How to pay for home care in Ohio

In short: most non-medical companion care is paid privately, sometimes with help from long-term care insurance, veterans' benefits, or — for those who qualify — Ohio Medicaid waivers. Medicare generally does not cover ongoing companion care.

1. Private pay

The most common route. Care is paid out of pocket — from income, savings, or family contributions — and billed hourly. Private pay offers the most flexibility over the schedule and caregiver, with no insurance authorization required.

2. Long-term care (LTC) insurance

Many LTC policies help pay for in-home non-medical care once eligibility triggers are met — typically needing help with a set number of activities of daily living, or having a cognitive impairment. Benefit amounts, elimination (waiting) periods, and rules vary widely by policy. Our long-term care insurance guide explains how to read your policy and file a claim.

3. Veterans' benefits

Some veterans and surviving spouses may qualify for the VA Aid and Attendance benefit, an increased monthly pension that can be applied toward in-home care. Accredited Veterans Service Organizations help you apply at no charge. See our veteran benefits guide.

4. Ohio Medicaid & the PASSPORT waiver

For older adults who meet financial and care-need eligibility, Ohio offers Medicaid programs and waivers that can cover some in-home services as an alternative to a nursing facility. The best-known in our area is PASSPORT, an Ohio Medicaid waiver coordinated regionally through Area Agencies on Aging — including the Central Ohio Area Agency on Aging (COAAA). Eligibility is based on age, income and assets, and level of care needed, and covered services are defined by the program.

5. Why Medicare usually doesn't apply

Original Medicare generally does not pay for ongoing non-medical companion or homemaker care. It covers specific, medically necessary skilled care under strict conditions — different from the daily support most families are seeking. Some Medicare Advantage plans have added limited in-home supportive benefits, but these vary by plan and year. Our Medicare guide covers the details.

6. Other options families use

• Family cost-sharing — siblings splitting costs, often with a simple written agreement
• Life insurance conversions — some policies can be converted to help pay for care
• Home equity — a line of credit or, for some, a reverse mortgage (weigh carefully with an advisor)
• Tax considerations — some care costs may be deductible medical expenses; ask a tax professional

Comparing your options at a glance

• Need flexibility now? Private pay starts fastest.
• Have an LTC policy? It may reimburse a large share — check the triggers.
• Veteran or surviving spouse? Explore Aid and Attendance.
• Limited income and assets? Ask COAAA about PASSPORT and other Medicaid options.

A practical way to plan

1. Estimate the hours of help needed per week (a consultation helps).
2. List what you have: income, savings, LTC policy, veteran status.
3. Check eligibility for LTC insurance, VA benefits, and Ohio Medicaid/PASSPORT.
4. Start with the fastest workable source and layer in others as they're approved.
5. Revisit the plan as needs — and budgets — change.

Central Ohio resources

The Central Ohio Area Agency on Aging (COAAA) and the Ohio Department of Aging offer free information and referral on benefits and in-home services for older adults and caregivers across Columbus, Dublin, New Albany, Westerville, and the surrounding communities. See all service areas.

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Related: LTC insurance · VA benefits · Medicare · Companion care guide · FAQ