How to Pay for Home Care in Pittsburgh

Medicaid's Community HealthChoices (CHC) Program

Pennsylvania's Community HealthChoices (CHC) managed care waiver is the most common way low- and moderate-income seniors in Allegheny County get home care covered at little or no cost. CHC is the state's Medicaid program designed specifically to help older adults and people with disabilities remain at home instead of moving to a nursing facility.

To qualify, a person generally must:

• Be 21 or older (most participants are seniors 60+)
• Meet Pennsylvania's Medicaid income and asset guidelines
• Require a nursing-facility level of care as assessed by the state
• Live in their own home or a family member's home in Allegheny County

If your parent qualifies, CHC can cover in-home care, personal care, companion care, homemaker help, and more — often with no copay or premium. Enrollment goes through a CHC Managed Care Organization (MCO); a care coordinator works with your family to build a care plan. Learn more on our dedicated page: PA CHC Medicaid Waiver Home Care.

VA Benefits for Pittsburgh Veterans

If your loved one is a veteran — or the surviving spouse of a veteran — there are several benefit programs that can help pay for home care in the Pittsburgh area.

Aid and Attendance (A&A) is the most widely used VA benefit for home care. It is a pension enhancement for wartime veterans or their surviving spouses who need help with activities of daily living. The monthly benefit amount depends on the veteran's status (single veteran, married veteran, surviving spouse) and is paid directly to the family to use toward care costs.

Other VA programs to ask about include:

• Homemaker and Home Health Aide Program — VA-funded non-medical home care through authorized providers
• Program of Comprehensive Assistance for Family Caregivers (PCAFC) — monthly stipend for a designated family caregiver
• Veteran-Directed Care — a self-directed budget to hire caregivers, including family members

Getting these benefits can take time and paperwork. Our page on VA Aid & Attendance for Pittsburgh Veterans walks through the process in plain language.

Long-Term Care Insurance

If your parent purchased a long-term care (LTC) insurance policy — often sold in the 1990s and 2000s — it may cover non-medical home care services. Many families forget these policies exist, or don't realize home care is covered (not just nursing homes).

Here is what to check before assuming the policy won't help:

• Benefit triggers: Most policies pay once the insured needs help with two or more activities of daily living (ADLs), such as bathing, dressing, or mobility — or has a cognitive impairment like dementia.
• Home care rider: Look for language like "home and community-based care" or a "home care rider" in the policy documents.
• Elimination period: Most policies have a waiting period (often 30–90 days) before benefits begin. Keep receipts for care provided during that window.
• Daily or monthly benefit amount: The policy will specify a maximum daily or monthly payout. Your care plan can be structured to stay within that limit.

Our guide Using Long-Term Care Insurance for Home Care covers how to file a claim and what to expect from the process.

Private Pay: Paying Out of Pocket

Many Pittsburgh families — especially those who do not qualify for Medicaid and do not have LTC insurance — pay for home care directly. This is called private pay, and it gives families the most flexibility in choosing services, schedules, and caregivers.

Private pay is straightforward: you pay for the hours of care you need, at an agreed hourly rate. You can start small (a few hours a week for companionship or help around the house) and increase hours as needs grow.

A few strategies families use to make private pay work:

• Start with the hours that matter most — morning routines, meal preparation, or overnight support — rather than trying to cover everything at once
• Combine with other funding — for example, use VA benefits for part of the cost and private pay for the remainder
• Use home equity — some families use a reverse mortgage or home equity line of credit; see our guide on using a reverse mortgage for home care
• Split costs among siblings — a shared family agreement can make private pay more manageable

For a clear picture of what care costs in the Pittsburgh area, visit our page on home care costs in Pittsburgh.

Not Sure Where to Start? We Can Help.

At Mary Angels Home Care, we serve families across Allegheny County — from the North Hills to Mt. Lebanon, Squirrel Hill to Monroeville — and we have helped many Pittsburgh families sort through exactly these questions. We offer a free in-home assessment with no obligation.

During that visit, we can:

• Help you understand which funding programs your loved one may qualify for
• Explain how to start the CHC or VA application process
• Build a care plan that fits your budget and your parent's needs
• Connect you with Allegheny County resources if additional support is needed

Call us at 412-900-9354 or email info@maryangelshomecare.com to schedule your free consultation. You can also review our home care consultation checklist to prepare for that first conversation.