How to Pay for Home Care in Raleigh, NC

Figuring out how to pay for home care can feel like a big challenge, but families in Raleigh, NC have more options than you might think., Whether you’re planning ahead or seeking immediate care solutions, exploring the array of payment options available, from private pay and insurance to state-supported programs, will empower you to pursue home care that balances quality and affordability.

In addition to paying out of pocket, families can explore other payment options such as long-term care insurance, veterans’ benefits, Medicaid and waiver programs, and community solutions.

In this guide, we will discuss each payment option, from private pay basics and insurance information, to government programs and community resources, breaking down eligibility, benefits, and practical steps for each. Whether you’re planning for long-term care or responding to an immediate need, the goal is to equip you with the tools to make informed financial decisions, so your loved one can receive the compassionate, reliable care they deserve in the comfort of home.

6 Ways to Pay for Home Care

When it comes to paying for home care in Raleigh, NC, families have several options to help manage costs. While paying out of pocket is common, there are also various programs, benefits, and financial tools that can make care more affordable. Understanding these options can help you choose the best fit for your loved one’s needs and financial situation.

1. Private Pay

For many families in Raleigh, the most straightforward way to cover home care costs is through private pay, also known as paying out of pocket. This approach provides the most flexibility when selecting a provider, establishing a schedule, and determining which services best meet your loved one’s needs.

Private pay can come from a variety of sources, including:

• Personal savings or retirement funds: Many families use accumulated savings, pensions, or Social Security income to manage care expenses.
• Home equity: Options such as reverse mortgages or home equity loans enable homeowners to utilize the value of their home to help fund care.
• Life insurance conversions: Certain policies can be sold or converted into a long-term care benefit plan to help cover the costs of home care.
• Family contributions: In some cases, multiple family members may pool their resources to share the financial responsibility of caring for a loved one.

Private pay may not be sustainable long term, but it can be an excellent short-term solution, especially while waiting for benefits, insurance claims, or Medicaid approvals to be processed.

2. Long-Term Care Insurance

If your loved one has a long-term care insurance (LTCI) policy, it can be one of the most effective ways to help pay for home care in Raleigh. These policies are specifically designed to cover the costs of long-term support services, including in-home care, assisted living, and nursing home stays.

The coverage and benefits depend on the individual policy, but most plans include:

• Home Care Services: Assistance with activities of daily living (ADLs) such as bathing, dressing, meal preparation, and mobility.
• Skilled Care: Services provided by nurses or therapists, often for chronic or ongoing health needs.
• Companionship and Homemaking: Help with errands, light housekeeping, or simply providing company.

To use LTCI benefits, most policies require that the policyholder be unable to perform at least two ADLs, such as eating, toileting, or transferring, or have a cognitive impairment like dementia.

It’s also important to understand:

• Elimination Periods: Many policies have a waiting period (typically 30–90 days) before benefits take effect.
• Daily or Monthly Limits: Policies typically pay up to a set amount per day or month for care.
• Benefit Periods: Coverage may last a certain number of years or until a lifetime maximum is reached.

Because every policy is different, families should carefully review the details and work with their insurance provider to confirm what services are covered and how claims should be filed. When available, long-term care insurance can greatly reduce the financial burden of home care and help preserve savings for other needs.

3. Veterans Benefits

For veterans and their surviving spouses in Raleigh, the U.S. Department of Veterans Affairs (VA) offers programs that can help offset the cost of home care. These benefits can enable older adults to remain safely at home while receiving the necessary support.

Key programs include:

• Aid & Attendance (A&A) Pension Benefit: Provides additional monthly financial assistance to eligible veterans and surviving spouses who require help with daily activities like bathing, dressing, or meal preparation.
• Housebound Benefits: Provides additional financial support for veterans who are significantly limited in their mobility due to a permanent disability, allowing them to remain at home.
• Homemaker and Home Health Aide Care: Delivers part-time, in-home support for veterans who need assistance with personal care or household tasks.
• Skilled Home Health Care: Available for veterans who require medical care at home, such as nursing or physical therapy, when ordered by a VA physician.

Eligibility for these benefits depends on factors like military service, income, disability status, and level of need. Because the application process can be complex, many families choose to work with a VA-accredited representative or local veterans service office for guidance.

By using available veterans’ benefits, qualifying families in Raleigh can reduce out-of-pocket costs and make high-quality in-home care more affordable and accessible.

4. Medicaid and State Waivers

For many families in Raleigh, Medicaid and its Home and Community-Based Services (HCBS) waivers offer essential options for funding in-home care, especially for individuals with complex medical needs or who require support to remain safely at home.

Medicaid — Home Health Services

Under North Carolina’s Medicaid State Plan, beneficiaries may qualify for medically necessary home health services, including:

• Skilled nursing care
• Physical, occupational, or speech therapy
• Home health aide services
• Medical supplies

These services are available in private residences and other qualifying settings when ordered by a medical provider.

HCBS Waivers

HCBS waivers, authorized by Section 1915(c) of the Social Security Act, allow Medicaid to fund a broad range of in-home or community-based services that aren’t typically covered under standard Medicaid, providing alternatives to nursing home placement.

North Carolina offers several key HCBS waivers:

• CAP/DA (Community Alternatives Program for Disabled Adults): Designed for adults aged 18+ who need a higher level of care but can safely live at home, the CAP/DA waiver supports a spectrum of services, including:
  • In-home aides (personal care assistance, homemaker services)
  • Case management and care coordination
  • Respite care (in-home and in a facility)
  • Meal delivery and adult day health services
  • Chore assistance, minor home modifications, specialized medical supplies
  • Personal Emergency Response Services (PERS) and non-medical transportation
  • Consumer-directed care options, allowing participants to hire and manage their own caregivers

Beneficiaries must meet Medicaid’s financial eligibility and a nursing home level of care assessment. Services are not guaranteed due to limited slots, with many applicants placed on waitlists.

• NC Innovations Waiver: Tailored for individuals with intellectual or developmental disabilities (I/DD), this waiver offers:
  • Community living support (e.g., help with daily tasks, supported or residential living)
  • Community participation, networking, and supported employment
  • Specialized consultation, natural support education, and tailored care management
• Other HCBS Waivers: Additional options include:
  • CAP/C for children with complex medical needs
  • TBI Waiver for individuals with traumatic brain injuries
  • PACE (Program of All-Inclusive Care for the Elderly), a comprehensive program combining Medicaid and Medicare services to enable older adults to remain in their communities while receiving care, therapy, transportation, home modifications, and more

Applying for Waiver Services

• Eligibility & Application: For CAP/DA, reach out to your local Medicaid case management agency (often through LME/MCOs). An assessment determines if you meet both functional and financial criteria.
• Waitlists: Due to limited slots and often exceeding demand, wait times can be lengthy. Alternatives, such as standard home health services or Medicaid State Plan benefits, may be available immediately.
• Self-Direction: Many HCBS waivers, including CAP/DA, offer consumer-directed options that allow beneficiaries to recruit, hire, and supervise their own caregivers (even family members), with a financial management agency handling payroll and taxes.

5. Medicare (Limited Coverage)

When it comes to paying for home care in Raleigh, it’s important to understand that Medicare has very limited coverage. While many families assume that Medicare will pay for ongoing personal care, the program is designed to cover only short-term, medically necessary services, not long-term assistance with daily living.

Medicare may pay for home health care if all of the following conditions are met:

• A doctor certifies that the care is medically necessary.
• The patient is homebound, meaning leaving home requires considerable effort or assistance.
• Services are provided by a Medicare-certified home health agency.

Covered services may include:

• Skilled nursing care (part-time or intermittent)
• Physical, occupational, or speech therapy
• Medical social services
• Certain medical supplies and durable medical equipment (like walkers or oxygen)

What Medicare does not cover:

• Ongoing custodial care (help with bathing, dressing, cooking, or housekeeping)
• 24-hour home care
• Long-term personal care or companion services

For many seniors in Raleigh, Medicare can be helpful after a hospitalization, surgery, or illness when short-term skilled care at home is required. However, families should plan for additional funding sources, such as private pay or long-term care insurance, if ongoing home care is needed.

5. Local and Community Resources

In addition to private pay and government programs, families in Raleigh can explore local and community-based resources to help reduce the cost of home care or supplement existing services. These options can be especially valuable for seniors who don’t fully qualify for Medicaid or who need additional support beyond what insurance covers.

1. Area Agency on Aging (AAA)

The Triangle J Council of Governments Area Agency on Aging serves Wake County and the surrounding areas. They connect families with caregiver support programs, respite services, and referrals to affordable home care resources.

2. Resources for Seniors, Inc.

Based in Raleigh, this nonprofit provides a wide range of services, including adult day programs, home-delivered meals, case management, and information on in-home care providers. They often have sliding-scale options for families with limited budgets.

3. Senior Centers and Faith-Based Programs

Many senior centers, community centers, and local churches offer volunteer-based assistance such as meal delivery, friendly visits, transportation, or light household help. While not a replacement for full-time care, these services can reduce costs and provide valuable social interaction.

4. Respite and Caregiver Support Services

Wake County programs and nonprofit organizations offer respite care, which is temporary in-home assistance that provides family caregivers a much-needed break. Some programs are grant-funded, making them available at low or no cost to eligible families.

5. Community Caregiver Networks

Neighborhood-based initiatives, time banks, and volunteer caregiving networks are increasingly available in Raleigh. These groups often focus on helping older adults remain engaged, safe, and supported in their homes.

By tapping into community resources, families can develop a comprehensive care plan that integrates professional home care with local support services, keeping costs manageable while ensuring seniors receive the necessary assistance.

Next Steps to Pay for In-Home Care in Raleigh, NC

Paying for home care can feel complex, but knowing your options makes the process much more manageable. From private pay and long-term care insurance to veterans’ benefits, Medicaid waivers, and community resources, Raleigh families have several pathways to ensure their loved ones receive the support they need without unnecessary financial stress.

At the end of the day, the goal is simple: helping seniors live safely, comfortably, and with dignity in the place they call home.

At A Place At Home – North Raleigh, our team works closely with families to not only provide compassionate, professional in-home care but also to guide you through the payment options available. Whether you’re just starting to explore options for home care or you’re ready for immediate support, we’ll help you create a personalized care plan that fits your loved one’s needs and budget.

Contact A Place At Home – North Raleigh by calling (919) 283-5600 to schedule a consultation and learn how we can support your family with affordable, high-quality home care solutions.

Frequently Asked Questions About Paying for Home Care in Raleigh, NC