How to Pay for In-Home Care
How to Pay for Home Care in West Virginia
Jump to a state to see its Medicaid programs, waivers, and other ways to help pay for in-home care.
West Virginia families typically start by screening adults 18+ who meet Medicaid waiver financial rules and a nursing-home level of care for the Aged and Disabled Waiver (ADW), which can authorize personal attendant care and other HCBS, using Personal Options to self-direct the personal attendant (though ADW excludes a spouse or legal guardian from being the paid self-directed worker). Qualifying people age 3+ with intellectual/developmental disabilities should look at the IDD Waiver for traditional and participant-directed supports; under Chapter 513 rules effective August 2026, its Family Person-Centered Support option may pay specified live-in relatives, though spouses are excluded and routine natural-support expectations still apply. Families should also screen the Traumatic Brain Injury Waiver for qualifying people age 3+, the Children with Serious Emotional Disorders Waiver for ages 3-21, the Children with Disabilities Community Services Program, Private Duty Nursing, and Children with Special Health Care Needs where appropriate. Medicaid Personal Care can provide hands-on in-home assistance and may be available while an ADW applicant is waiting; Lighthouse is a state-funded option for certain adults 60+ who aren't Medicaid-eligible for in-home services; FAIR can provide dementia-caregiver respite; and Take Me Home supports transitions from institutions to the community. Every plan can be layered with M-WIN, WVABLE, Medicare Savings Programs, Extra Help, WV SHIP, SNAP, LIEAP/utility discounts, weatherization, senior property-tax credits, assistive technology, and Veteran benefits.
Updated August 2026
Reviewed by Valerie VanBooven, RN, BSN
Medicaid LTSS
Aged and Disabled Waiver (ADW)
YesHelps pay for: Long-term services and supports that help eligible adults remain at or return home instead of receiving nursing-home care.
Who qualifies: Age 18+; West Virginia resident; Medicaid waiver financial eligibility; nursing-home level of care; assessed needs in at least five specified areas; funded opening required.
How to start: Submit the Medical Necessity Evaluation Request (MNER) and complete financial/medical eligibility.
Good to know: Family caregiver payment: Depends on service/worker rules
ADW Service
Personal Attendant Services
YesHelps pay for: Hands-on help with bathing, dressing, grooming, eating, meal preparation and other authorized personal-care needs.
Who qualifies: Must be enrolled in ADW and have the service authorized in the person-centered plan.
How to start: Ask case manager about personal-attendant authorization and delivery model.
Good to know: Family caregiver payment: Potentially under Personal Options
Case Management
IndirectHelps pay for: Assessment, person-centered planning, coordination, referrals, monitoring and advocacy.
Who qualifies: Available to enrolled ADW members; case-management requirements apply regardless of personal-attendant delivery model.
How to start: Select/work with an approved ADW case-management provider.
Good to know: Family caregiver payment: No
Medical Adult Day Care
Indirect / partialHelps pay for: Structured therapeutic, social, health-maintenance and restorative day services that can reduce home-care hours/caregiver burden.
Who qualifies: Must be authorized under ADW and provided by a qualified center; availability varies.
How to start: Ask case manager about authorized medical adult day care nearby.
Good to know: Family caregiver payment: No regular family wage
Skilled Nursing
Yes - skilledHelps pay for: Nursing assessment and monitoring connected to the member’s ADW care.
Who qualifies: Must be medically necessary and authorized under ADW.
How to start: Discuss skilled-nursing need with case manager/clinician.
Good to know: Family caregiver payment: No regular family wage
Non-Medical Transportation
IndirectHelps pay for: Transportation for authorized community activities and essential errands such as groceries or prescriptions.
Who qualifies: Must be in the service plan and follow ADW transportation rules.
How to start: Add transportation needs to the person-centered plan.
Good to know: Family caregiver payment: May be delivered by authorized worker when allowed
ADW Self-Direction
ADW Personal Options
YesHelps pay for: Self-directed personal attendant services; member hires, supervises and schedules approved workers within the authorized plan/budget.
Who qualifies: ADW member must choose self-direction and meet employer/worker, background-check, EVV and program requirements. ADW states self-directed staff cannot be the member’s spouse or legal guardian.
How to start: Tell the ADW case manager you want Personal Options and enroll with Palco.
Good to know: Family caregiver payment: Yes, for qualifying workers; spouse/legal guardian excluded
ADW Home Modification
Environmental Accessibility Adaptations - Home
IndirectHelps pay for: Approved physical adaptations to the member’s or family home that improve accessibility and independence.
Who qualifies: Must be related to assessed need, authorized and meet waiver rules/limits.
How to start: Request through the ADW case manager before purchase or construction.
Good to know: Family caregiver payment: No
ADW Vehicle Modification
Environmental Accessibility Adaptations - Vehicle
IndirectHelps pay for: Approved adaptations to a vehicle used as the member’s primary transportation.
Who qualifies: Must be medically/functionally justified, authorized and meet waiver requirements.
How to start: Request through the person-centered plan before work begins.
Good to know: Family caregiver payment: No
ADW Safety Support
Personal Emergency Response System (PERS)
IndirectHelps pay for: Emergency call/monitoring technology that can help a person remain safely at home.
Who qualifies: Must be assessed and authorized under the waiver.
How to start: Ask case manager whether PERS fits the assessed risk/need.
Good to know: Family caregiver payment: No
ADW Home Safety
Pest Eradication
IndirectHelps pay for: Approved pest-suppression/eradication when infestation threatens health and safety and community living.
Who qualifies: Must meet waiver health/safety criteria and be authorized.
How to start: Document the health/safety risk with the case manager before service.
Good to know: Family caregiver payment: No
Self-Direction
Personal Options - ADW / IDDW / TBIW
YesHelps pay for: West Virginia’s participant-directed service model for three HCBS waivers, with individualized spending plans and participant-employer control.
Who qualifies: Must be medically/financially eligible for the applicable waiver and choose participant direction. Current IDDW service-specific rules can be stricter than general Personal Options materials.
How to start: Ask the waiver case manager to enroll in Personal Options and create the spending/service plan.
Good to know: Family caregiver payment: Potentially; waiver/service relationship rules apply
Self-Direction Family Worker
Personal Options Family / Friend Worker Pathway
YesHelps pay for: Allows a participant to recruit and employ approved friends or relatives for eligible self-directed services instead of relying only on agency staff.
Who qualifies: General Personal Options materials permit friends/family but exclude a spouse, legal guardian or legal representative acting as decision-maker. Always verify the current waiver/service-specific rule; current IDDW rules expressly exclude spouses for Person-Centered Support.
How to start: Identify the proposed worker to the case manager/resource consultant before enrollment.
Good to know: Family caregiver payment: Yes, with exclusions
Self-Direction Administration
Palco Financial Management Services / Support Brokerage
IndirectHelps pay for: Payroll, tax withholding/filing, worker enrollment, spending-plan support and financial oversight for Personal Options.
Who qualifies: Palco is the FMS/support-brokerage vendor for WV Personal Options in ADW, IDDW and TBIW; service eligibility comes from the waiver, not Palco.
How to start: Enroll after selecting Personal Options through the waiver team.
Good to know: Family caregiver payment: Processes approved worker payroll
Medicaid State Plan
West Virginia Medicaid Personal Care Services
YesHelps pay for: Hands-on in-home assistance with ADLs and related activities for eligible Medicaid members.
Who qualifies: Requires qualifying Medicaid coverage, functional need/medical authorization and an enrolled provider. ADW materials specifically identify Personal Care as a possible support while waiting for ADW.
How to start: Contact the Personal Care program/provider for assessment and authorization.
Good to know: Family caregiver payment: Agency/provider rules; verify family employment
Medicaid Home Health
Yes - skilledHelps pay for: Medically necessary home-health nursing, therapy and related services under West Virginia Medicaid.
Who qualifies: Requires Medicaid coverage, medical necessity, orders/authorization and qualified provider.
How to start: Ask treating clinician/home-health agency to verify Medicaid coverage and prior authorization.
Good to know: Family caregiver payment: No regular family wage
Hospice
West Virginia Medicaid / Medicare Hospice
Yes - hospiceHelps pay for: Hospice team services, symptom management, related equipment/medications and limited respite when eligibility is met.
Who qualifies: Requires hospice eligibility/election and certified provider; routine custodial care is not automatically covered around the clock.
How to start: Request a hospice evaluation through clinician or certified hospice.
Good to know: Family caregiver payment: No regular family wage
Pediatric Medicaid
Private Duty Nursing (PDN)
Yes - skilledHelps pay for: Extended skilled nursing for eligible members, commonly important for medically complex children who need substantial nursing at home.
Who qualifies: Requires Medicaid eligibility, medical necessity, physician/authorized practitioner orders and PDN coverage criteria.
How to start: Ask the child’s specialist/care coordinator about PDN authorization.
Good to know: Family caregiver payment: No regular family wage unless separately authorized under another rule
Medicaid Equipment
DMEPOS / Medical Equipment and Supplies
IndirectHelps pay for: Covered durable medical equipment, prosthetics, orthotics and supplies can reduce out-of-pocket costs and hands-on care burden.
Who qualifies: Medicaid coverage, medical necessity, prescription/order and supplier rules apply.
How to start: Ask clinician and enrolled DME supplier to verify coverage/prior authorization.
Good to know: Family caregiver payment: No
Transportation Cost Offset
Medicaid Non-Emergency Medical Transportation (NEMT)
IndirectHelps pay for: Transportation to and from covered routine medical care for eligible Medicaid members.
Who qualifies: Must have qualifying Medicaid coverage and an eligible trip; scheduling rules apply.
How to start: Schedule through the Medicaid transportation contractor.
Good to know: Family caregiver payment: No
Older Adult / Disability Transportation
IndirectHelps pay for: Local aging/disability transportation can reduce family driving and caregiver time for essential trips and services.
Who qualifies: Trip purpose, age/disability status, funding source and local availability vary.
How to start: Ask county aging provider/ADRC about local transportation options.
Good to know: Family caregiver payment: No
Medicaid HCBS
Traumatic Brain Injury Waiver (TBIW)
YesHelps pay for: Home and community services for eligible people with documented traumatic brain injury who otherwise meet nursing-facility level-of-care criteria.
Who qualifies: Age 3+; documented qualifying TBI; financial eligibility; nursing-home level of care and program criteria; choose community care over nursing facility.
How to start: Apply through Acentra and request TBIW eligibility review.
Good to know: Family caregiver payment: Potentially through Personal Options
Intellectual and Developmental Disabilities Waiver (IDDW)
YesHelps pay for: Community supports for eligible people with intellectual/developmental disabilities or severe related conditions.
Who qualifies: Age 3+; WV resident; qualifying condition manifested before age 22; substantial functional limitations; financial/medical eligibility and available waiver slot.
How to start: Submit IDDW application to Acentra and complete eligibility process.
Good to know: Family caregiver payment: Yes for some services/relationships; service-specific
TBIW Service
TBIW Personal Attendant / Personal Options
YesHelps pay for: ADL assistance in home/community; personal attendant service is one of the TBIW services that can be participant-directed.
Who qualifies: Must be enrolled in TBIW and have authorized personal-attendant need. General Personal Options relationship exclusions and worker qualifications apply.
How to start: Choose Traditional or Personal Options during person-centered planning.
Good to know: Family caregiver payment: Yes, for qualifying Personal Options workers; restrictions apply
TBIW Home / Vehicle
TBIW Environmental Accessibility Adaptations
IndirectHelps pay for: Approved home or vehicle modifications that increase accessibility and independence.
Who qualifies: Must be authorized in the TBIW person-centered service plan and meet program rules.
How to start: Request through TBIW case manager before purchase/modification.
Good to know: Family caregiver payment: No
TBIW Safety / Community
TBIW Transportation, PERS and Pest Eradication
IndirectHelps pay for: Authorized non-medical transportation, emergency response technology and pest services that help sustain community living.
Who qualifies: Each service must meet TBIW criteria and be in the person-centered plan.
How to start: Discuss these supports with the TBIW case manager/resource consultant.
Good to know: Family caregiver payment: Transportation may be delivered through authorized service
IDDW Paid Family Support
Family Person-Centered Support
YesHelps pay for: Paid direct support by specified family members/specialized family care providers living with the member, focused on skills, independence and community inclusion.
Who qualifies: Effective 8/1/2026, eligible family categories include parents/stepparents, adult siblings/step-siblings, grandparents/step-grandparents, aunts/uncles/step-aunts/uncles, and specialized family care providers; other relationships need BMS prior approval. Spouses are excluded, and service cannot replace routine care/supervision expected from parents/specialized family providers.
How to start: Ask IDDW case manager to assess and place Family PCS in the IPP if appropriate.
Good to know: Family caregiver payment: Yes - specified live-in relatives; spouse excluded
IDDW Self-Direction
Person-Centered Support - Personal Options
YesHelps pay for: Participant-directed person-centered support; workers may live in the member’s home and services are controlled through the approved spending plan.
Who qualifies: Current Chapter 513 requires assessed need/prior authorization and individualized budget. A member’s representative cannot be the paid Personal Options employee for the member, and spouses are excluded from Personal Options PCS.
How to start: Choose Personal Options and develop the spending plan with case manager/resource consultant.
Good to know: Family caregiver payment: Potentially; spouse and representative exclusions apply
Participant-Directed Goods and Services
Indirect / partialHelps pay for: Approved disability-related goods/services within the participant-directed budget when they meet policy and are not otherwise available.
Who qualifies: Must be in the participant-directed plan and meet Chapter 513 permissible-use rules; funds are paid to the vendor, not as cash to member/family/worker.
How to start: Discuss proposed item/service with resource consultant before purchase.
Good to know: Family caregiver payment: Not a wage; vendor paid
IDDW Worker Rule
IDDW Family / Representative Relationship Guardrails
Yes - rule clarificationHelps pay for: Clarifies when a relative or decision-maker can and cannot be paid for IDDW direct support.
Who qualifies: Family PCS has a defined relationship list and excludes spouses; Personal Options PCS excludes a spouse and the member’s representative as paid employee. Do not apply ADW/TBIW family-worker rules to IDDW without checking Chapter 513.
How to start: Have the case manager identify the exact service code/model before enrolling a family worker.
Good to know: Family caregiver payment: Varies by service; not all relatives qualify
IDDW Respite
In-Home / Out-of-Home Respite
Yes - temporaryHelps pay for: Temporary substitute care to relieve the primary caregiver.
Who qualifies: Current Chapter 513 bars spouses, co-residents and biological/adoptive parents or stepparents from specified respite services; Personal Options respite also has residence/relationship restrictions.
How to start: Ask the IDDW team to authorize respite and verify the proposed worker before enrollment.
Good to know: Family caregiver payment: Restricted; not a parent/spouse/co-resident route
IDDW Home / Vehicle
IDDW Environmental Accessibility Adaptations
IndirectHelps pay for: Approved adaptations to the home or vehicle that increase independence and access.
Who qualifies: Must be documented in the IPP, use other funding first where required, and receive authorization.
How to start: Request through the IDDW case manager before purchase or construction.
Good to know: Family caregiver payment: No
IDDW Employment Support
Job Development / Supported Employment
IndirectHelps pay for: Employment preparation, job development and supports that can increase independence and earned income.
Who qualifies: Must be authorized based on assessed need and current IDDW employment-service rules.
How to start: Add employment goals to the IPP and ask the team about applicable services.
Good to know: Family caregiver payment: No regular family wage
IDDW Waitlist Support
IDDW Waitlist Support Grant
Indirect / partialHelps pay for: Limited support for eligible individuals waiting for a funded IDDW slot.
Who qualifies: Availability, amounts and permitted uses are program-specific and can change; applicant must be on/meet waitlist criteria.
How to start: Ask IDDW/Acentra about current waitlist support grant eligibility.
Good to know: Family caregiver payment: Not an ongoing caregiver wage
Pre-Waiver Family Support
Family and Community Support Program
Partial / supportiveHelps pay for: May assist with respite, transportation, equipment, health-related costs, community goods/services and home modifications for qualifying people with developmental disabilities.
Who qualifies: Program is separate from IDDW waiver enrollment and has its own eligibility/funding limits.
How to start: Contact the developmental-disability service system and ask about Family and Community Support.
Good to know: Family caregiver payment: May fund respite/support; not blanket family wages
Children Medicaid
Children with Disabilities Community Services Program (CDCSP)
Indirect / medicalHelps pay for: Medicaid coverage for certain children with severe disabilities who would otherwise require institutional-level services, allowing medically necessary State Plan services in the community.
Who qualifies: Child must meet CDCSP medical and financial/program criteria; not an HCBS waiver service budget.
How to start: Ask BMS/DoHS about CDCSP eligibility and application.
Good to know: Family caregiver payment: No regular family wage
Children Health Support
Children with Special Health Care Needs (CSHCN)
Indirect / medicalHelps pay for: Care coordination and health-support resources for eligible children with special health care needs.
Who qualifies: Program/service eligibility varies by child and service; may coordinate with Medicaid and other pediatric supports.
How to start: Call the statewide children’s health contact or ask pediatric care coordinator.
Good to know: Family caregiver payment: No regular family wage
Behavioral Health HCBS
Children with Serious Emotional Disorders Waiver (CSEDW)
Yes / supportiveHelps pay for: Additional Medicaid HCBS for ages 3–21 with serious mental, behavioral or emotional health needs to remain with family/in community instead of facility/group-home care.
Who qualifies: Age 3–21; WV residency; program clinical criteria including severe functional assessment score; must choose HCBS and enroll with designated MCO; funded space required.
How to start: Begin through the WV Children’s Crisis and Referral Line (844-HELP4WV).
Good to know: Family caregiver payment: No general parent wage stated
CSEDW Family Support
In-Home Family Therapy / Family-Caregiver Support
Yes / supportiveHelps pay for: In-home therapy plus guidance/support for family, parents and caregivers to stabilize the child at home.
Who qualifies: Must be medically necessary and included in the CSEDW plan of care.
How to start: Ask CSEDW care manager/team to include appropriate in-home family supports.
Good to know: Family caregiver payment: No regular caregiver wage
CSEDW Respite
CSEDW Respite
Yes - temporaryHelps pay for: Short-term relief for the child’s primary caregiver as part of the CSEDW service array.
Who qualifies: Must be medically necessary/authorized in the plan of care; provider and managed-enrollment availability apply.
How to start: Request respite through the CSEDW care team.
Good to know: Family caregiver payment: No general parent wage
Facility Transition
Take Me Home, West Virginia (Money Follows the Person)
Yes / transitionHelps pay for: Transition planning and supports for eligible Medicaid members moving from long-term-care facilities to qualified community settings; can fund transition needs and extended direct-care supports.
Who qualifies: Institutional stay, Medicaid and MFP/TMH transition criteria apply; service package is individualized.
How to start: Ask facility discharge planner or BMS Take Me Home team before discharge.
Good to know: Family caregiver payment: Not a regular family wage
State-Funded Senior Home Care
Lighthouse Program
Yes / limitedHelps pay for: State-funded personal care, mobility, nutrition/diet and environmental help for eligible older adults who are not eligible for Medicaid in-home services.
Who qualifies: Generally age 60+ with functional need and income/assets that disqualify from Medicaid in-home services; openings and cost-sharing vary by county/income.
How to start: Contact Bureau of Senior Services/Aging Network or county aging provider.
Good to know: Family caregiver payment: No regular family wage
Dementia Respite
FAIR - Family Alzheimer’s In-Home Respite
Yes - respiteHelps pay for: One-on-one respite for a person with written Alzheimer’s/related-dementia diagnosis, giving the family caregiver scheduled relief.
Who qualifies: Available statewide; current ADW information says family caregivers may receive up to 16 hours of relief per week based on need and availability; cost depends on care-recipient income.
How to start: Contact aging network/county provider and provide diagnosis documentation.
Good to know: Family caregiver payment: Pays respite service, not ongoing caregiver wages
Caregiver Support
Title III-E / National Family Caregiver Support
Indirect / respiteHelps pay for: Information, counseling, caregiver training, respite navigation and supplemental services through the aging network.
Who qualifies: Older Americans Act target-population and local program criteria/funding apply.
How to start: Call Bureau of Senior Services/Aging Network for local caregiver program.
Good to know: Family caregiver payment: Usually not wages
Aging Network
Older Americans Act / LIFE / County Aging Services
Indirect / sometimes directHelps pay for: Local homemaker, transportation, nutrition, social and supportive services that can reduce paid-care burden and help older adults remain at home.
Who qualifies: Age, need, local funding and service availability vary by county/provider.
How to start: Locate the county aging provider through Bureau of Senior Services.
Good to know: Family caregiver payment: Usually no family wage
Nutrition Cost Offset
Home-Delivered Meals / Senior Nutrition
IndirectHelps pay for: Prepared meals reduce grocery/meal-preparation burden and can support safe independent living.
Who qualifies: Local Older Americans Act/provider eligibility and availability apply.
How to start: Contact county aging provider or Aging Network.
Good to know: Family caregiver payment: No
Medicaid Eligibility
Medicaid Work Incentive (M-WIN)
IndirectHelps pay for: Full Medicaid coverage pathway that helps certain working people with disabilities keep essential medical coverage while employed.
Who qualifies: Current WV guidance describes M-WIN for disabled workers generally ages 16–65, with financial/asset rules, a $50 enrollment fee and income-based premium; verify current eligibility calculation.
How to start: Apply through WV PATH/DoHS and identify M-WIN coverage group.
Good to know: Family caregiver payment: No
Asset / Benefit Protection
WVABLE
Indirect / cash managementHelps pay for: Tax-advantaged ABLE account for qualified West Virginians with disabilities; qualified disability expenses can include housing, transportation, health care and assistive technology while preserving eligibility under ABLE rules.
Who qualifies: Beginning in 2026 the disability must generally have begun before age 46; federal/state ABLE contribution and SSI/Medicaid rules apply.
How to start: Use WVABLE eligibility screener and open account if qualified.
Good to know: Family caregiver payment: No
Medicare
Medicare Home Health
Yes - limited/skilledHelps pay for: Part-time/intermittent skilled nursing, therapy and home-health aide services when federal coverage criteria are met.
Who qualifies: Must meet Medicare home-health eligibility, including need for qualifying skilled care; Medicare does not cover 24/7 custodial home care.
How to start: Ask physician/allowed practitioner for certification and use Medicare-certified agency.
Good to know: Family caregiver payment: No
Medicare Cost Offset
Medicare Savings Programs (QMB / SLMB / QI)
IndirectHelps pay for: Can pay Medicare premiums and, for QMB, certain Medicare cost sharing, preserving income for care.
Who qualifies: Medicare entitlement plus income/resource rules; state Medicaid determines eligibility.
How to start: Apply through WV PATH/DoHS or ask WV SHIP for help.
Good to know: Family caregiver payment: No
Prescription Cost Offset
Medicare Part D Extra Help
IndirectHelps pay for: Reduces Part D premiums, deductibles and copays, preserving household funds for care.
Who qualifies: Income/resource rules apply unless automatically eligible.
How to start: Apply through Social Security or ask WV SHIP.
Good to know: Family caregiver payment: No
Medicare Advantage
Plan Supplemental In-Home / Support Benefits
Sometimes / limitedHelps pay for: Some Medicare Advantage plans may offer limited meals, transportation, home-safety or in-home support benefits.
Who qualifies: Benefits vary by plan, county, health status/eligibility and year; not a substitute for Medicaid LTSS.
How to start: Review plan Evidence of Coverage or compare plans with WV SHIP.
Good to know: Family caregiver payment: Usually no direct family wage
Medicare Counseling
West Virginia SHIP
IndirectHelps pay for: Free personalized Medicare counseling, including plan comparisons and help identifying Medicare Savings Programs/Extra Help.
Who qualifies: Available to Medicare beneficiaries and families; counseling is independent of insurance companies.
How to start: Call WV SHIP for one-on-one counseling.
Good to know: Family caregiver payment: No
Food Cost Offset
SNAP
IndirectHelps pay for: Monthly nutrition benefits can reduce grocery costs and preserve income for home care and utilities.
Who qualifies: Household SNAP eligibility rules apply; West Virginia uses WV PATH for screening/application.
How to start: Screen/apply through WV PATH or local DoHS office.
Good to know: Family caregiver payment: No
Utility Cost Offset
LIEAP / Emergency LIEAP
IndirectHelps pay for: Seasonal heating/cooling assistance for eligible households; emergency components open when funded.
Who qualifies: Income, household size, heating/cooling responsibility and open application period matter. Funds can close early when exhausted.
How to start: Watch BFA announcements and apply through WV PATH/local DoHS when open.
Good to know: Family caregiver payment: No
Utility Discount
Special Reduced Rate Service Program (20% Utility Discount)
IndirectHelps pay for: Eligible participants can receive a 20% discount on participating gas/electric service during specified months and American Water service year-round.
Who qualifies: Program-specific eligibility and utility participation rules apply; verify current enrollment/automatic qualification criteria.
How to start: Check BFA utility-assistance page or ask DoHS/utility.
Good to know: Family caregiver payment: No
Home Cost Offset
Weatherization / Heating-Cooling Repair and Replacement
IndirectHelps pay for: Energy-efficiency improvements and, in qualifying cases, emergency heating/cooling repair or replacement can reduce utility costs and improve home safety.
Who qualifies: Income, household and technical/homeownership criteria apply; priority criteria can apply for repair/replacement.
How to start: Ask DoHS/Community Action about current weatherization and repair programs.
Good to know: Family caregiver payment: No
Property Tax / Housing
Senior Citizen Tax Credit / Homestead-Related Relief
IndirectHelps pay for: Property-tax relief can reduce housing costs and preserve funds for care for qualifying older or permanently disabled homeowners.
Who qualifies: Senior Citizen Tax Credit generally requires participation in Homestead Exemption, paid property tax and income below program limits; other homestead/excess credits have separate rules.
How to start: Contact county assessor for Homestead Exemption and WV Tax Division for credits.
Good to know: Family caregiver payment: No
Tax Offset
West Virginia Child and Dependent Care Credit
Indirect / tax offsetHelps pay for: State nonrefundable credit equal to 50% of the federal Child and Dependent Care Credit for taxpayers who qualify federally; may offset qualifying work-related care expenses.
Who qualifies: Available for tax years beginning on/after Jan. 1, 2024 to a person allowed the federal §21 credit. Federal qualifying-person and employment-related expense rules control the underlying eligibility.
How to start: Claim with WV income tax return; consult tax professional for disabled-spouse/dependent situations.
Good to know: Family caregiver payment: Can help offset qualifying care expense, not an hourly program wage
Assistive Technology
West Virginia Assistive Technology System (WVATS)
IndirectHelps pay for: Device demonstrations, short-term loans, reuse and funding information can reduce the need to buy equipment and may increase independence.
Who qualifies: Open to West Virginia residents of all ages/abilities for AT services; device inventory and program-specific eligibility vary.
How to start: Contact WVATS for demonstration, loan/reuse or funding guidance.
Good to know: Family caregiver payment: No
Veteran Benefit
VA Homemaker / Home Health Aide
YesHelps pay for: VA-authorized homemaker and personal-care assistance through community agencies.
Who qualifies: VA enrollment, clinical need, eligibility and local authorization apply.
How to start: Ask VA primary care/social work for H/HHA assessment.
Good to know: Family caregiver payment: No direct family wage
Veteran Self-Direction
Veteran-Directed Care (VDC)
YesHelps pay for: Participant-directed VA budget for personal care and supports where locally available.
Who qualifies: VA eligibility, clinical need and local VDC availability required.
How to start: Ask VA Geriatrics/Extended Care or social work if VDC is available locally.
Good to know: Family caregiver payment: Potentially, under VDC worker rules
Veteran Caregiver Support
VA PCAFC Caregiver Stipend
Direct caregiver supportHelps pay for: Monthly stipend and supports for an approved primary family caregiver when Veteran/caregiver meet PCAFC criteria.
Who qualifies: Not hourly home-care wages; current PCAFC eligibility rules apply.
How to start: Apply through VA Caregiver Support.
Good to know: Family caregiver payment: Yes - stipend
Veteran Pension
VA Aid & Attendance / Housebound
Cash offsetHelps pay for: Additional VA pension amount can help qualifying Veterans/survivors pay for assistance at home.
Who qualifies: Must first qualify for VA pension/survivors pension and meet Aid & Attendance or Housebound criteria.
How to start: File with VA or an accredited VSO such as West Virginia Department of Veterans Assistance.
Good to know: Family caregiver payment: Can be used toward care expenses; not VA hourly wage
Private Funding
Long-Term Care Insurance / Personal Savings / Private Home Care
YesHelps pay for: Private LTC insurance, savings, retirement income, home equity or family resources may pay for care not covered publicly.
Who qualifies: Policy terms, taxes, labor law, Medicaid transfer/estate rules and affordability matter. Paying relatives privately should be documented and tax/labor rules followed.
How to start: Review insurance policy and create a written care/payment plan; seek elder-law/tax advice when needed.
Good to know: Family caregiver payment: Yes, if privately arranged and lawful
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 enrollment, 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 locally available.
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 availability.
Who qualifies: VA-enrolled Veteran with clinical need; benefit limits and 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 and 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 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 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 VA Caregiver Support.
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 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 - West Virginia Region 1
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: West Virginia is in CCN Region 1, 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 - West Virginia Region 1.
Good to know: Family caregiver payment: Depends on underlying benefit
VA Caregiver Support Program - West Virginia
Direct navigationHelps pay for: Navigation to respite, caregiver programs, in-home services and community resources.
Who qualifies: Each VA benefit has its own eligibility; caregiver support staff can triage options. Call national Caregiver Support Line and request local coordinator.
How to start: Ask the VA social worker or care team about VA Caregiver Support Program - West Virginia.
Good to know: Family caregiver payment: Connects to PCAFC and other programs
West Virginia Department of Veterans Assistance
Indirect / navigationHelps pay for: State Veteran benefit navigation, accredited claims assistance and referrals through statewide field/claims offices.
Who qualifies: Benefit-specific Veteran/dependent eligibility applies. Contact WVDVA or an accredited VSO for claims/benefit navigation.
How to start: Ask the VA social worker or care team about West Virginia Department of Veterans Assistance.
Good to know: Family caregiver payment: No direct caregiver wage
Where West Virginia Families Can Start
Not sure where to begin? Match your situation to a contact below.
Older-adult home-care navigation, Lighthouse, FAIR, caregiver support, county aging providers and general LTSS referrals.
West Virginia Bureau of Senior Services / Aging Network
ADW application questions, waiver eligibility/process and Personal Options questions.
Aged and Disabled Waiver - Bureau of Senior Services
ADW utilization management, managed enrollment, authorization verification and assessments.
Acentra Health - ADW
Waiver application/eligibility support for IDDW, TBIW and CSEDW.
Acentra Health - IDDW / TBIW / CSEDW
Worker enrollment, payroll/FMS, resource consulting and self-direction support for ADW, IDDW and TBIW.
Palco - West Virginia Personal Options
Medicaid program questions, HCBS policy, State Plan services and coverage questions.
WV Bureau for Medical Services (Medicaid)
Apply/manage Medicaid, SNAP and related benefits; report eligibility changes.
WV DoHS Customer Service / WV PATH
Start CSEDW referral and obtain children’s behavioral-health/crisis service navigation.
HELP4WV Children’s Crisis and Referral Line
Schedule eligible non-emergency medical transportation.
West Virginia Medicaid NEMT
Free Medicare counseling, plan comparisons, Medicare Savings Programs and Extra Help screening.
West Virginia SHIP
Device demos, short-term loans, reuse, AT funding information and independence tools.
West Virginia Assistive Technology System (WVATS)
State Veteran claims/benefit navigation and referral to field/claims offices.
West Virginia Department of Veterans Assistance
Before You Rely on Any Payment Source
Planning Issue
What to Know / What to Do
Start with the right West Virginia entry door
For an adult age 18+ who may meet nursing-home level of care, screen ADW and State Plan Personal Care. For I/DD, use IDDW; for traumatic brain injury use TBIW; for a child age 3–21 with serious emotional disorder use CSEDW. A person may apply for more than one waiver waitlist, but cannot receive multiple HCBS waivers at the same time.
ADW Personal Options has a clear spouse/legal-guardian exclusion
ADW allows a member to self-direct personal attendant care, but the current ADW page says staff hired by the member cannot be the member’s spouse or legal guardian. Do not promise spouse payment under ADW.
General Personal Options materials are not enough for IDDW
Personal Options spans ADW, IDDW and TBIW, and general materials say friends/family may be hired with certain exclusions. IDDW has more detailed service-specific rules in Chapter 513; identify the exact IDDW service before deciding whether a relative can be paid.
Chapter 513 changed on August 1, 2026
BMS published a new IDDW Chapter 513 effective August 1, 2026. Use that current manual for family Person-Centered Support, Personal Options, respite, participant-directed goods/services and worker qualifications rather than older September 2024 summaries.
IDDW Family Person-Centered Support is a real paid-family pathway, but narrow
Current IDDW rules allow specified live-in parents/stepparents, adult siblings/step-siblings, grandparents/step-grandparents, aunts/uncles/step-relatives and specialized family care providers; other relationships need BMS approval. Spouses are excluded, and the service cannot replace routine care/supervision expected from a parent/specialized family provider.
IDDW respite is not the same paid-family route
Current IDDW respite rules exclude spouses and people living in the member’s home for specified respite models, and biological/adoptive parents and stepparents cannot provide the identified respite services. Use Family PCS/other authorized supports rather than assuming the primary caregiver can bill respite.
Self-direction means employer responsibilities
Personal Options gives the participant/employer hiring and scheduling control, while Palco handles fiscal/employer-agent functions. Worker enrollment, background checks, EVV where applicable, documentation, approved rates/hours and spending-plan limits still apply.
State Plan Personal Care may bridge an ADW wait
West Virginia’s ADW materials specifically identify Medicaid Personal Care as a possible service while waiting for ADW when the person has appropriate Medicaid coverage. ADW and State Plan Personal Care may coexist if the person qualifies, but duplicate billing/services are not allowed.
Use Lighthouse and FAIR when Medicaid waiver funding is not immediately available
Lighthouse is state funded for eligible adults age 60+ who need home help but are not eligible for Medicaid in-home services; availability and cost-sharing vary. FAIR is statewide for Alzheimer’s/related dementia and can provide up to 16 respite hours per week based on need, staff availability and funding.
Waiver slots and managed-enrollment lists matter
An applicant can meet clinical/financial criteria and still wait for a funded opening. Apply early, keep contact information current, and ask about Personal Care, Lighthouse/FAIR or IDDW waitlist supports while waiting.
Watch the January 1, 2027 Medicaid community-engagement change
West Virginia says some Medicaid members ages 19–64 will have new 80-hours-per-month work/approved-activity requirements starting January 1, 2027 unless exempt. Many people with disabilities or other circumstances may qualify for exemptions; do not assume an LTSS member is affected without checking the coverage category and exemption rules.
Veterans should screen VA benefits in parallel
For a Veteran, ask about H/HHA, Veteran-Directed Care, respite, PCAFC and pension Aid & Attendance while pursuing West Virginia Medicaid/HCBS. West Virginia is in VA Community Care Network Region 1, administered by Optum, but non-emergency community care generally requires VA eligibility/referral/authorization.
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 West Virginia to help you navigate the application process.
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