How to Pay for In-Home Care
How to Pay for Home Care in Wyoming
Jump to a state to see its Medicaid programs, waivers, and other ways to help pay for in-home care.
Wyoming families typically start by screening adults 65+ and adults 19-64 with qualifying disabilities who meet nursing-facility level of care and Medicaid requirements for the Community Choices Waiver (CCW), which can authorize personal support and other HCBS; a July 2026 renewal added and updated services along with participant-directed spouse-worker rules. Qualifying people with intellectual/developmental disabilities and certain adults with brain injury should look at the Comprehensive and Supports waivers, where participant direction is available for specified services, though family-payment rules differ sharply from CCW: relatives may qualify through the certified-provider route, while relatives, spouses, and legally authorized representatives cannot simply be hired through DD self-direction. Qualifying youth with serious emotional disturbance or mental illness who meet a hospital level of care should screen the Children's Mental Health Waiver and Magellan of Wyoming High Fidelity Wraparound services, including family/youth supports and care coordination. Adults 18+ at risk of premature institutionalization can look at Wyoming Home Services for in-home assistance, respite, adult day, and related supports subject to funding and local availability, and ADRC Wyoming plus the National Family Caregiver Support Program can help identify respite and caregiver resources. Every plan can be layered with EID Medicaid for qualifying workers with disabilities, Medicare Savings Programs/Extra Help, WSHIIP, SNAP, LIEAP, weatherization, property-tax relief, assistive-technology loans, and Veteran benefits.
Updated August 2026
Reviewed by Valerie VanBooven, RN, BSN
Medicaid LTSS
Community Choices Waiver (CCW)
YesHelps pay for: HCBS that help eligible people remain in community settings instead of nursing-facility care.
Who qualifies: Generally age 65+ or ages 19–64 with qualifying disability; Medicaid financial eligibility and nursing-facility level of care apply. Current renewal effective July 1, 2026.
How to start: Contact Wyoming HCBS and begin CCW eligibility/assessment.
Good to know: Family caregiver payment: Depends on service/worker rules
CCW Service
Personal Support Services
YesHelps pay for: Hands-on assistance and support with authorized daily living and community needs.
Who qualifies: Must be enrolled in CCW, assessed for the service and have authorized units in the person-centered service plan.
How to start: Ask the case manager about personal support and delivery model.
Good to know: Family caregiver payment: Yes under participant direction for qualifying workers
Homemaker
Yes / supportiveHelps pay for: Household tasks needed to support safe community living.
Who qualifies: CCW enrollment, assessed need and service authorization required.
How to start: Request homemaker need in the person-centered plan.
Good to know: Family caregiver payment: Potentially if worker is otherwise eligible
Home Health Aide
YesHelps pay for: Authorized home health aide support under the waiver.
Who qualifies: Must meet waiver/service criteria and be authorized.
How to start: Ask case manager/clinician whether home health aide is appropriate.
Good to know: Family caregiver payment: Relationship rules depend on delivery model
Respite
Yes - temporaryHelps pay for: Temporary relief for an unpaid caregiver.
Who qualifies: Must be authorized under CCW and delivered by a qualified provider/worker.
How to start: Add respite need to the person-centered plan.
Good to know: Family caregiver payment: Not a payment to the caregiver receiving the break
Skilled Nursing
Yes - skilledHelps pay for: Authorized nursing services needed to maintain health and community living.
Who qualifies: Medical necessity, waiver authorization and provider qualifications apply.
How to start: Discuss skilled nursing need with clinician and case manager.
Good to know: Family caregiver payment: Generally not a family wage unless qualified/authorized under applicable rules
Adult Day Services
Indirect / partialHelps pay for: Structured day services that can reduce caregiver burden and home-care hours.
Who qualifies: Must be authorized and available through a qualified provider.
How to start: Ask about local adult-day options.
Good to know: Family caregiver payment: No regular family wage
Companion Services
Yes / supportiveHelps pay for: Supervision, social support and related assistance as authorized by the waiver.
Who qualifies: Added/recognized in the current CCW renewal; must be assessed and authorized.
How to start: Ask whether companion services fit assessed needs.
Good to know: Family caregiver payment: Potentially, subject to service and worker rules
CCW Self-Direction
Participant-Directed Services
YesHelps pay for: Participant-directed model that lets the participant/designated employer recruit, hire, schedule and supervise qualifying workers within authorized services.
Who qualifies: Participant must elect participant direction and complete employer/FMS requirements. Only waiver-authorized services may be self-directed.
How to start: Tell the case manager you want participant direction; complete the ACES$ referral/enrollment.
Good to know: Family caregiver payment: Yes, subject to worker/relationship rules
CCW Family Caregiver
Relative / Spouse Worker Pathway
YesHelps pay for: Allows qualifying relatives and, under current rules, certain spouses to provide participant-directed CCW services.
Who qualifies: The 2026 renewal allows a participant-directed employer to hire a spouse when there is no evidence of financial decision-making authority; approved waiver/service standards and provider qualifications still apply. Other relatives may also qualify.
How to start: Ask the case manager to confirm the exact service and relationship rule before enrolling the worker.
Good to know: Family caregiver payment: Yes, when all conditions are met
CCW Residential Alternative
Assisted Living Facility Services
Alternative to home careHelps pay for: Waiver-supported services in an approved assisted-living setting for eligible participants.
Who qualifies: Must meet CCW eligibility and service-setting rules; provider must be enrolled/qualified.
How to start: Discuss setting options with case manager.
Good to know: Family caregiver payment: No
CCW Support
Assistive Technology
IndirectHelps pay for: Devices/technology that improve independence or reduce reliance on hands-on assistance.
Who qualifies: Must meet waiver definition, assessed need, authorization and any cost/approval requirements.
How to start: Request through the person-centered plan before purchase.
Good to know: Family caregiver payment: No
CCW Home Modification
Environmental Modifications
IndirectHelps pay for: Approved home changes that improve accessibility, safety and community living.
Who qualifies: Must be related to assessed disability/functional need and authorized before work begins.
How to start: Ask case manager about assessment, bids and prior authorization.
Good to know: Family caregiver payment: No
CCW Nutrition
Home-Delivered Meals
IndirectHelps pay for: Authorized delivered meals that support nutrition and may reduce meal-preparation burden.
Who qualifies: CCW service-plan authorization and provider requirements apply.
How to start: Ask case manager whether meals can be included.
Good to know: Family caregiver payment: No
CCW Transportation
Non-Medical Transportation
IndirectHelps pay for: Authorized transportation that supports community participation and waiver-plan needs.
Who qualifies: Must be service-plan authorized; transportation type and limits apply.
How to start: Document transportation needs in the plan.
Good to know: Family caregiver payment: May be provided only under approved service rules
CCW Safety
Personal Emergency Response System (PERS)
IndirectHelps pay for: Emergency call/monitoring technology that can support safe independent living.
Who qualifies: Must meet assessed need and waiver/provider requirements.
How to start: Ask case manager about PERS authorization.
Good to know: Family caregiver payment: No
CCW Transition
Transition Intensive Case Management / Setup
Indirect / transitionHelps pay for: Planning and one-time supports for eligible people transitioning from institutions to community settings.
Who qualifies: Transition services must meet waiver criteria and be authorized as part of the transition plan.
How to start: Ask HCBS/case manager about transition eligibility before discharge.
Good to know: Family caregiver payment: No
I/DD & Brain Injury
Comprehensive Waiver
YesHelps pay for: Broad HCBS array for qualifying people with I/DD and certain adults with brain injury who meet applicable institutional level-of-care criteria.
Who qualifies: CMS describes I/DD ages 0+ and brain injury ages 21+ target groups; Medicaid, clinical and program eligibility apply.
How to start: Contact HCBS and apply; complete eligibility and person-centered planning.
Good to know: Family caregiver payment: Potentially through certified relative-provider rules; not simply through self-direction
Supports Waiver
YesHelps pay for: HCBS supports for qualifying people with I/DD and certain adults with brain injury, with a service array that overlaps the Comprehensive Waiver.
Who qualifies: CMS describes I/DD ages 0+ and brain injury ages 21+ target groups; Medicaid, clinical and program eligibility apply.
How to start: Contact HCBS and apply for the appropriate DD waiver.
Good to know: Family caregiver payment: Potentially through certified relative-provider rules; not simply through self-direction
DD Self-Direction
Self-Administered / Participant-Directed Services
YesHelps pay for: Allows participants to direct specified Comprehensive/Supports waiver services with ACES$ fiscal-management support.
Who qualifies: Only designated services may be self-directed. Current DD provider rules state a relative provider, spouse, or legally authorized representative cannot be hired to provide services through self-direction.
How to start: Ask case manager which authorized services can be self-directed and submit the ACES$ referral.
Good to know: Family caregiver payment: Not for relative/spouse/LAR workers under the DD provider rule
DD Family Caregiver
Certified Relative Provider
YesHelps pay for: A relative can become a certified waiver provider for specified services and receive reimbursement when program conditions are met.
Who qualifies: Relative must form an LLC or other corporation, maintain provider certification, disclose the relationship and provide only eligible services that would otherwise require a qualified provider and are not ordinary unpaid family functions.
How to start: Ask the DD case manager which services allow a relative provider and begin provider certification.
Good to know: Family caregiver payment: Yes, through certified-provider route
DD Spouse Rule
Spouse Reimbursement - Narrow Exception
PotentiallyHelps pay for: Potential spouse reimbursement for qualifying DD waiver services under a narrow provider-rule condition.
Who qualifies: DD provider rule states a spouse may receive direct/indirect reimbursement only if a certified court order establishes another party as the participant’s legally authorized representative; service eligibility still applies.
How to start: Have case manager/HCBS review legal-representative status and service rules before relying on spouse payment.
Good to know: Family caregiver payment: Potentially, but narrow
DD Service
Personal Care
YesHelps pay for: Hands-on assistance with authorized personal-care needs under Comprehensive/Supports waivers.
Who qualifies: Must be in the individualized plan and meet service/provider requirements; relationship/conflict safeguards apply.
How to start: Add assessed personal-care need to the plan.
Good to know: Family caregiver payment: Potentially through certified relative-provider rules
Homemaker
Yes / supportiveHelps pay for: Authorized household supports under Comprehensive/Supports waivers.
Who qualifies: Must be assessed, authorized and delivered by an eligible provider/worker.
How to start: Request through the individualized plan.
Good to know: Family caregiver payment: Potentially through certified relative-provider rules
Respite
Yes - temporaryHelps pay for: Temporary relief for unpaid caregivers.
Who qualifies: Must be authorized and comply with DD waiver provider/relationship rules. Do not assume the primary caregiver can be the paid respite worker.
How to start: Ask case manager to verify respite provider eligibility.
Good to know: Family caregiver payment: Relationship restrictions are service-specific
Community Living Services
YesHelps pay for: Supports for daily living and participation in community settings.
Who qualifies: Comprehensive/Supports waiver eligibility, assessed need and service authorization required.
How to start: Discuss community-living goals in person-centered planning.
Good to know: Family caregiver payment: Depends on provider and relationship rules
Community Support Services
Yes / supportiveHelps pay for: Supports for skill building, community participation and independence.
Who qualifies: Must be authorized in the plan and delivered under waiver standards.
How to start: Request during person-centered planning.
Good to know: Family caregiver payment: Depends on provider and relationship rules
Adult Day Services
Indirect / partialHelps pay for: Structured daytime habilitative/support services.
Who qualifies: Available within Comprehensive/Supports service arrays when authorized.
How to start: Ask case manager about local provider availability.
Good to know: Family caregiver payment: No regular family wage
DD Employment
Supported Employment
IndirectHelps pay for: Employment coaching and supports that can strengthen income and independence.
Who qualifies: Must meet waiver service criteria and employment-plan needs.
How to start: Discuss employment goals with case manager.
Good to know: Family caregiver payment: No
DD Behavioral
Behavioral Support / Crisis Intervention
Indirect / supportiveHelps pay for: Behavioral assessment/support and crisis intervention designed to maintain safety and community living.
Who qualifies: Must be clinically/behaviorally indicated, authorized and delivered by qualified providers.
How to start: Ask team to assess behavioral-support needs.
Good to know: Family caregiver payment: No regular family wage
DD Child Service
Child Habilitation Services
Yes / supportiveHelps pay for: Habilitative supports for eligible children within the DD waiver service array.
Who qualifies: Waiver eligibility, child’s assessed needs and service authorization apply.
How to start: Ask case manager whether child habilitation is available/appropriate.
Good to know: Family caregiver payment: Depends on provider/relationship rules
DD Habilitation
Individual Habilitation Training
Yes / supportiveHelps pay for: Training/support to build or maintain skills needed for independence.
Who qualifies: Must be authorized in the individualized plan.
How to start: Include habilitation goals and supports in planning.
Good to know: Family caregiver payment: Depends on provider/relationship rules
Comprehensive Only
Special Family Habilitation Home
Yes / residential supportHelps pay for: Specialized family-home habilitation available in the Comprehensive Waiver service array.
Who qualifies: Comprehensive Waiver only; provider certification and service-specific requirements apply.
How to start: Ask case manager whether this residential option fits the participant’s needs.
Good to know: Family caregiver payment: Potentially under specialized provider rules
DD Clinical
Skilled Nursing
Yes - skilledHelps pay for: Authorized skilled nursing under Comprehensive/Supports waivers.
Who qualifies: Must be medically necessary, authorized and delivered by qualified nursing provider.
How to start: Coordinate with clinician and case manager.
Good to know: Family caregiver payment: No regular family wage unless qualified/authorized under applicable provider rules
DD Therapy
OT / PT / Speech-Hearing-Language / Dietitian
Indirect / skilledHelps pay for: Authorized clinical therapies and nutrition support that may reduce functional barriers and caregiver burden.
Who qualifies: Must meet service definitions, medical need and waiver authorization.
How to start: Ask team about therapy/dietitian assessments.
Good to know: Family caregiver payment: No regular family wage
DD Cognitive Support
Cognitive Retraining / Companion Services
Yes / supportiveHelps pay for: Cognitive skill support and companion services within the DD waiver service array.
Who qualifies: Must be assessed and authorized under the applicable waiver.
How to start: Ask case manager which service definition matches the need.
Good to know: Family caregiver payment: Depends on exact service/provider rules
DD Equipment
Specialized Equipment
IndirectHelps pay for: Approved equipment needed for function, communication, safety or independence.
Who qualifies: Must meet waiver criteria and be authorized before purchase.
How to start: Use the specialized-equipment request process with the team.
Good to know: Family caregiver payment: No
DD Home Modification
Environmental Modification
IndirectHelps pay for: Approved home accessibility/safety changes.
Who qualifies: Must be disability-related, cost-effective/authorized and follow waiver modification rules.
How to start: Request assessment and prior authorization before construction.
Good to know: Family caregiver payment: No
DD Transportation
Transportation Services
IndirectHelps pay for: Authorized transportation supporting waiver goals and community access.
Who qualifies: Must be authorized in the plan and comply with waiver transportation requirements.
How to start: Add transportation needs to the plan.
Good to know: Family caregiver payment: Depends on service/provider rules
Child Behavioral Health
Children’s Mental Health Waiver (CMHW)
Yes / supportiveHelps pay for: HCBS youth/family training and support for qualifying children/youth who meet hospital level-of-care criteria.
Who qualifies: CMS targets serious emotional disturbance ages 4–17 and mental illness ages 18–21; Magellan coordinates Wyoming Wraparound for eligible youth.
How to start: Refer through Magellan of Wyoming for screening and provider connection.
Good to know: Family caregiver payment: No regular family wage; family support roles differ from employee wages
CMHW Care Coordination
High Fidelity Wraparound / Family Care Coordination
Indirect / supportiveHelps pay for: Intensive team-based care coordination to organize behavioral-health, family and community supports.
Who qualifies: Must meet program eligibility and be enrolled through the care-management entity.
How to start: Call Magellan or submit an online referral.
Good to know: Family caregiver payment: No
CMHW Family Support
Youth & Family Training / Peer Support
IndirectHelps pay for: Training, education, skill-building and peer/family support that can reduce caregiver burden and improve stability.
Who qualifies: Must be part of authorized CMHW/CME services and delivered under provider rules.
How to start: Ask the Wraparound team which family/youth supports are authorized.
Good to know: Family caregiver payment: May include paid peer roles through qualified providers, not a general family-caregiver wage
CMHW Respite
Behavioral-Health Respite
Yes - temporaryHelps pay for: Short-term relief/support within the Wyoming CME/waiver service framework when authorized.
Who qualifies: Eligibility, authorization and provider availability apply.
How to start: Discuss respite need with the Wraparound care coordinator.
Good to know: Family caregiver payment: Not a regular caregiver wage
Medicaid State Plan
Wyoming Medicaid Home Health
Yes - skilled/home healthHelps pay for: Medically necessary home-health services under the Medicaid State Plan, subject to coverage and prior-authorization rules.
Who qualifies: Must be Medicaid-eligible and meet medical-necessity/coverage requirements; physician/qualified-practitioner orders and authorization may apply.
How to start: Ask treating clinician and Medicaid about covered home health.
Good to know: Family caregiver payment: No general family wage
Medicaid Equipment
Durable Medical Equipment (DME)
IndirectHelps pay for: Covered durable equipment and supplies that can reduce hands-on care needs or support safety/function.
Who qualifies: Medicaid coverage, medical necessity, supplier and prior-authorization rules apply.
How to start: Get the required prescription/order and use an enrolled supplier.
Good to know: Family caregiver payment: No
Medicaid Transportation
Medicaid Travel Assistance
IndirectHelps pay for: Mileage/transportation assistance for eligible medically necessary Medicaid appointments under program rules.
Who qualifies: Member eligibility, distance/medical appointment and documentation requirements apply; advance request may be required.
How to start: Call Member Services or use the member portal for a travel request.
Good to know: Family caregiver payment: May offset family transportation costs when program rules permit
Working Disabled Medicaid
Employed Individuals with Disabilities (EID)
Indirect / enables coverageHelps pay for: Full Medicaid coverage that can help a worker with a disability retain coverage while earning income; may protect access to waiver services when eligible.
Who qualifies: Age 16–64, disabled and employed; current Wyoming materials describe a 7.5% gross monthly income premium and no earned-income limit, with other rules applying.
How to start: Apply through Wyoming Medicaid and ask specifically for EID screening.
Good to know: Family caregiver payment: No direct caregiver wage
Children’s Health Support
Children’s Special Health Program
Indirect / condition-specificHelps pay for: Supplemental resources for eligible children/youth with qualifying chronic physical, developmental, behavioral or emotional conditions.
Who qualifies: Program eligibility and covered condition/provider limits apply; not a replacement for Medicaid waiver eligibility.
How to start: Contact local Public Health Nursing or IHS office for application information.
Good to know: Family caregiver payment: No
Private Coverage
Long-Term Care Insurance / Hybrid LTC Benefits
PotentiallyHelps pay for: Policy benefits may reimburse or pay for qualifying home care, personal care or caregiver services depending on contract terms.
Who qualifies: Benefits vary by policy, elimination period, ADL/cognitive triggers, licensed-provider requirements and daily/monthly limits.
How to start: Request a written benefit determination and home-care policy provisions from insurer.
Good to know: Family caregiver payment: Sometimes, only if policy permits informal/family care
State Aging / Disability
Wyoming Home Services (WyHS)
Yes / supportiveHelps pay for: State-supported community services for qualifying adults at risk of premature institutionalization, subject to funds and local availability.
Who qualifies: Wyoming law/program materials describe adults age 18+ at risk of institutionalization; services and fees depend on assessment, funding and local provider.
How to start: Contact Aging Division/ADRC for local WyHS provider and assessment.
Good to know: Family caregiver payment: Generally service support rather than a family wage
WyHS Service
In-Home Assistance / Homemaker / Personal Care
YesHelps pay for: Help with household and personal tasks that can delay institutional placement.
Who qualifies: WyHS assessment, service availability and sliding/ability-to-pay policies may apply.
How to start: Ask the local WyHS provider for assessment and fee information.
Good to know: Family caregiver payment: Generally no direct family wage
WyHS Caregiver Relief
Respite + Adult Day Services
Yes / temporaryHelps pay for: Temporary caregiver relief and structured day support through the Wyoming aging/community-living network when available.
Who qualifies: Program/provider availability and funding apply; participant may have cost share based on local/state policy.
How to start: Ask ADRC or WyHS provider about respite/adult day nearby.
Good to know: Family caregiver payment: Not a regular family wage
Caregiver Support
National Family Caregiver Support Program (NFCSP)
Indirect / respiteHelps pay for: Information, counseling/support, caregiver training and respite/supportive services through the aging network.
Who qualifies: Older Americans Act caregiver eligibility and local funding/service availability apply.
How to start: Ask ADRC for the local caregiver-support provider.
Good to know: Family caregiver payment: No regular caregiver wage
Navigation
Wyoming Aging & Disability Resource Center (ADRC)
IndirectHelps pay for: No-wrong-door information, options counseling and referrals for home care, respite, benefits, transportation and caregiver supports.
Who qualifies: Available statewide to older adults, people with disabilities and caregivers; not an entitlement/payment program.
How to start: Call 211 or the statewide ADRC navigator line.
Good to know: Family caregiver payment: No
Medicare Counseling
Wyoming State Health Insurance Information Program (WSHIIP)
IndirectHelps pay for: Free personalized Medicare counseling to reduce premiums/copays and identify coverage options.
Who qualifies: Medicare beneficiaries/caregivers can seek unbiased counseling.
How to start: Call WSHIIP and request benefit review.
Good to know: Family caregiver payment: No
Medicare
Medicare Home Health
Yes - limited/skilledHelps pay for: Part A/Part B home health for beneficiaries who meet Medicare coverage requirements, including homebound/skilled-service criteria.
Who qualifies: Medicare does not generally cover long-term custodial home care; covered home health requires eligibility and a Medicare-certified agency.
How to start: Ask clinician for home-health certification/order and use a Medicare-certified agency.
Good to know: Family caregiver payment: No regular family wage
Medicare Cost Offset
Medicare Savings Programs
IndirectHelps pay for: Medicaid-administered programs that may pay Medicare premiums and, for some categories, cost sharing.
Who qualifies: Income/resource/category rules apply and change annually.
How to start: Ask Wyoming Medicaid/WSHIIP to screen for QMB, SLMB and QI.
Good to know: Family caregiver payment: No
Prescription Cost Offset
Medicare Extra Help
IndirectHelps pay for: Federal Low-Income Subsidy that reduces Part D premiums, deductibles and prescription costs.
Who qualifies: Income/resource and automatic-qualification rules apply.
How to start: Apply through Social Security or ask WSHIIP for help.
Good to know: Family caregiver payment: No
Medicare Advantage
Supplemental In-Home / Support Benefits
Sometimes / limitedHelps pay for: Some Medicare Advantage plans offer supplemental benefits such as limited in-home support, meals, transportation or safety benefits.
Who qualifies: Benefits are plan-specific, service-area specific and may require qualifying chronic conditions or prior authorization.
How to start: Review Evidence of Coverage and confirm benefits directly with the plan.
Good to know: Family caregiver payment: Usually no
Food Cost Offset
SNAP
IndirectHelps pay for: Monthly food assistance that can free household income for care-related expenses.
Who qualifies: Household income, deductions and program rules apply; elderly/disabled households can have special deduction treatment.
How to start: Apply through Wyoming DFS and complete required interview/verification.
Good to know: Family caregiver payment: No
Utility Cost Offset
Low Income Energy Assistance Program (LIEAP)
IndirectHelps pay for: Pays a portion of eligible winter heating costs and can assist with heating emergencies, preserving funds for care.
Who qualifies: Seasonal program; 2025–26 applications are closed and Wyoming says 2026–27 applications open in early fall 2026.
How to start: Apply when the 2026–27 portal opens; sign up for updates now.
Good to know: Family caregiver payment: No
Home Cost Offset
Weatherization Assistance Program (WAP)
IndirectHelps pay for: No-cost energy-efficiency improvements for eligible low-income households, reducing ongoing utility costs.
Who qualifies: Applications accepted year-round; income and property/program rules apply.
How to start: Apply through Wyoming DFS; housebound applicants can call for assistance.
Good to know: Family caregiver payment: No
Property Tax Offset
Wyoming Property Tax Refund Program
IndirectHelps pay for: Refund can reduce housing costs and preserve household resources for care.
Who qualifies: Annual application; amount may be up to one-half of median residential property tax or 75% of the bill, whichever is less, subject to eligibility/funding rules.
How to start: Check current-year eligibility and apply through the local County Treasurer/Department of Revenue.
Good to know: Family caregiver payment: No
Assistive Technology
Wyoming Assistive Technology Resources (WATR)
IndirectHelps pay for: Free AT information, demonstrations and short-term device loans can reduce purchase costs and support independence.
Who qualifies: Statewide resource; device loans/demos have program agreements and availability rules.
How to start: Contact WATR for device demonstration, loan or funding-navigation help.
Good to know: Family caregiver payment: No
Veterans
VA Home Care / Caregiver / Pension Benefits
Yes / depends on benefitHelps pay for: VA programs may provide home care, respite, caregiver support/stipends, participant-directed care or pension supplements for eligible Veterans/survivors.
Who qualifies: Veteran status, VA enrollment, clinical need, service connection/pension rules and local availability differ by program.
How to start: Screen the VA Benefits Detail tab and contact VA/Wyoming Veterans Commission in parallel.
Good to know: Family caregiver payment: Yes for some VA caregiver/VDC pathways
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 available in the Veteran’s area.
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 caregiver reliefHelps 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
Program of Comprehensive Assistance for Family Caregivers (PCAFC)
Supports sustained home caregivingHelps pay for: Education, support, health coverage in some cases and a monthly stipend for an eligible primary family caregiver.
Who qualifies: Veteran/caregiver must meet current PCAFC eligibility, service-connected disability and personal-care/supervision criteria. Apply online or 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 primary family caregiver
Program of General Caregiver Support Services (PGCSS)
Supports unpaid caregiverHelps pay for: Coaching, education, peer support and caregiver resources without requiring a service-connected disability.
Who qualifies: Veteran must be enrolled in VA health care and receive care from a family caregiver; program 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
Home Based Primary Care (HBPC)
Reduces travel / supports home careHelps pay for: Interdisciplinary VA primary care delivered at home for Veterans with complex chronic conditions who have difficulty traveling.
Who qualifies: Clinical appropriateness, VA enrollment and local team capacity apply. Ask VA primary care/social work about HBPC referral.
How to start: Ask the VA social worker or care team about Home Based Primary Care (HBPC).
Good to know: Family caregiver payment: No direct family wage
VA Adult Day Health Care
Reduces daytime home-care burdenHelps pay for: Health maintenance, therapy, socialization and caregiver respite in an adult-day setting.
Who qualifies: VA eligibility, clinical need, local program/provider availability and authorization apply. Ask VA social work/Geriatrics about adult day health.
How to start: Ask the VA social worker or care team about VA Adult Day Health Care.
Good to know: Family caregiver payment: No
VA Hospice / Palliative Care
Direct end-of-life/supportive careHelps pay for: Comfort-focused care, symptom management and caregiver support at home or other settings.
Who qualifies: Clinical eligibility and VA authorization/coordination apply. Ask VA clinician/palliative care team for assessment.
How to start: Ask the VA social worker or care team about VA Hospice / Palliative Care.
Good to know: Family caregiver payment: No regular family wage
VA Pension Aid & Attendance / Housebound
Cash can help pay care expensesHelps pay for: Additional monthly VA pension amounts for qualifying Veterans/survivors who need personal assistance or are substantially confined.
Who qualifies: Must qualify for VA pension and meet Aid & Attendance or Housebound criteria; income/net-worth rules apply. Apply with VA; consider help from an accredited VSO.
How to start: Ask the VA social worker or care team about VA Pension Aid & Attendance / Housebound.
Good to know: Family caregiver payment: Indirect - beneficiary controls funds
VA Community Care Network - Region 4
Access to authorized community home health/other careHelps pay for: VA-authorized community providers when eligibility/referral rules are met; Region 4 is administered by TriWest.
Who qualifies: Wyoming is in CCN Region 4. Community care generally requires VA referral/authorization except qualifying emergency/urgent circumstances. Work through VA care team before non-emergency community services.
How to start: Ask the VA social worker or care team about VA Community Care Network - Region 4.
Good to know: Family caregiver payment: No direct family wage
Wyoming Veterans Commission / Veteran Service Officers
Improves access to VA/state resourcesHelps pay for: Statewide benefit navigation, VA claims/pension help, service-officer access and Wyoming Veteran benefit guidance.
Who qualifies: Veteran/survivor/caregiver status and benefit-specific rules apply. Wyoming also has a separate Veteran property-tax exemption for qualifying residents. Call the Wyoming Veterans Hotline or locate a VSO.
How to start: Ask the VA social worker or care team about Wyoming Veterans Commission / Veteran Service Officers.
Good to know: Family caregiver payment: No direct wage
Where Wyoming Families Can Start
Not sure where to begin? Match your situation to a contact below.
Medicaid applications, eligibility, renewals, covered-services questions, travel assistance and member questions.
Wyoming Medicaid Customer Service Center
Community Choices, Comprehensive and Supports waiver information; waiver applications, eligibility and program questions.
Wyoming Medicaid HCBS Section
CCW assessment, person-centered planning, service authorization and participant-direction questions.
Community Choices Waiver / Case Management
Payroll/tax/FMS support for participant-directed Community Choices, Comprehensive and Supports waiver services after referral.
ACES$ Financial Management Services - Wyoming
CMHW / High Fidelity Wraparound referral, screening and provider connection.
Magellan of Wyoming / Children’s Mental Health Waiver
State-funded/community home services, in-home assistance, respite/adult-day navigation and local provider information.
Wyoming Home Services - Aging Division
No-wrong-door LTSS navigation, respite/caregiver resources, home-care options, benefits and local referrals.
Wyoming Aging & Disability Resource Center
Free Medicare counseling, Medicare Savings/Extra Help screening and plan questions.
Wyoming State Health Insurance Information Program (WSHIIP)
Food-benefit application and case-navigation starting point.
Wyoming Department of Family Services - SNAP
Heating assistance, heating-emergency help and year-round weatherization application support.
Wyoming LIEAP / Weatherization
AT demonstrations, short-term device loans, reuse/funding guidance and independence supports.
Wyoming Assistive Technology Resources (WATR)
VA/state benefit navigation, accredited Veteran Service Officer access and Wyoming Veteran resources.
Wyoming Veterans Commission
Before You Rely on Any Payment Source
Planning Issue
What to Know / What to Do
Start with the correct Wyoming entry door
For an older adult/person with physical disability who may meet nursing-facility level of care, start with Community Choices. For I/DD or qualifying adult brain injury, screen Comprehensive/Supports. For qualifying serious child/youth behavioral-health needs, screen the Children’s Mental Health Waiver. For non-Medicaid/state-funded help, ask about Wyoming Home Services.
CCW was renewed effective July 1, 2026
CMS lists Community Choices R07 as effective July 1, 2026. Use the renewed service definitions and current participant-directed worker standards rather than relying on older CCW materials.
CCW now has a meaningful spouse-worker pathway
The 2026 CCW renewal updated participant-directed standards to allow an employer to hire a spouse when there is no evidence of financial decision-making authority, subject to the approved waiver/service rules and qualifications. Verify the exact service and worker circumstances before promising payment.
CCW family rules do not transfer to the DD waivers
Comprehensive/Supports use a different framework. Wyoming’s DD provider rule says a relative provider, spouse or legally authorized representative cannot be hired through self-direction. Do not apply the CCW spouse rule to DD self-direction.
DD relatives may instead use the certified-provider route
A relative can be paid for specified DD waiver services by becoming a certified provider, forming an LLC/other corporation, maintaining certification and meeting disclosure/conflict safeguards. Payment is only for qualifying services that would otherwise require a provider—not ordinary unpaid family functions.
DD spouse reimbursement is especially narrow
The DD provider rule says a spouse may receive direct or indirect reimbursement only if a certified court order establishes another party as the participant’s legally authorized representative, and the exact service must permit the arrangement. Have HCBS/case management review it before relying on spouse payment.
Self-direction still means employer responsibilities
For participant-directed services, the participant/designated employer manages recruitment, hiring, scheduling, supervision and service delivery while ACES$ handles fiscal/employer-agent functions. Authorized hours, worker qualifications, EVV/timekeeping and spending limits still apply.
Wyoming Home Services is funding- and availability-dependent
WyHS can be valuable for adults at risk of institutional placement, including people who do not qualify for Medicaid HCBS, but services depend on state/local funding, assessment and provider availability and may include ability-to-pay fees.
PACE is not a current Wyoming Medicaid pathway
CMS records show Wyoming eliminated PACE as a Medicaid state-plan option effective April 1, 2021. Do not list PACE as an active Wyoming home-care payment route.
Use EID when work income threatens disability Medicaid coverage
Wyoming’s EID category serves qualifying employed people with disabilities ages 16–64 and uses a premium model. Ask Medicaid to screen EID before assuming work earnings require loss of Medicaid/waiver access.
Energy assistance timing matters in August 2026
Wyoming says the 2025–26 LIEAP season is closed and the 2026–27 application period will open in early fall 2026. Weatherization remains available year-round, so apply for WAP now and watch for the new LIEAP opening.
Veterans should screen VA benefits in parallel
Ask about H/HHA, Veteran-Directed Care, respite, PCAFC and Aid & Attendance while pursuing Wyoming Medicaid/HCBS. Wyoming is in VA Community Care Network Region 4, administered by TriWest; 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 Wyoming to help you navigate the application process.
← Back to How to Pay for In-Home CareHome Care Providers in Wyoming
These providers serve families in Wyoming and can help you apply what you've learned above to your specific situation.
