Personal Care Services in Philadelphia: What’s Covered and How to Get Started

Personal care is the most common type of home care Philadelphia families need — and the one most fully covered by Medicaid. If your loved one needs hands-on help with bathing, dressing, grooming, eating, mobility, or toileting, personal care services through Community HealthChoices can provide that help at home, at no out-of-pocket cost, with a family member as the paid caregiver if you choose.

What Personal Care Services Include

Personal care covers the activities of daily living that become difficult or unsafe to perform independently. In practical terms, this means assistance getting in and out of the shower or bathtub, washing, drying, and maintaining hygiene. Help putting on and removing clothing, managing buttons and zippers, and selecting weather-appropriate outfits. Support with eating —cutting food, managing utensils, and in some cases feeding assistance. Help getting in and out of bed, standing from a chair, and moving through the home safely. Toileting assistance including getting to the bathroom, managing clothing, and incontinence care. And grooming — brushing teeth, combing hair, and other personal maintenance.

These are the services that families describe most often when they contact CareChoice. In our experience, the family member has usually been providing exactly this type of help for months or years before they learn that Medicaid will cover it — and that they can be the one getting paid todo it.

How Medicaid Covers Personal Care in Philadelphia

Personal care is authorized through Community HealthChoices after a functional eligibility assessment determines your loved one needs a nursing-facility level of care. The assessment scores each daily activity category, and the resulting care plan specifies how many hours of personal care are authorized per week.

The care plan drives everything: the types of services, the hours, and ultimately the caregiver’s paycheck. In our experience, the assessment is the single most important step in the process —families who prepare thoroughly (describing the worst days, having documentation ready, ensuring the caregiver is present) get more accurate, more generous authorizations.

Personal Care Through a Family Caregiver

When your family chooses Participant-Directed Services, the personal care is provided by a family member who becomes a paid W-2 employee.  The caregiver logs hours through electronic visit verification and receives biweekly direct deposits.

The family caregiver doesn’t need a license or certification — the care plan defines the tasks, and the family member provides them. In our experience, family caregivers consistently outperform agency-assigned aides in one critical area: they already know the person. They know that Dad gets anxious in the shower and needs to be talked through it. They know that Mom prefers to dress herself as much as possible and only wants help with the buttons. That personalization is the core value of family-directed personal care.

Getting Started

Check Medicaid eligibility→ contact PCA at (215) 765-9040→ enroll in CHC→ get assessed →request PDS→ start getting paid.

Contact CareChoice →Philadelphia team

Written by Carolyn Choates, Assistant Marketing Manager | CareChoice