West Virginia Lighthouse Program: Eligibility, Costs, and How to Apply
West Virginia Lighthouse Program: Eligibility, Costs, and How to Apply
The Lighthouse Program is West Virginia's safety net for seniors who need in-home care but make too much money for Medicaid. It's administered by the Bureau of Senior Services and delivered through county-level senior centers and Area Agencies on Aging across the state.
For families managing a parent's hospital discharge, the Lighthouse Program fills a critical gap: your parent needs daily help at home but doesn't qualify for the Aged and Disabled Waiver. Unlike Medicaid-based programs, the Lighthouse has no asset limits and uses a sliding-scale fee that makes it accessible to middle-income seniors.
Eligibility Requirements
The Lighthouse Program has two requirements — age and functional need — and one notable thing it doesn't require: a Medicaid-level financial screen.
Age: The senior must be at least 60 years old.
Functional need: A registered nurse from the provider agency evaluates the senior using the Bureau of Senior Services Intake Form (BIF). The senior must demonstrate at least two ADL deficits rated as requiring "much assistance" or "cannot perform" in areas including:
- Bathing
- Dressing
- Grooming
- Eating
- Walking
- Transferring (bed to chair)
- Toileting
Two deficits is a significantly lower bar than the five-deficit threshold required by the Aged and Disabled Waiver, making the Lighthouse Program accessible to seniors with moderate functional limitations.
No asset test: There are no asset or savings limits. A senior with $200,000 in savings can participate as long as they meet the age and functional requirements.
What the Lighthouse Program Covers
Approved participants receive up to 60 hours of in-home care per month, divided across four service categories:
- Personal care: Bathing, dressing, grooming, toileting assistance
- Mobility support: Help with transferring and walking
- Nutrition: Meal preparation, grocery shopping, pharmacy runs
- Environmental: Light housekeeping, linen changes, laundry
One important restriction: environmental and housekeeping services cannot exceed one-third of the total monthly hours. If your parent receives 60 hours per month, no more than 20 can be used for housekeeping.
The program does not cover skilled nursing, therapy, or medical services. If your parent needs wound care, medication management, or physical therapy, those must come from Medicare home health or a separate Medicaid program.
The Sliding Scale Fee Schedule
Instead of a hard income cutoff, the Lighthouse Program charges an hourly fee based on the senior's household income. Medical expenses can be deducted from income before the fee is calculated, which often drops participants into a lower bracket.
| Individual Annual Income | Married Annual Income | Hourly Fee |
|---|---|---|
| $27,180 and under | $36,620 and under | $1.50 |
| $27,181 – $32,180 | $36,621 – $43,620 | $2.00 |
| $32,181 – $37,180 | $43,621 – $50,620 | $4.00 |
| $37,181 – $42,180 | $50,621 – $57,620 | $6.00 |
| $42,181 – $47,180 | $57,621 – $64,620 | $8.00 |
| $47,181 – $52,180 | $64,621 – $71,620 | $10.00 |
| $52,181 – $57,180 | $71,621 – $78,620 | $12.00 |
| $57,181 – $62,180 | $78,621 – $85,620 | $14.00 |
| Over $62,181 | Over $85,621 | $16.00 |
At the lowest bracket, 60 hours of monthly care costs just $90. Even at the highest bracket, 60 hours runs $960 per month — a fraction of what private-duty home care agencies charge, which typically ranges from $20 to $30 per hour in West Virginia.
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How to Apply
The application process goes through the local county senior center or Area Agency on Aging:
Contact the local provider. The Bureau of Senior Services website or a call to your county senior center will identify which agency administers the Lighthouse Program in your parent's area.
Schedule the functional assessment. The agency's registered nurse will visit your parent's home to complete the BIF intake form and evaluate ADL deficits.
Submit income documentation. Provide proof of household income (Social Security statements, pension documents, tax returns). The agency calculates the hourly fee and verifies medical expense deductions.
Develop the care plan. Once approved, the agency creates a monthly care plan specifying which services will be provided and how many hours are allocated to each category.
Lighthouse vs the Aged and Disabled Waiver
Families often ask which program to apply for. The answer depends on your parent's financial and medical situation:
| Factor | Lighthouse Program | Aged and Disabled Waiver |
|---|---|---|
| Income limit | None (sliding scale) | $2,982/month |
| Asset limit | None | $2,000 |
| Functional threshold | 2 ADL deficits | 5 functional deficits |
| Maximum monthly hours | 60 | Varies by care plan |
| Cost to participant | $1.50–$16.00/hour | $0 (Medicaid-funded) |
| Paid family caregivers | Yes (non-spouse, per county policy) | Yes (non-spouse/non-guardian) |
| Skilled nursing | No | Yes |
If your parent qualifies for Medicaid and meets the five-deficit threshold, the ADW provides more comprehensive coverage at no cost. If your parent's income or assets exceed Medicaid limits, or if they have fewer than five deficits, the Lighthouse Program is the practical alternative.
Many families apply for both simultaneously — the Lighthouse provides immediate support while the longer ADW application process runs its course.
The West Virginia Hospital Discharge Guide includes a Lighthouse Program cost calculator, a side-by-side waiver comparison, and a county-by-county resource directory to help you identify the local provider for your parent's area.
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