How to Pay for Home Care
Many families assume professional care is out of reach. Before you decide that, talk with us. There may be more support available than you expect.
Home care does not have to mean paying entirely out of pocket. Depending on your location, your loved one’s diagnosis, age, and eligibility, you may qualify for funding through Medicaid waiver programs, long-term care insurance, veterans benefits, or a combination of sources.
Medicaid Waivers
Medicaid waiver programs, formally called Home and Community-Based Services (HCBS) waivers, allow states to fund care for eligible individuals in their homes rather than in institutional settings. Each state runs its own programs with its own eligibility rules, covered services, and application process.
In general, to qualify for a Medicaid waiver your loved one must be Medicaid-eligible and meet a functional eligibility threshold, meaning they need a level of support that would otherwise require a nursing facility or intermediate care facility. Individuals with autism, intellectual and developmental disabilities, physical disabilities, or complex medical needs may qualify, depending on the specific program and its financial, functional, and other eligibility requirements.
Medicaid waiver funding may be available through participating Butterfly Home Care locations, depending on the state program, individual eligibility, and local provider participation. The programs accepted in each state are listed below.
Medicaid and waiver programs that may be available in Virginia include:
- CCC+ Waiver (Commonwealth Coordinated Care Plus) — for individuals who require a nursing facility level of care, including seniors, adults with physical disabilities, and those with complex chronic needs
- DD Waiver (Developmental Disabilities Waiver) — including the Building Independence (BI), Family and Individual Supports (FIS), and Community Living (CL) Waivers — for Medicaid-eligible individuals with intellectual and developmental disabilities, including autism, who require the applicable level of care.
Medicaid and waiver programs that may be available in New Jersey include:
- CCPED Waiver (Community Care Program for the Elderly and Disabled) — for seniors and adults with physical disabilities who require nursing facility level care
- Supports Program Waiver — for individuals with intellectual and developmental disabilities who need a lower level of supports
- ABI Waiver (Acquired Brain Injury Waiver) — for adults with acquired brain injuries requiring community-based support
- PCA Waiver (Personal Care Assistance Waiver) — for Medicaid-eligible individuals who need personal care services at home
- HCBS Waiver (Home and Community-Based Services Waiver) — for individuals with IDD who require an ICF/IID level of care
- MLTSS Program (Managed Long-Term Services and Supports) — a managed care program providing long-term services and supports for eligible individuals
Medicaid and waiver programs that may be available in Maryland include:
- Community Options Waiver — for adults with physical disabilities or chronic illness who require a nursing facility level of care
- Medical Day Care Services Waiver — for adults who need medically supervised day care as an alternative to nursing facility placement
- Community Pathways Waiver — for individuals with intellectual and developmental disabilities who require an ICF/IID level of care
- Autism Waiver — for children and young adults with autism spectrum disorder who need intensive community-based support
Medicaid and waiver programs that may be available in Georgia include:
- EDWP (Elder and Disabled Waiver Program) — including Community Care Services Program (CCSP) and Service Options Using Resources in a Community Environment (SOURCE) — for seniors and adults with physical disabilities who require a nursing facility level of care.
- ICWP (Independent Care Waiver Program) — for adults with physical disabilities who want to live independently in the community
- NOW Waiver (New Options Waiver) — for individuals with intellectual and developmental disabilities, including autism, who require an ICF/IID level of care
- COMP Waiver (Comprehensive Supports Waiver) — for individuals with IDD who have more intensive support needs than the NOW Waiver covers
Medicaid and waiver programs that may be available in Texas include:
- CLASS Waiver (Community Living Assistance and Support Services) — for individuals with related conditions such as autism or other neurological disorders who require an ICF/IID level of care
- HCS Waiver (Home and Community-based Services) — for individuals with intellectual disabilities who require an ICF/IID level of care
- DBMD Waiver (Deaf Blind with Multiple Disabilities) — for individuals who are deaf-blind with additional disabilities requiring intensive support
- STAR+PLUS Home and Community Based Services (HCBS) Program — for adults aged 21 and older who are enrolled in STAR+PLUS and require a nursing facility level of care
Medicaid and waiver programs that may be available in Florida include:
- iBudget Waiver — for individuals with intellectual and developmental disabilities who require an ICF/IID level of care; provides a self-directed budget for community-based services
- Model Waiver — For children age 20 or younger who are medically complex or medically fragile, including applicable degenerative spinocerebellar conditions, and who meet the program’s level-of-care requirements.
- Statewide Medicaid Managed Care (SMMC) Long-Term Care (LTC) Program — for seniors and adults with physical disabilities who require a nursing facility level of care and want to receive services in the community
Not sure which waiver applies to your situation or how to apply? Waiver eligibility, application processes, and waitlists vary by state and program. We help families navigate this every day.
Call us and we will point you in the right direction.
Long-Term Care Insurance
If you or your loved one has a long-term care (LTC) insurance policy, it may cover home care services. LTC insurance was designed specifically for situations like this, to help cover the cost of ongoing care when someone needs help with daily activities over an extended period.
What it typically covers
Personal care, companion care, respite care, and other home-based support services. Coverage depends on the specific policy terms, benefit triggers, and daily or monthly benefit limits.
How Butterfly works with LTC insurance
We work with families who use long-term care insurance and can assist with the documentation needed to support a claim. Our team can help you understand whether your policy applies and assist with the documentation needed to support your claim.
If you are unsure whether your policy covers home care or how to begin using it, contact us. We can walk through what information you will need and how to get started.
Veterans Benefits
Veterans and surviving spouses may be eligible for benefits that help cover the cost of home care. These programs are often underused because families do not know they exist or assume the process is too complicated to navigate. Butterfly Home Care is partnered with Veterans Care Coordination to help eligible veterans and their families understand and access the benefits they have earned.
VA Aid & Attendance Benefit
The Aid & Attendance benefit is a pension supplement available to veterans and surviving spouses who need help with daily activities such as bathing, dressing, eating, or getting around. It can significantly increase monthly VA pension payments and is specifically designed to help cover the cost of care at home or in assisted living.
Many veterans who qualify have never applied because they did not know this benefit existed.
- Must be eligible for VA Pension or Survivors Pension, based on qualifying wartime service
- Must require assistance with activities of daily living
- Must meet income and net worth requirements
- Does not require a service-connected disability
Not sure if you or a family member qualifies for veterans benefits?
We work with Veterans Care Coordination to help families navigate eligibility and the application process.
Call us at 703-278-2898 to learn more.
Private Pay
If you are paying for care out of pocket, Butterfly provides transparent pricing with no hidden fees. We are upfront about our rates before services begin so there are no surprises.
Accepted payment methods
Credit card, debit card, and direct bank transfer. We keep the process simple and straightforward.
No hidden fees
We tell you what care costs before we begin. Rates are based on the type of support, number of hours, and scheduling. Contact us for a personalized quote.
Some families use private pay while a waiver application is being processed, or to supplement coverage from another funding source. We can help you think through the right approach for your situation.
How to Get Started
Getting started does not require you to have your funding sorted first. Many families call us before they know which payment source applies. That is fine. We will help you figure it out.
Step 1 — Call or contact us
Reach out by phone or through our website. Tell us about your loved one’s situation and what kind of support you are looking for. No commitment required.
Step 2 — We help you understand your options
We will ask a few questions about location, diagnosis, age, and any insurance or benefits you may already have. Then we will walk you through what funding may be available.
Step 3 — We build a care plan
Once funding is confirmed or private-pay arrangements are finalized, we conduct an assessment and build a personalized care plan before services begin.
Step 4 — Care begins
In many cases, services can start within days of completing the intake process. If your situation is urgent, let us know and we will move as quickly as possible.
COMBINING FUNDING SOURCES
Many Families Use More Than One Source
You do not have to choose just one funding option. Some families combine Medicaid waiver coverage with private pay for additional care, when permitted by the applicable program and state rules. Others use veterans’ benefits alongside long-term care insurance. Some transition between sources as eligibility or needs change.
We help families figure out what is available to them — not just tell them what we accept.
Common Questions About Paying for Care
What if I do not qualify for a Medicaid waiver?
Waiver programs have specific eligibility requirements, and not everyone qualifies. Some eligible individuals may also be placed on a waitlist before services become available. If funding is not currently available, private pay may be an option while you explore other resources.
Are Medicaid waiver waitlists long?
Some waiver programs in Virginia and Georgia do have waitlists, including Virginia’s Developmental Disability (DD) waivers. The length of the wait depends on the program and the individual’s priority status.
Butterfly Home Care can help families understand the process and available care options while they wait, but eligibility and waiver placement are determined by the applicable state program.
Can I use long-term care insurance and a Medicaid waiver at the same time?
Long-term care insurance and Medicaid may sometimes be used together, but how the benefits coordinate depends on your insurance policy and the applicable Medicaid program. Because Medicaid is generally the payer of last resort, available long-term care insurance benefits may need to be applied before Medicaid pays for covered services. We can help you understand how your specific situation might work.
What if I am not sure whether my loved one qualifies for a Medicaid waiver?
Call us. We help families navigate this regularly. If we cannot answer your question directly, we will connect you with the right resource.
Do you help with the waiver application process?
We can help you understand the process and connect you with the right contacts. Waiver applications are managed through state agencies and case managers, but we can help you understand what to expect and what documentation may be needed.
What if I need care to start before funding is confirmed?
We offer private pay on a transparent, straightforward basis. Many families start with private pay and transition to waiver or insurance coverage once it is in place. We will work with you on what makes sense for your situation.