level of care but do not qualify for Medicaid HCBS due to financial eligibility.

Helps pay for: Attendant care/personal assistance that supports community living.

Who qualifies: Must meet Act 150 functional and program requirements and be able to hire, fire and supervise workers/manage affairs.

How to start: Apply through Pennsylvania’s Independent Enrollment Broker.

Good to know: State-funded and targeted to physical disability; cost sharing or program limits may apply.

OBRA Waiver

Best fit: Adults with severe developmental physical disabilities who meet OBRA waiver criteria.

Helps pay for: Daily-living services, environmental adaptations, assistive technology, community integration, respite and transportation.

Who qualifies: Specific disability onset, functional limitation and level-of-care rules apply.

How to start: Contact OLTL/PA Link or begin HCBS application through DHS.

Good to know: Not an aging-only program; eligibility is disability-specific.

Nursing Home Transition (NHT)

Best fit: Medicaid-eligible or potentially eligible nursing-facility residents who want to return to the community.

Helps pay for: Transition planning and supports needed to move from a nursing facility to home/community.

Who qualifies: Must meet NHT and long-term-services eligibility rules.

How to start: Ask nursing-facility social worker, CHC MCO/LIFE provider, or NHT helpline/provider.

Good to know: Not a general home-care benefit for someone already living at home; it supports facility-to-community transition.

OPTIONS Program

Best fit: Pennsylvania residents age 60+ who want to remain at home and need support with daily living.

Helps pay for: Personal care, home support, home-delivered meals, adult day services, home health when not otherwise covered and specialized medical transportation; local supplemental services may be available.

Who qualifies: Age 60+, Pennsylvania resident; assessed need and local AAA resources; cost sharing may apply.

How to start: Contact local Area Agency on Aging or PA Link.

Good to know: Availability and waiting lists vary by AAA; this can be important for people who are not Medicaid eligible.

Area Agencies on Aging — local in-home and supportive services

Best fit: Older adults who need help staying at home and caregivers seeking local programs.

Helps pay for: May include personal assistance, meals, transportation, caregiver support, protective services, senior centers, benefits counseling and other local services.

Who qualifies: Eligibility and availability vary by service and county/AAA.

How to start: Find the local AAA through Pennsylvania Department of Aging or PA Link.

Good to know: Pennsylvania has 52 AAAs; services and waiting lists vary locally.

Pennsylvania Caregiver Support Program

Best fit: Eligible unpaid caregivers supporting an older adult, person with dementia or certain relatives with disabilities.

Helps pay for: Respite, consumable supplies, supportive/supplemental services, home modifications, assistive devices, care management and training.

Who qualifies: No absolute financial-eligibility cutoff for services, but reimbursement percentage uses income sliding scale; some LTSS enrollees are excluded.

How to start: Apply through local AAA.

Good to know: Current maximum reimbursement is up to $600/month based on reimbursement percentage and up to $5,000 lifetime for home modifications/assistive devices, subject to program rules.

PA Link to Aging and Disability Resources

Best fit: Older adults, people with disabilities and caregivers who do not know which program fits.

Helps pay for: Connects people to home care, LTSS, meals, transportation, benefits, assistive technology and other local resources.

Who qualifies: Open to people seeking aging/disability resource information.

How to start: Call statewide helpline or search local providers.

Good to know: One of the best first calls when eligibility or program choice is unclear.

Home-delivered meals, congregate meals, SNAP and Senior Food Box

Best fit: Older adults whose food costs or meal preparation increase caregiver hours.

Helps pay for: Meals/food assistance can reduce grocery and caregiver meal-preparation costs.

Who qualifies: Program-specific age/income/functional rules apply.

How to start: Contact local AAA for meals; apply for SNAP through COMPASS; ask about Senior Food Box.

Good to know: Not a caregiver wage, but reducing meal tasks can lower paid-care hours.

Pennsylvania senior shared-ride and local AAA transportation

Best fit: Adults 65+ or other eligible riders who otherwise pay a caregiver for transportation/wait time.

Helps pay for: Shared rides and other local transportation to appointments, shopping and essential activities.

Who qualifies: Eligibility and reservation rules vary by transit agency/program.

How to start: Use PennDOT public transportation map and local AAA/transit provider.

Good to know: Can reduce caregiver driving hours but may not meet all mobility or medical-transport needs.

PACE and PACENET pharmaceutical assistance

Best fit: Qualified Pennsylvania residents age 65+ with prescription costs.

Helps pay for: Reduces out-of-pocket prescription drug costs, freeing household income for care.

Who qualifies: Age, residency and income rules apply; coordinates with Medicare Part D and other coverage.

How to start: Apply online or by phone.

Good to know: This is prescription assistance, not payment for caregiver hours.

Property Tax/Rent Rebate Program

Best fit: Eligible homeowners/renters age 65+, widows/widowers 50+, and adults with disabilities meeting income rules.

Helps pay for: Rebate can help preserve cash for home care and household needs.

Who qualifies: 2025 rebate claims use program age/disability and income rules; maximum standard rebate up to $1,000, with possible supplemental rebate for some households.

How to start: Apply through myPATH or Department of Revenue.

Good to know: Annual application required; not restricted to home-care spending.

LIHEAP home-heating assistance

Best fit: Income-eligible households during an open LIHEAP season.

Helps pay for: Heating-bill grants can preserve income for care.

Who qualifies: Seasonal and income-based.

How to start: Apply through COMPASS when season is open.

Good to know: 2025-26 season is closed as of August 2026; check for the next season before relying on it.

VA Homemaker and Home Health Aide Care

Best fit: Eligible veterans who need assistance with ADLs and approved homemaker/personal care.

Helps pay for: Authorized aide help with bathing, dressing, grooming, toileting, mobility and related tasks.

Who qualifies: VA health-care eligibility, clinical assessment, service availability and possible copay.

How to start: Ask VA primary care, geriatrics or social worker for assessment.

Good to know: Hours are based on VA assessment and authorization; not automatically full-time care.

VA Skilled Home Health Care

Best fit: Veterans needing skilled nursing, therapy or other medical home health.

Helps pay for: Skilled nursing, therapy, wound care, IV therapy and case management.

Who qualifies: Clinical need and VA authorization apply.

How to start: Ask VA provider or discharge planner.

Good to know: Medical home health, not ongoing companion care.

Veteran-Directed Care

Best fit: Eligible veterans who need home/community services and want control over workers and approved budget.

Helps pay for: Personal care and other approved HCBS; may allow hiring family/friends under local rules.

Who qualifies: Availability and eligibility vary by VA medical center/community program.

How to start: Ask VA social worker whether Veteran-Directed Care serves the veteran’s location.

Good to know: Do not assume every Pennsylvania VA market offers VDC or that every relative can be hired.

VA Aid and Attendance or Housebound pension increase

Best fit: Veterans/survivors who first qualify for VA pension and meet additional care/homebound criteria.

Helps pay for: Additional pension income can be used toward home care and other living expenses.

Who qualifies: Underlying VA pension eligibility plus Aid and Attendance/Housebound criteria.

How to start: Use an accredited VSO or VA to screen and apply.

Good to know: Not a standalone caregiver program; it increases qualifying pension payments.

Program of Comprehensive Assistance for Family Caregivers (PCAFC)

Best fit: Eligible veterans with qualifying service-connected disability and personal-care needs, plus approved family caregiver.

Helps pay for: Monthly stipend for primary caregiver plus training, counseling, respite and possible health coverage.

Who qualifies: VA assessment and program criteria apply.

How to start: Apply through VA Caregiver Support Program.

Good to know: Eligibility is narrower than general veteran home-care eligibility.

VA Community Care Network (CCN) — Pennsylvania Region 1 / Optum

Best fit: Eligible veterans when VA authorizes care from a community provider.

Helps pay for: Authorized home health, rehabilitation, hospice and other approved community services; home health can be delivered through CCN.

Who qualifies: Routine care generally requires VA referral/authorization; Pennsylvania is in Region 1, administered by Optum.

How to start: Start with VA care team; do not independently hire a provider expecting reimbursement.

Good to know: CCN is the provider network/payment mechanism, not a cash benefit or unrestricted caregiver allowance.

VA Respite Care, Adult Day Health Care and Home-Based Primary Care

Best fit: Eligible veterans with clinical or caregiver-support needs.

Helps pay for: Temporary respite, adult day services and interdisciplinary primary care in the home for qualifying veterans.

Who qualifies: Program-specific VA eligibility, assessment and local availability.

How to start: Ask VA social worker/geriatrics team to screen for all relevant home/community services at once.

Good to know: Can be combined with other VA services when clinically appropriate.

Pennsylvania DMVA / accredited Veterans Service Officers

Best fit: Pennsylvania veterans and families who need help identifying or applying for VA/state benefits.

Helps pay for: Free benefits screening and claim assistance can help access VA pension, health care, caregiver and other programs.

Who qualifies: Veteran/service eligibility varies by benefit.

How to start: Contact county Veterans Affairs office, accredited VSO, or Pennsylvania DMVA outreach.

Good to know: Use accredited assistance; be cautious of companies charging for initial VA claims or asset-restructuring schemes.

Veterans Temporary Assistance (VTA)

Best fit: Eligible Pennsylvania veterans or beneficiaries with temporary financial need.

Helps pay for: Up to $1,600 in a 12-month period for necessities such as food, shelter, fuel and clothing, preserving other funds for care.

Who qualifies: Pennsylvania residency, qualifying veteran status and temporary need rules apply.

How to start: Apply through county Director of Veterans Affairs or approved channels.

Good to know: Not specifically a home-care benefit, but can stabilize essential household expenses.

Medicare, Medicaid, VA or private-insurance hospice benefit

Best fit: People with terminal illness who meet hospice eligibility and elect comfort-focused care.

Helps pay for: Nursing, hospice aide/homemaker services, equipment, medications, social work and limited respite per plan of care.

Who qualifies: Program-specific hospice eligibility and election requirements.

How to start: Ask treating clinician or hospice; verify payer rules.

Good to know: Hospice is not a general 24/7 custodial home-care benefit.

Workers compensation, auto insurance, liability settlement or court-ordered damages

Best fit: People whose need for home care resulted from a work injury, vehicle crash or other compensable event.

Helps pay for: Home health, attendant care or related costs when legally covered.

Who qualifies: Depends on policy, claim, medical necessity, settlement language and state law.

How to start: Contact insurer/claims administrator and attorney when appropriate.

Good to know: Do not assume standard health or auto coverage automatically pays long-term custodial care.

Local nonprofits, disease-specific charities, faith communities, volunteer respite and 211 referrals

Best fit: Families with gaps not covered by insurance or public programs.

Helps pay for: Small grants, respite, transportation, home modifications, meals, equipment or volunteer assistance.

Who qualifies: Varies by organization, diagnosis, geography and funding cycle.

How to start: Call PA 211 and local AAA; search disease-specific and local community foundations.

Good to know: Usually supplemental rather than a stable long-term payer.

Employer caregiver benefits, EAP, paid leave if offered, flexible work and federal FMLA job protection

Best fit: Working family caregivers balancing employment and care.

Helps pay for: Employer backup-care benefits or paid leave can offset private care; flexible schedules may reduce paid hours.

Who qualifies: Employer-specific. Pennsylvania does not currently require statewide paid family leave for private employers; federal FMLA may provide unpaid job-protected leave for eligible workers.

How to start: Ask HR for caregiving, leave, EAP and backup-care benefits.

Good to know: Confirm whether leave is paid or unpaid and how health coverage continues.