Home Care for Veterans in Philadelphia

Philadelphia has one of the largest veteran populations of any city in the country. Many of those veterans are aging, living with service-connected disabilities, or managing chronic conditions that require daily help at home. What most veteran families don’t realize is that the home care system isn’t limited to one program or one funding source — and combining what’s available can create a level of support that neither Medicaid nor the VA provides alone.
If your family includes a veteran who needs help at home, here’s how the different pieces fit together.

Two Systems, One Family

Veterans in Philadelphia may have access to home care through two separate systems:
Medicaid (specifically Community HealthChoices) and the U.S. Department of Veterans Affairs (VA). These are independent programs with different eligibility rules, different funding sources, and different services — but they’re not mutually exclusive. A veteran can receive benefits from both simultaneously.

This is the point most families miss. They assume it’s one or the other — that being enrolled in VA care means they can’t access Medicaid, or that having Medicaid means VA benefits don’t apply. In reality, many veterans qualify for both, and using them together can significantly expand the care available.

Medicaid Home Care for Veterans in Philadelphia

On the Medicaid side, veterans follow the same pathway as any Pennsylvania resident. If the veteran is enrolled in Medical Assistance (Medicaid) and needs help with daily activities, they can access home care services through Community HealthChoices. The process involves enrollment in CHC, assignment to an MCO (AmeriHealth Caritas, Keystone First CHC, or PA Health & Wellness), a functional eligibility assessment, and development of a care plan.

The paid family caregiver option works the same way for veterans as for everyone else. Through Participant-Directed Services, the veteran chooses their own caregiver — a spouse is generally excluded, but an adult child, sibling, grandchild, or other qualifying family member can be hired and paid through the Agency with Choice model.

For veterans whose income or assets exceed standard Medicaid thresholds, Pennsylvania’s Medicaid rules for long-term care have specific provisions — including spousal impoverishment protections and the potential use of Special Income Trusts — that may still make eligibility possible. Don’t assume a veteran with retirement pay or a VA pension is automatically disqualified from Medicaid.

VA Home Care Programs

The VA offers several home care programs for eligible veterans. Understanding which ones your loved one qualifies for depends on their enrollment priority, service-connected disability rating, and assessed care needs.

VA Homemaker and Home Health Aide Program provides personal care services to veterans who need help with daily activities. A VA-employed or VA-contracted aide comes to the home to assist with bathing, dressing, meal preparation, and light housekeeping. This program is available to veterans enrolled in VA health care who are assessed as needing home care.

Veteran-Directed Home and Community-Based Services (VD-HCBS) is the VA program most similar to Medicaid’s paid family caregiving model. Under VD-HCBS, the veteran receives a flexible budget and directs their own care — including the ability to hire family members or friends as paid caregivers. The veteran manages their budget with the help of a fiscal intermediary, and they choose who provides their care, when, and how.

VD-HCBS is particularly powerful because it explicitly allows family members — and in some cases spouses — to be paid as caregivers. The rules around spousal payment under VD-HCBS are more generous than under most Medicaid programs. For veteran families where the spouse is the primary caregiver, this can fill a gap that Medicaid doesn’t cover.

Program of Comprehensive Assistance for Family Caregivers (PCAFC) is available to veterans with serious injuries who need a designated caregiver. Under PCAFC, the VA provides a monthly stipend to the caregiver, health insurance for the caregiver (through CHAMPVA), mental health counseling, respite care, and training. This program is limited to veterans with qualifying injuries, but for those who meet the criteria, the support is substantial.

Aid and Attendance is a pension benefit for wartime veterans (or their surviving spouses) who need assistance with daily activities. It provides a monthly cash payment that can be used to pay for home care services. Aid and Attendance doesn’t restrict how the money is spent, so it can effectively supplement a family caregiver’s income from Medicaid PDS or VD-HCBS.

How the Programs Work Together

Here’s where the real planning happens. A veteran in Philadelphia might be receiving Medicaid-funded home care through CHC with a daughter hired as the paid caregiver through Agency with Choice for 30 hours per week. At the same time, they might be enrolled in VD-HCBS through the VA, receiving an additional flexible budget that covers hours or services Medicaid doesn’t. They might also be receiving Aid and Attendance, which provides extra monthly income.

The combination of these programs can create a comprehensive support system — adequate hours, adequate pay for the caregiver, and access to services (like the VA’s mental health support and caregiver training) that Medicaid alone doesn’t provide.

Coordinating across the two systems takes planning. The Medicaid MCO and the VA don’t automatically communicate with each other, and it’s important to avoid billing both programs for the same hours of care. CareChoice helps veteran families structure the arrangement so that Medicaid and VA benefits complement each other without overlap.

Getting Started for Veteran Families in Philadelphia

On the Medicaid side, the first step is confirming Medical Assistance eligibility through COMPASS at compass.state.pa.us. If the veteran is already on Medicaid, contact the MCO to start the CHC assessment process.

On the VA side, the starting point is enrollment in VA health care (if not already enrolled)through the Philadelphia VA Medical Center at 3900 Woodland Avenue or by calling 1-800-827-1000. Once enrolled, the veteran can be assessed for home care programs including VD-HCBSand the Homemaker/Home Health Aide program.

For PCAFC and Aid and Attendance, contact the VA directly or work with a Veterans Service Organization (VSO) — organizations like the Veterans of Foreign Wars (VFW), American Legion, and Disabled American Veterans (DAV) have trained representatives who help veterans apply for benefits at no cost.

The Philadelphia Corporation for Aging (PCA) at (215) 765-9040 is also a useful resource for veteran families, as they can provide referrals to both Medicaid and VA programs and help coordinate services.

CareChoice Serves Veteran Families

CareChoice works with veteran families across the Philadelphia area to access Medicaid homecare services through Community HealthChoices. We help with the CHC enrollment, functional assessment, Participant-Directed Services activation, and family caregiver onboarding — and we coordinate with the VA-side benefits so the whole picture makes sense for your family.

Your veteran served this country. The programs exist to serve them now. Let us help you make sure they’re getting everything they’ve earned.

Contact CareChoice →Philadelphia team