In Virginia, the answer is generally no—there are very few programs specifically designed to pay a Medicaid recipient's required "patient pay" (also called a share of cost) for personal care aide services. Under Virginia Medicaid Long-Term Services and Supports (LTSS), certain recipients must contribute part of their income toward the cost of their care, and Medicaid pays the remainder. This required contribution is known as the patient's "patient pay."
However, there are some potential sources of assistance depending on the individual's circumstances:
1. Medicaid Deductions and Recalculations
Before looking for outside assistance, it is important to ensure the patient pay amount has been calculated correctly. Virginia Medicaid allows certain deductions and allowances when determining patient pay, including some expenses for spouses, dependent children, and other approved deductions. A caseworker may be able to review the calculation.
2. Department for Aging and Rehabilitative Services (DARS)
For individuals with significant disabilities who are not eligible for comparable Medicaid services, the Virginia Department for Aging and Rehabilitative Services offers Personal Assistance Services (PAS). While this program generally does not pay Medicaid patient pay obligations, it may provide an alternative source of attendant care in some situations.
3. Local Charities and Nonprofit Organizations
Some local nonprofits, faith-based organizations, and disability support agencies occasionally provide limited financial assistance for in-home care expenses. These programs vary widely by locality and funding availability.
4. Auxiliary Grant Program
For individuals living in assisted living facilities rather than receiving in-home personal care services, Virginia's Auxiliary Grant Program may help cover room-and-board costs when combined with other income sources. However, this program generally does not pay a Medicaid patient pay obligation for personal care aide services provided in the home.
5. Medicaid Appeals and Financial Hardship Reviews
If the patient pay amount creates a financial hardship, it may be worthwhile to request a review, appeal, or consultation with a Medicaid eligibility worker. In some cases, allowable expenses were not considered in the original calculation.
Where to Ask for Help
If you are trying to find assistance with a Virginia Medicaid patient pay requirement, consider contacting:
- Cover Virginia
- Virginia Department of Medical Assistance Services (DMAS)
- Virginia Department for Aging and Rehabilitative Services (DARS)
- Your local Department of Social Services office
- Your Medicaid waiver support coordinator or case manager