CCC Plus Waiver Virginia — Home Care Benefits, Eligibility, and How to Apply

Your parent needs daily help with bathing, meals, and medication reminders, but moving them into a nursing home feels premature — and costs $8,669 to $9,825 per month for a Virginia facility. The Commonwealth Coordinated Care Plus (CCC Plus) waiver is how Virginia Medicaid pays for that same level of care delivered at home.

Here is how it works, who qualifies, and the steps to get services started.

What the CCC Plus Waiver Covers

The CCC Plus waiver funds home and community-based services (HCBS) for individuals who meet nursing facility level of care but can safely remain in the community with support. Covered services include:

• Personal care aides — help with bathing, dressing, toileting, transferring, and meal preparation
• Adult day health programs — structured daytime supervision with medical monitoring
• Respite care — temporary relief for family caregivers (up to 480 hours annually)
• Assistive technology — personal emergency response systems, grab bars, wheelchair ramps
• Transition coordination — help moving from a nursing facility back into the community
• Consumer-directed care — your parent hires and manages their own aides, including family members

The waiver does not cover room, board, or rent. It covers the care services that make staying at home safe.

Two Ways to Receive Care

Agency-directed: A home health agency assigns a registered nurse to supervise your parent's care plan. The agency hires, trains, and schedules the personal care aides. Your parent has less control over scheduling but also less administrative burden.

Consumer-directed: Your parent (or their authorized representative) hires their own personal care attendants, sets schedules, and manages timesheets through the Time4Care mobile app. A fiscal agent (PPL) handles payroll and tax withholding. This option lets you hire family members as paid caregivers — including adult children, siblings, or grandchildren — without the "extraordinary care" test that applies to spouses.

Since July 2025, Virginia permanently authorized the Legally Responsible Individuals (LRI) provision, which means spouses and parents of minor children can also be paid as consumer-directed attendants, though the care must be deemed "extraordinary" and is capped at 40 hours per week.

Eligibility Requirements

Your parent must meet both a clinical test and a financial test:

Clinical: A Pre-Admission Screening (PAS) team — a DSS social worker and a Department of Health nurse — evaluates your parent using the Uniform Assessment Instrument (UAI). The parent must need hands-on help with at least two Activities of Daily Living or have a cognitive impairment requiring supervision. The screening can be requested through the local Department of Social Services, the health department, or a hospital discharge planner.

Financial: The same Medicaid financial rules apply as for nursing home coverage. Your parent's countable assets must be at or below $2,000 (single) or $4,000 (married, both applying). Income above $2,982/month does not disqualify them — Virginia is a medically needy state, so excess income is spent down against care costs.

Once clinically authorized, services must begin within 180 days or the screening expires.

How to Apply

1. Contact your local Department of Social Services and request a Pre-Admission Screening for LTSS
2. The PAS team schedules an in-person UAI assessment (typically in the parent's home)
3. If clinically approved, the screener documents authorization on Form DMAS-96
4. Submit the Medicaid application through CommonHelp, Cover Virginia (1-833-522-5582), or in person at the local DSS — include Appendix D for assets and Appendix F if your parent is 19–64 and not yet on Medicare
5. Once financially approved, your parent's Cardinal Care MCO assigns a care coordinator who develops the service plan

The Personal Maintenance Allowance Difference

CCC Plus waiver recipients living at home keep a much larger share of their income compared to nursing home residents. The Personal Maintenance Allowance (PMA) is $1,641/month — retained to cover rent, utilities, and daily living expenses. Compare that to the $40/month Personal Needs Allowance for nursing home residents. This is a major financial advantage of the waiver for families where the parent can safely remain at home.

For the complete eligibility walkthrough, financial planning worksheets, and step-by-step application instructions, the Virginia Medicaid Long-Term Care & Asset Protection Guide covers the CCC Plus waiver alongside nursing home and assisted living options.

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