How to Pay for In-Home Care
How to Pay for Home Care in South Carolina
Jump to a state to see its Medicaid programs, waivers, and other ways to help pay for in-home care.
South Carolina families typically start with Community Choices, the state's principal nursing-facility-level HCBS waiver for frail adults 65+ and adults 18-64 with physical disabilities, coordinated through CLTC intake and offering both agency and participant-directed service models. Community Choices permits payment to some qualified relatives in self-directed services, but excludes specified legally responsible relationships, so families should not assume a spouse or parent of a minor can be paid and should verify the exact relationship and service before hiring. Families of a medically complex child ages 1-21 should look at the Medically Complex Children waiver's self-directed Children's Attendant Care service, which can pay an eligible parent, relative, or guardian hourly for extraordinary day-to-day care when program requirements and authorization are met. Intellectual/developmental disability or related-disability needs route through the separate BHDD Office of Intellectual and Developmental Disabilities system (ID/RD, Community Supports, and HASCI), where self-direction and caregiver rules differ from CLTC and should be verified independently. Since Healthy Connections Prime ended in January 2026, dual-eligible planning now centers on D-SNP coordination plus Medicaid LTSS, and every plan can be layered with Medicare Savings Programs, Extra Help, SNAP, energy assistance, senior nutrition, caregiver respite, property-tax relief, HIPP, and Veteran benefits.
Updated August 2026
Reviewed by Valerie VanBooven, RN, BSN
Medicaid LTSS
Healthy Connections Medicaid LTSS / HCBS
Yes, when authorizedHelps pay for: State Plan and waiver long-term services that can support care at home and in the community.
Who qualifies: Must meet Medicaid financial rules and the clinical criteria for the applicable service or waiver.
How to start: Call CLTC for HCBS/waiver screening and Healthy Connections for Medicaid eligibility.
Good to know: Family caregiver payment: Depends on program/service
Community Choices
Community Choices (CC) Waiver
YesHelps pay for: Home and community-based alternatives to nursing-facility care, including personal assistance, respite and other supports.
Who qualifies: Generally serves frail adults 65+ and adults 18-64 with physical disabilities who meet nursing-facility level of care and Medicaid requirements.
How to start: Request CLTC screening and waiver assessment.
Good to know: Family caregiver payment: Potentially for qualified relatives in eligible services
CC Personal Care
YesHelps pay for: Hands-on help with ADLs and authorized personal care needs.
Who qualifies: Must be in the authorized Community Choices plan and delivered by an enrolled/qualified worker or agency.
How to start: Ask CLTC/case manager to assess and authorize personal-care needs.
Good to know: Family caregiver payment: Potentially under applicable family-caregiver policy
CC Companion Care - Agency
YesHelps pay for: Agency-provided companion/supervision supports.
Who qualifies: Current renewal materials distinguish agency-model family caregiver rules from self-directed rules.
How to start: Ask case manager for participating companion-care agencies and relationship rules.
Good to know: Family caregiver payment: Potentially, but legally responsible relationships are restricted
CC Respite - In Home
Yes - temporary/respite careHelps pay for: Short-term relief for an unpaid primary caregiver.
Who qualifies: Must be authorized in the waiver plan and meet service criteria.
How to start: Tell the case manager how many unpaid-care hours and relief needs exist.
Good to know: Family caregiver payment: Usually not a direct wage to the primary caregiver
CC Adult Day Health Care
Can reduce paid home-care hoursHelps pay for: Daytime health, supervision, therapeutic and social supports that can reduce home-care hours.
Who qualifies: Must be waiver-authorized and use an enrolled provider.
How to start: Ask case manager about local adult-day availability.
Good to know: Family caregiver payment: No direct family wage
CC Adult Day Health Care Nursing
Indirect/clinical supportHelps pay for: Nursing services delivered through approved adult-day health settings.
Who qualifies: Clinical need and waiver authorization required.
How to start: Ask case manager/adult-day provider about nursing authorization.
Good to know: Family caregiver payment: No direct family wage
CC Home-Delivered Meals
Offsets a care taskHelps pay for: Prepared meals delivered to the home, reducing meal-preparation burden.
Who qualifies: Must be waiver-authorized and meet service criteria.
How to start: Request meal-service screening through case management.
Good to know: Family caregiver payment: No
CC Personal Emergency Response System (PERS)
IndirectHelps pay for: Emergency call system that supports safety and can reduce supervision burden.
Who qualifies: Must be authorized based on assessed need.
How to start: Ask the case manager about PERS eligibility.
Good to know: Family caregiver payment: No
CC Telemonitoring
IndirectHelps pay for: Remote monitoring/technology that can support safety and care coordination.
Who qualifies: Must be clinically appropriate and waiver-authorized.
How to start: Ask case manager whether telemonitoring fits the service plan.
Good to know: Family caregiver payment: No
CC Home Accessibility / Environmental Modifications
Offsets care needsHelps pay for: Approved home modifications that improve safe access and reduce hands-on assistance.
Who qualifies: Must meet waiver service definition and prior-authorization requirements.
How to start: Discuss specific barriers and obtain authorization before work begins.
Good to know: Family caregiver payment: No
CC Specialized Medical Equipment & Supplies
IndirectHelps pay for: Approved equipment/supplies beyond ordinary Medicaid coverage when waiver criteria are met.
Who qualifies: Medical necessity and waiver authorization apply.
How to start: Ask case manager to coordinate with medical providers/vendors.
Good to know: Family caregiver payment: No
CC Pest Control
Indirect household offsetHelps pay for: Approved pest-control service to maintain a safe home environment.
Who qualifies: Must meet waiver service criteria and authorization.
How to start: Ask case manager whether the assessed home environment qualifies.
Good to know: Family caregiver payment: No
CC Case Management
IndirectHelps pay for: Assessment, service planning, referrals and coordination across authorized home/community services.
Who qualifies: Available to enrolled waiver participants.
How to start: Use assigned case manager to build and revise the care plan.
Good to know: Family caregiver payment: No
Community Choices - Self Direction
CC Attendant Care - Self-Directed
YesHelps pay for: Participant-directed assistance with personal needs and daily activities.
Who qualifies: Participant-directed service; family relationship and worker qualifications must meet current SCDHHS rules.
How to start: Ask the case manager specifically for participant-directed attendant care and FMS setup.
Good to know: Family caregiver payment: Yes for some qualified relatives; exclusions apply
CC Companion Care - Individual
YesHelps pay for: Participant-directed companion/supervision and approved assistance.
Who qualifies: Must be authorized; worker relationship and qualifications are program-specific.
How to start: Ask case manager about individual/self-directed companion care.
Good to know: Family caregiver payment: Yes for some qualified relatives; exclusions apply
Paid Family Caregiver
Community Choices - Qualified Family Caregiver Payment
YesHelps pay for: Certain qualified relatives may be paid for eligible self-directed or other waiver services when relationship and provider rules are satisfied.
Who qualifies: Current materials exclude specified legally responsible relationships; verify exact relationship, service model and provider qualifications before hiring.
How to start: Ask CLTC/case manager for a written relationship determination for the intended worker.
Good to know: Family caregiver payment: Potentially yes
Community Choices - Agency-Model Family Caregiver Employment
YesHelps pay for: An enrolled agency may employ some relatives for covered services when family-caregiver policy permits.
Who qualifies: Agency rules are more restrictive for legally responsible relationships; spouse and parent/stepparent/foster parent of a minor are among relationships described as excluded in current materials.
How to start: Ask the agency and case manager to verify worker relationship before onboarding.
Good to know: Family caregiver payment: Potentially for eligible relatives
MCC Paid Parent / Relative / Guardian Care
YesHelps pay for: Hourly payment to an eligible parent, relative or guardian for authorized extraordinary day-to-day care under CAC.
Who qualifies: Program-specific worker training, service authorization and payroll requirements apply.
How to start: Ask Waiver Nurse Case Manager for CAC family-worker enrollment steps.
Good to know: Family caregiver payment: Yes
Self Direction Administration
Community Choices Financial Management Services (FMS)
Enables paid self-directed careHelps pay for: Payroll, tax withholding and employer-support functions for participant-directed services.
Who qualifies: Applies when participant-directed services are authorized.
How to start: Complete FMS/employer enrollment with the case-management team.
Good to know: Family caregiver payment: Supports payroll to approved worker
Medicaid State Plan
Medicaid Incontinence Supplies
Offsets recurring care costsHelps pay for: Diapers, briefs, pads, underpads, wipes and related supplies delivered for eligible members.
Who qualifies: Generally age 4+, Medicaid eligible, with physician certification and program criteria.
How to start: Call CLTC Centralized Intake and obtain required medical documentation.
Good to know: Family caregiver payment: No
Medicaid Home Health / Skilled Services
Yes - skilled/clinical careHelps pay for: Intermittent skilled nursing, therapy and home-health services when covered and medically necessary.
Who qualifies: Medicaid eligibility, medical necessity and provider requirements apply.
How to start: Ask physician/care manager for a home-health referral and authorization.
Good to know: Family caregiver payment: No direct family wage
Children - State Plan
Children’s Personal Care
YesHelps pay for: In-home personal care for Medicaid-enrolled children when medically necessary and authorized.
Who qualifies: Medicaid eligibility, medical necessity and authorization required.
How to start: Ask the child’s Medicaid care team/provider for assessment and authorization.
Good to know: Family caregiver payment: Depends on provider/worker rules
Home-Based Private Duty Nursing
Yes - skilled nursingHelps pay for: Extended skilled nursing in the home for qualifying Medicaid children/beneficiaries.
Who qualifies: Requires medical necessity, physician orders and prior authorization.
How to start: Work with treating clinician and enrolled PDN provider.
Good to know: Family caregiver payment: Not generally a family wage unless a specific pathway permits
Medicaid / Hospice
Medicaid Hospice + HCBS Coordination
Yes - hospice servicesHelps pay for: Hospice can cover end-of-life clinical/supportive care while other Medicaid LTSS may address separate authorized needs.
Who qualifies: Hospice eligibility and coordination rules apply; avoid duplicate billing for the same service.
How to start: Ask hospice and Medicaid case manager to coordinate covered services.
Good to know: Family caregiver payment: No direct family wage
Children - Waiver
Medically Complex Children (MCC) Waiver
YesHelps pay for: HCBS for children with chronic physical/health conditions who meet hospital-level care criteria.
Who qualifies: Clinical/Medicaid eligibility and waiver requirements apply.
How to start: Request MCC screening through the child’s care team / SC Solutions.
Good to know: Family caregiver payment: Yes through specific self-directed service
Children - Self Direction
MCC Children’s Attendant Care (CAC)
YesHelps pay for: Self-directed home-based attendant care for eligible MCC participants ages 1-21.
Who qualifies: Must be enrolled in MCC, meet age/service criteria, and have extraordinary care authorized in the plan.
How to start: Ask the Waiver Nurse Case Manager to assess and authorize CAC.
Good to know: Family caregiver payment: Yes - eligible parents, relatives or guardians may be paid
Medicaid Waiver
Mechanical Ventilator Dependent Waiver
YesHelps pay for: HCBS for qualifying people who are ventilator dependent and meet waiver/level-of-care criteria.
Who qualifies: Must meet program clinical, Medicaid and level-of-care requirements.
How to start: Request waiver screening through SCDHHS/CLTC.
Good to know: Family caregiver payment: Depends on service and worker rules
HIV/AIDS Waiver
YesHelps pay for: HCBS for eligible Medicaid members with HIV/AIDS who meet program criteria.
Who qualifies: Must meet waiver medical/financial criteria and service authorization.
How to start: Contact SCDHHS/CLTC for current eligibility and service access.
Good to know: Family caregiver payment: Depends on service and worker rules
Integrated Care
PACE - Program of All-Inclusive Care for the Elderly
Yes, as part of PACE planHelps pay for: Comprehensive medical and LTSS package, including home/community services, for qualifying older adults.
Who qualifies: Age 55+, live in service area, meet nursing-home level of care and be able to live safely in the community with PACE support. Available only in participating counties.
How to start: Contact a PACE organization serving the member’s county.
Good to know: Family caregiver payment: Not usually a direct family wage
Dual Eligible
Dual Special Needs Plan (D-SNP) Coordination
Indirect / may coordinate home servicesHelps pay for: Coordinates Medicare benefits with Medicaid for dual-eligible members; HIDE D-SNPs may provide tighter alignment.
Who qualifies: Must meet Medicare/Medicaid and plan enrollment rules; Medicaid waiver services remain governed by Medicaid.
How to start: Compare available D-SNPs and coordinate with Medicaid LTSS/case management.
Good to know: Family caregiver payment: No direct family wage
Transition
Home Again / Money Follows the Person
Can help establish home careHelps pay for: Transition services and supports for eligible Medicaid members moving from institutional care back to the community.
Who qualifies: Generally requires at least 60 consecutive days in a nursing facility/hospital, Medicaid payment for at least one day, and qualifying level of care.
How to start: Submit a Home Again referral through CLTC.
Good to know: Family caregiver payment: No direct family wage
Medicaid Eligibility
Working Disabled Medicaid
Can unlock Medicaid home-care coverageHelps pay for: Medicaid eligibility pathway for qualifying working adults with disabilities, helping preserve health/LTSS coverage while employed.
Who qualifies: Under 65, disabled and working; income/resource and unearned-income rules apply.
How to start: Apply for Healthy Connections Medicaid and identify Working Disabled status.
Good to know: Family caregiver payment: Depends on program/service
Children - Medicaid Eligibility
TEFRA / Katie Beckett Medicaid
Can unlock home-care coverageHelps pay for: Allows certain children with disabilities who meet institutional level-of-care criteria to qualify without counting parental income/resources.
Who qualifies: Child under 19; disability/level-of-care and child income/resource criteria apply.
How to start: Apply through SCDHHS using TEFRA process/forms.
Good to know: Family caregiver payment: Not itself a caregiver wage
Children - Medicaid
EPSDT Medically Necessary Services
Can include medically necessary home servicesHelps pay for: For Medicaid members under 21, requires coverage of medically necessary services within the federal EPSDT framework.
Who qualifies: Under 21, Medicaid enrolled, service medically necessary and within covered federal/state framework.
How to start: Ask the child’s clinician/Medicaid plan for EPSDT review when a needed service is denied or not routinely listed.
Good to know: Family caregiver payment: Depends on underlying service
I/DD Waiver
Intellectual Disability / Related Disabilities (ID/RD) Waiver
YesHelps pay for: Home/community supports for eligible people with intellectual or related disabilities.
Who qualifies: BHDD-OIDD eligibility plus Medicaid/waiver criteria and available capacity.
How to start: Start with OIDD eligibility screening.
Good to know: Family caregiver payment: Depends on service and worker rules
Community Supports (CS) Waiver
YesHelps pay for: HCBS for eligible people with intellectual/related disabilities; includes opportunities to self-direct certain services.
Who qualifies: BHDD-OIDD and waiver eligibility; service authorization and capacity apply.
How to start: Start OIDD eligibility and ask specifically about Community Supports/self-direction.
Good to know: Family caregiver payment: Potentially depending on self-directed service rules
Brain Injury / Related Disability
HASCI Waiver
YesHelps pay for: HCBS for eligible people with head and spinal cord injury or related disabilities.
Who qualifies: BHDD-OIDD eligibility and waiver clinical/financial criteria apply.
How to start: Contact OIDD for eligibility and waiver screening.
Good to know: Family caregiver payment: Depends on service/worker rules
I/DD Self Direction
Community Supports Self-Directed Services
YesHelps pay for: Participant-controlled supports for eligible OIDD waiver participants.
Who qualifies: Only services designated for self-direction; individual budget and service-plan rules apply.
How to start: Ask OIDD case manager/service coordinator which authorized services can be self-directed.
Good to know: Family caregiver payment: Potentially, subject to worker/relationship rules
I/DD Caregiver Support
ID/RD Caregiver Coaching
IndirectHelps pay for: Coaching/training to strengthen caregiver skills and support successful community living.
Who qualifies: Must be authorized under the applicable OIDD service plan.
How to start: Ask OIDD case manager whether caregiver coaching is available/appropriate.
Good to know: Family caregiver payment: No direct family wage
I/DD Services
OIDD Adult Companion Services
Yes / supervision supportHelps pay for: Companion/support services available through qualified OIDD providers when authorized.
Who qualifies: OIDD eligibility and service-plan authorization required.
How to start: Use OIDD service directory/case manager to identify providers.
Good to know: Family caregiver payment: Depends on service model
OIDD Respite Services
Yes - respiteHelps pay for: Temporary relief for unpaid caregivers through authorized OIDD supports.
Who qualifies: OIDD eligibility and service-plan authorization required.
How to start: Ask case manager to assess respite need and available providers.
Good to know: Family caregiver payment: Usually not a wage to the primary caregiver
OIDD Assistive Technology / Environmental Supports
IndirectHelps pay for: Approved technology/equipment/home supports that can improve independence and reduce hands-on care.
Who qualifies: Must fit an authorized service and plan.
How to start: Discuss barriers and technology/home-support options with OIDD case manager.
Good to know: Family caregiver payment: No
OIDD Case Management / Community Supports
IndirectHelps pay for: Assessment, coordination and connection to waiver/community services.
Who qualifies: OIDD eligibility and program assignment apply.
How to start: Complete OIDD eligibility and use assigned coordinator to develop plan.
Good to know: Family caregiver payment: No
Aging Network
Family Caregiver Support Program
Can fund/arrange respite or supportsHelps pay for: Information, counseling, training, support groups and respite support through Area Agencies on Aging.
Who qualifies: Eligibility follows Older Americans Act caregiver categories and local AAA priorities/funding.
How to start: Contact GetCareSC / local AAA and ask for Family Caregiver Support.
Good to know: Family caregiver payment: No regular caregiver wage
AAA Personal Care
PotentiallyHelps pay for: Local aging-network personal care assistance for eligible older adults, subject to funding and local availability.
Who qualifies: Generally targeted to adults 60+ with assessed need; local criteria/wait lists vary.
How to start: Call GetCareSC/local AAA for assessment.
Good to know: Family caregiver payment: No direct family wage
AAA Homemaker / Chore Services
Offsets care tasksHelps pay for: Help with household tasks that can preserve independence and reduce paid-care burden.
Who qualifies: Local eligibility, funding and availability vary.
How to start: Ask local AAA about supportive/home services.
Good to know: Family caregiver payment: No
AAA Respite
Yes - temporary careHelps pay for: Short-term relief for caregivers through aging-network programs.
Who qualifies: Local assessment, funding and caregiver eligibility apply.
How to start: Contact local AAA / Family Caregiver Support.
Good to know: Family caregiver payment: No regular caregiver wage
AAA Home Devices / Assistive Technology
IndirectHelps pay for: Devices/equipment that support safety and independence at home.
Who qualifies: Availability and cost-sharing vary by local AAA/program.
How to start: Ask local AAA what home devices/supports are funded.
Good to know: Family caregiver payment: No
Transportation
AAA Transportation
Offsets transportation/caregiver timeHelps pay for: Medical, essential, meal-site and assisted transportation depending on local availability.
Who qualifies: Generally targeted to older adults; local routes, eligibility and funding vary.
How to start: Call local AAA/GetCareSC.
Good to know: Family caregiver payment: No
Nutrition
Senior Nutrition - Home-Delivered Meals
Offsets a care taskHelps pay for: Meals for qualifying homebound older adults, reducing meal preparation burden.
Who qualifies: Generally age 60+ and homebound; spouse may qualify in some circumstances; local assessment applies.
How to start: Contact local AAA/meal provider through GetCareSC.
Good to know: Family caregiver payment: No
Caregiver Support
South Carolina Respite Coalition / Lifespan Respite Navigation
Can help locate respiteHelps pay for: Respite information, navigation and caregiver resources across age/disability groups.
Who qualifies: Program/grant availability varies.
How to start: Ask SCDOA Family Caregiver Support/local AAA for respite navigation.
Good to know: Family caregiver payment: No regular caregiver wage
Medicare Counseling
I-CARE / SHIP Medicare Counseling
Indirect cost reductionHelps pay for: Free Medicare counseling to optimize coverage and identify premium/drug-cost assistance.
Who qualifies: Medicare beneficiaries/caregivers; no income requirement for counseling itself.
How to start: Contact SCDOA/GetCareSC for SHIP/I-CARE counseling.
Good to know: Family caregiver payment: No
Medicare Cost Offset
Medicare Savings Programs (QMB / SLMB / QI)
Frees cash for careHelps pay for: Can pay Medicare Part B premiums and, for some programs, other Medicare cost sharing.
Who qualifies: Must meet current Medicaid income/resource and Medicare eligibility rules.
How to start: Apply through Healthy Connections / SCDHHS.
Good to know: Family caregiver payment: No
Medicare
Medicare Home Health
Yes - limited/clinical home healthHelps pay for: Part-time/intermittent skilled nursing, therapy and eligible home-health aide care when Medicare conditions are met.
Who qualifies: Homebound status and need for qualifying skilled care under a Medicare-certified plan/provider.
How to start: Ask treating clinician for Medicare home-health certification/referral.
Good to know: Family caregiver payment: No direct family wage
Medicare Hospice
Yes - hospice servicesHelps pay for: Hospice team services, medications/equipment related to terminal illness, respite and other covered end-of-life care.
Who qualifies: Physician certification of terminal illness and hospice election required.
How to start: Ask clinician/hospice for eligibility assessment.
Good to know: Family caregiver payment: No direct family wage
Prescription Cost Offset
Medicare Part D Extra Help
Frees cash for careHelps pay for: Reduces Part D premiums, deductibles and prescription copays for eligible people with limited income/resources.
Who qualifies: Must meet federal Extra Help rules; some Medicaid/MSP beneficiaries qualify automatically.
How to start: Apply through Social Security or seek SHIP help.
Good to know: Family caregiver payment: No
Insurance Cost Offset
Medicaid HIPP
Indirect cost reductionHelps pay for: May pay employer/private health-insurance premiums when cost effective for Medicaid.
Who qualifies: Medicaid member must have access to qualifying private coverage and meet HIPP cost-effectiveness rules.
How to start: Contact SCDHHS HIPP for screening.
Good to know: Family caregiver payment: No
Food Assistance
SNAP
Indirect cost reductionHelps pay for: Monthly food benefits that can preserve household funds for caregiving and other necessities.
Who qualifies: Income/resource and household rules apply; special rules/deductions may help elderly/disabled households.
How to start: Apply through SC DSS.
Good to know: Family caregiver payment: No
South Carolina Combined Application Project (SCCAP)
Indirect cost reductionHelps pay for: Simplified SNAP pathway for certain SSI recipients who live alone or buy/prepare food separately.
Who qualifies: SSI-related eligibility and household rules apply.
How to start: Ask DSS whether SCCAP applies.
Good to know: Family caregiver payment: No
Energy Assistance
LIHEAP
Indirect cost reductionHelps pay for: Helps eligible low-income households with home energy costs.
Who qualifies: Income and local administering-agency rules/funding apply.
How to start: Apply through local community action agency.
Good to know: Family caregiver payment: No
Home Cost Offset
Weatherization Assistance Program
Indirect cost reductionHelps pay for: Energy-efficiency improvements that can reduce utility burden and improve home safety/comfort.
Who qualifies: Income and property/program rules apply; prioritization/waiting lists possible.
How to start: Apply through local weatherization provider/community action agency.
Good to know: Family caregiver payment: No
Property Tax
South Carolina Homestead Exemption
Indirect cost reductionHelps pay for: Exempts the first $50,000 of fair-market value of a legal residence for qualifying older/disabled/blind homeowners.
Who qualifies: Generally age 65+, totally/permanently disabled, or legally blind, plus residency/ownership rules.
How to start: Apply through county auditor.
Good to know: Family caregiver payment: No
Residential Alternative
Optional State Supplementation (OSS)
No - residential, not home careHelps pay for: State-funded support for eligible residents in licensed Community Residential Care Facilities; can be an alternative when remaining at home is no longer workable.
Who qualifies: SSI-related age/disability, income/resource and facility rules apply. This is not an in-home benefit.
How to start: Ask SCDHHS about OSS eligibility and licensed participating CRCFs.
Good to know: Family caregiver payment: No
Private Funding
Long-Term Care Insurance / Personal Savings / Private Home Care
YesHelps pay for: Private insurance benefits, savings, retirement income or family funds can purchase care without Medicaid service limits.
Who qualifies: Policy definitions, elimination periods, benefit limits and private contracts control.
How to start: Review LTC policy and compare licensed/qualified providers or lawful private-employment arrangements.
Good to know: Family caregiver payment: Yes, if policy/private arrangement allows and employment/tax rules are followed
VA Benefits
VA Homemaker / Home Health Aide (H/HHA)
Direct in-home helpHelps pay for: VA-authorized personal care and homemaker assistance through community agencies.
Who qualifies: VA-enrolled Veteran; clinical need, eligibility and local authorization apply. Ask VA primary care/social work for H/HHA assessment.
How to start: Ask the VA social worker or care team about VA Homemaker / Home Health Aide (H/HHA).
Good to know: Family caregiver payment: No direct family wage
Veteran-Directed Care (VDC)
Direct/self-directed home careHelps pay for: Participant-directed budget for personal care/supports where locally available.
Who qualifies: VA eligibility, clinical need and local VDC availability required. Ask VA Geriatrics/Extended Care or social work whether VDC is available locally.
How to start: Ask the VA social worker or care team about Veteran-Directed Care (VDC).
Good to know: Family caregiver payment: Potentially, under VDC worker rules
VA Skilled Home Health
Direct skilled home careHelps pay for: Intermittent skilled nursing, therapy and related home health authorized by VA.
Who qualifies: Clinical need and VA authorization/provider participation apply. Ask VA clinician for skilled-home-health referral.
How to start: Ask the VA social worker or care team about VA Skilled Home Health.
Good to know: Family caregiver payment: No direct family wage
VA Respite Care
Temporary relief for caregiverHelps pay for: In-home, adult-day or facility respite depending on eligibility and local program availability.
Who qualifies: VA-enrolled Veteran with clinical need; benefit limits/availability apply. Ask VA social work/caregiver support for respite assessment.
How to start: Ask the VA social worker or care team about VA Respite Care.
Good to know: Family caregiver payment: No regular caregiver wage
VA Adult Day Health Care
Can reduce paid home-care hoursHelps pay for: Daytime health/rehabilitation/social services that can reduce home-care burden.
Who qualifies: Clinical eligibility, local availability and VA authorization apply. Ask VA Geriatrics/social work for Adult Day Health referral.
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 (HBPC)
Reduces outside medical visitsHelps pay for: Interdisciplinary primary care delivered at home for Veterans with complex chronic conditions who have difficulty traveling.
Who qualifies: VA-enrolled Veteran with qualifying clinical need and local program availability. Ask VA primary care or social work for HBPC screening.
How to start: Ask the VA social worker or care team about VA Home Based Primary Care (HBPC).
Good to know: Family caregiver payment: No direct family wage
Program of Comprehensive Assistance for Family Caregivers (PCAFC)
Direct caregiver supportHelps pay for: Education, support and, when eligibility criteria are met, a monthly stipend and other benefits for an approved primary family caregiver.
Who qualifies: Veteran and caregiver must meet current PCAFC clinical/service requirements; stipend is not hourly home-care wages. Apply through VA Caregiver Support.
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 - stipend for approved caregiver
Program of General Caregiver Support Services (PGCSS)
Indirect caregiver supportHelps pay for: Training, coaching, peer support, referrals and caregiver resources.
Who qualifies: Generally for caregivers of Veterans enrolled in VA health care; program-specific rules apply. Contact a South Carolina VA Caregiver Support Coordinator.
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
Cash may offset private home careHelps pay for: Additional pension amount for qualifying Veterans/survivors who need ADL help, are housebound or meet specified criteria.
Who qualifies: Must qualify for VA pension/survivors pension and meet A&A or Housebound criteria. File with VA or an accredited VSO/claims representative.
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 for care expenses; not an hourly VA wage
VA Community Care Network - South Carolina Region 3
May include authorized home health/community servicesHelps pay for: VA-authorized community providers can deliver approved care when Community Care eligibility/referral applies.
Who qualifies: South Carolina is in CCN Region 3, administered by Optum. Non-emergency community care generally requires VA referral/authorization. Work through VA care team/community care office before scheduling non-emergency care.
How to start: Ask the VA social worker or care team about VA Community Care Network - South Carolina Region 3.
Good to know: Family caregiver payment: Depends on underlying benefit
South Carolina VA Caregiver Support Teams
Direct navigationHelps pay for: Local navigation to respite, caregiver programs, in-home services and VA/community resources.
Who qualifies: Each VA benefit has its own eligibility; caregiver support staff can help triage options. Call the nearest caregiver support team.
How to start: Ask the VA social worker or care team about South Carolina VA Caregiver Support Teams.
Good to know: Family caregiver payment: Connects to PCAFC and other programs
South Carolina Department of Veterans’ Affairs
Indirect - helps unlock benefitsHelps pay for: State and county claims assistance, benefits navigation and referral to federal/state Veteran resources.
Who qualifies: Benefit-specific Veteran/dependent eligibility applies. Contact SCDVA or county Veterans Affairs Office for accredited claims help.
How to start: Ask the VA social worker or care team about South Carolina Department of Veterans’ Affairs.
Good to know: Family caregiver payment: No direct caregiver wage
Where South Carolina Families Can Start
Not sure where to begin? Match your situation to a contact below.
Medicaid eligibility, member questions, D-SNP coordination and general program navigation.
SCDHHS Healthy Connections
Best first call for Community Choices, HCBS waiver screening, incontinence supplies and Home Again referrals.
Community Long Term Care (CLTC) Centralized Intake
AAA services, caregiver support, meals, transportation, home services and Medicare counseling.
South Carolina Department on Aging / GetCareSC
Application/navigation help for Medicaid, SNAP and other benefits.
SC Thrive
MCC waiver and Children’s Attendant Care questions.
Medically Complex Children / SC Solutions
Start eligibility for ID/RD, Community Supports, HASCI and other developmental-disability services.
BHDD-OIDD Eligibility
Waiver/service navigation after or during eligibility screening.
BHDD-OIDD General Information
Determine whether PACE serves the county and compare participating organizations.
PACE / SCDHHS
Free Medicare counseling, Medicare Savings Program and Extra Help navigation.
I-CARE / SHIP
Nursing-facility/hospital-to-community transition referral and program questions.
Home Again
VA caregiver programs, respite, PCAFC/PGCSS and home-care navigation.
VA Caregiver Support - South Carolina
Benefits and claims assistance through SCDVA and county Veterans Affairs offices.
South Carolina Department of Veterans’ Affairs
Before You Rely on Any Payment Source
Planning Issue
South Carolina-Specific Note
Start with CLTC for nursing-facility-level home care
For Community Choices and related CLTC pathways, call Centralized Intake at 888-971-1637. A Medicaid application alone does not substitute for the functional/level-of-care waiver process.
Community Choices target population
Community Choices generally serves frail adults 65+ and adults 18-64 with physical disabilities who meet nursing-facility level of care plus Medicaid/waiver requirements.
Family caregiver payment is relationship-specific
Community Choices renewal materials distinguish self-directed and agency-model rules. Certain relatives can be paid, but legally responsible relationships are restricted. Obtain a written determination for the intended worker before assuming payment is allowed.
MCC Children’s Attendant Care is a separate paid-parent pathway
The MCC waiver permits eligible parents, relatives or guardians to be paid hourly through Children’s Attendant Care for authorized extraordinary care for participants ages 1-21. Do not apply Community Choices family-worker rules to this program.
Healthy Connections Prime is over
Healthy Connections Prime ended January 1, 2026. Current dual-eligible planning should evaluate available D-SNPs and separately coordinate Medicaid LTSS/waiver services.
2026 managed-care carve-in can split responsibilities
Beginning January 1, 2026, certain waiver populations receive medical/State Plan services through managed care while waiver services remain fee-for-service. Families may need both the MCO and waiver case manager for different authorizations.
PACE is geographically limited
PACE requires age 55+, nursing-home level of care, safe community living with PACE support and residence in a participating service area. It is not available statewide.
Home Again is a transition program, not 24-hour home care
Home Again can help eligible institutional residents transition after qualifying stays, but SCDHHS notes that Home Again/waiver services do not provide 24-hour care or replace all natural supports.
TEFRA and MCC solve different problems
TEFRA/Katie Beckett is primarily a Medicaid eligibility pathway that can disregard parental income/resources; MCC is a waiver/service package. A medically complex child may need screening for both.
BHDD-OIDD and CLTC are separate operating systems
For ID/RD, Community Supports or HASCI, begin with OIDD eligibility. Waiver capacity, self-direction and worker rules are not the same as Community Choices.
Aging-network services vary locally
AAA personal care, respite, meals, transportation and devices depend on local funding, assessment and wait-list conditions. GetCareSC/SCDOA is the statewide entry point.
Veteran benefits run on a separate eligibility track
South Carolina is in VA Community Care Network Region 3 (Optum). VA home care, caregiver stipends, respite and pension benefits require separate VA authorization/eligibility and can sometimes layer with non-duplicative state services.
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 South Carolina to help you navigate the application process.
← Back to How to Pay for In-Home CareHome Care Providers in South Carolina
These providers serve families in South Carolina and can help you apply what you've learned above to your specific situation.
A Better Solution In Home Care – Greenville, SC
Serving South Carolina
A Better Solution In Home Care – Greenville, SC provides home care services in the Greenville area.
Communities Served
Greenville
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Avodah Home Care
Serving South Carolina
avodahhomecare provides home care services in Columbia, SC and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Abbeville, Aiken, Anderson and surrounding areas
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Home Care Plus
Serving South Carolina
Home Care Plus provides home care services in Mt. Pleasant, SC and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Charleston, Mount Pleasant, Tri-County Area
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Integrity Home Care SC
Serving South Carolina
Integrity Home Care SC provides home care services in Okatie, SC and the surrounding communities it serves.
Services Available
24-Hour Home Care • Companion Care • Personal Care • Dementia & Alzheimer's Care • Respite Care
Communities Served
Beaufort County, Jasper County, Hampton County and surrounding areas
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The Springs at Simpsonville
Serving South Carolina
The Springs at Simpsonville is an independent senior living community in Simpsonville, SC, offering private residences with maintenance, meals, and activities for older adults who manage their own daily care.
Services Available
Independent Senior Living
Communities Served
Simpsonville
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