What is the difference between home care and home health in Virginia?
Home care is non-medical help -- bathing, dressing, meals, housekeeping, companionship and errands -- paid privately or through Medicaid's CCC Plus Waiver, while home health is skilled, physician-ordered nursing and therapy delivered in intermittent visits and usually covered by Medicare for homebound patients.
Families often need both: a home health nurse for a wound or a therapist after surgery, and a home care aide for the daily tasks in between.
| Home care (non-medical) | Home health (skilled) | |
|---|---|---|
| Services | Personal care, meals, companionship | Nursing, physical/occupational/speech therapy |
| Ordered by | The family | A physician |
| Typical payer | Private pay or CCC Plus Waiver | Medicare (homebound, intermittent) |
How much does in-home care cost around Richmond?
CareScout's 2025 Virginia median for a non-medical caregiver is $80,080 a year at 44 hours a week -- about $6,673 a month or roughly $35 an hour -- and no Richmond-specific median is published, so get written hourly rates and minimum shift lengths from each agency.
Ask whether rates differ for nights, weekends and holidays, and whether the agency charges a higher rate for short visits.
How do I choose a home care agency in Richmond, Henrico or Chesterfield?
Choose a licensed agency that employs and supervises its caregivers, ask how it screens and trains them, how it covers a missed shift, and whether it accepts CCC Plus Waiver or VA payment if that applies to you.
- Ask for the same small group of caregivers rather than whoever is free.
- Ask how the agency handles a medication change or a hospital discharge.
- Get the service agreement, cancellation terms and rates in writing.
Can family members be paid to provide care at home in Virginia?
In some cases, yes: Virginia's CCC Plus Waiver offers consumer-directed personal care and respite, under which an eligible Medicaid member can hire and direct their own attendant, and in certain circumstances that attendant can be a family member, subject to program rules on legally responsible individuals.
A services facilitator helps with hiring paperwork and training, and the member or a representative acts as the employer of record. Ask the screening team and your Cardinal Care plan's care coordinator which family members can and cannot be paid under current DMAS rules before you plan around it.
Outside Medicaid, some long-term care insurance policies and VA programs also pay for home care; check each policy's definition of a qualified caregiver.
How many home care hours does a Richmond senior usually need?
It varies from a few hours a week for errands and bathing to round-the-clock care; a practical way to estimate is to list each task that needs help, when it happens and how long it takes, then add supervision time if the person cannot be left alone safely.
Revisit the estimate after any hospital stay or fall, and compare the monthly total with assisted living once the hours approach a full-time schedule.
