Whether due to aging, chronic illness, or a disability, when a family member requires assistance to remain at home, families want high-quality in-home care services that are compassionate and affordable. For thousands of North Carolina residents, the waiver is a lifeline to help cover in-home care.
However, figuring out how to qualify for a Medicaid waiver can be complex. Here at ABloom Home Care, we are focused on providing the best care to families in Durham, Wake, Franklin, Nash, and 13 other counties in North Carolina.
We’ll explain the Medicaid waiver, who qualifies for it, and how it connects to our home care services, such as personal care, dementia care, sitter services, and live-in caregivers.
What Is the Medicaid Waiver in North Carolina?
The Medicaid waiver, or Home and Community-Based Services (HCBS) waiver, is a program designed to help people who may need to enter a nursing home or other facility to be able to stay in their own home instead.
This waiver is called the Community Alternatives Program for Disabled Adults (CAP/DA) in our home state of North Carolina. It allows Medicaid to “waive” the usual requirement of institutional care and reimburse a diverse array of in-home services for the older population.
For seniors and adults with disabilities, personal care, post-operative care, dementia care, or stroke recovery care can be provided directly in the comfort of their home by an agency such as ABloom Home Care.
Who Qualifies for NC Medicaid Waiver?
Eligibility is determined by both financial need and medical necessity.
1. Financial Eligibility
To qualify for the CAP/DA waiver, applicants must be eligible for Medicaid in North Carolina and meet certain income and asset limits.
- Income Limit (2025): Typically around $1,255/month for an individual (subject to annual changes)
- Asset Limit: $2,000 in countable resources (not including primary home, car, personal belongings)
If your loved one has too much income and/or assets to qualify for Medicaid, there may still be ways to qualify through spend-down programs or Miller Trusts, and we encourage you to consult with a Medicaid planner.
2. Medical Eligibility
Applicants must:
- Be 18 or older
- Require the level of care provided in a nursing facility.
- Be able to remain safely at home with available service.s
A case manager will perform a full assessment to see if the applicant qualifies based on these conditions. That usually means a functional needs assessment that looks at things like mobility, memory, what activities of daily living (ADLs) people with disabilities can and cannot do, and overall health risks.
What Home Care Services Are Covered by the Medicaid Waiver?
If approved, the CAP/DA waiver may cover a complete selection of home care and personal care services, including:
- Bathing and grooming assistance
- Meal preparation and feeding
- Medication reminders
- Toileting and incontinence care
- Dementia and Alzheimer’s care
- Stroke recovery support
- Sitter and companion services
- Mobility assistance
- Post-operative care
- Home health equipment coordination
- Respite care for family caregivers
At ABloom Home Care, we customize these services based on each person’s specific needs, whether they require a few hours per day or 24/7 live-in assistance.
How to Apply for the Medicaid Waiver in North Carolina
Applying for the CAP/DA waiver requires a few key steps:
Step 1: Confirm Medicaid Eligibility
Visit NC ePASS to apply for Medicaid or contact your local Department of Social Services (DSS).
Step 2: Request a CAP/DA Assessment
Once Medicaid eligibility is confirmed, you or your provider can request a CAP/DA waiver assessment.
Step 3: Functional Assessment by the Local Contact Agency
A case manager will conduct an in-home evaluation to determine if the applicant qualifies for a nursing-home level of care.
Step 4: Waitlist and Slot Availability
The CAP/DA waiver has limited availability in each county. If approved, you may be placed on a waiting list until a slot opens in your region.
Note: As of the latest update, this waiver often has long waitlists. It’s best to apply early and explore temporary private-pay home care options if needed.
Which Counties Does ABloom Home Care Serve?
We are honored to serve clients in these counties within North Carolina:
- Wake
- Durham
- Orange
- Franklin
- Johnston
- Lee
- Harnett
- Wayne
- Wilson
- Nash
- Edgecombe
- Pitt
- Halifax
- Northampton
- Warren
- Vance
- Granville
- Hertford
ABloom Home Care can help guide you through the Medicaid Waiver process with expert service, whether you need Home Care Raleigh NC, Wake Forest NC, or Apex NC.
Why Choose ABloom Home Care?
Allowing anyone to care for a loved one in your home is a significant decision. That’s why families throughout central and eastern North Carolina rely on ABloom for:
- Trained, certified, and compassionate caregivers
- Personalized care plans tailored to each client’s condition and needs
- Specialized dementia and Alzheimer’s care
- Post-surgery and stroke recovery support
- Respite care options for family caregivers
- Veterans support through the Aid & Attendance program.
- Mental health home care services
- Live-in caregiver and overnight options
We’re more than just a home care agency; we’re your wellness and peace of mind partner.
What If My Loved One Doesn’t Qualify for the Medicaid Waiver?
Even if your loved one fails to qualify financially or medically for the CAP/DA waiver, you still have options:
- Private-pay home care: ABloom offers flexible scheduling and competitive rates.
- Long-term care insurance: Many plans cover in-home personal care and companionship.
- Veteran’s Aid and Attendance benefit: Available to qualifying veterans and spouses.
- Local aging programs and nonprofit grants: Some counties offer additional support.
We can walk you through these options during a free care consultation.
FAQs: Medicaid Waiver & Home Care in NC
Q: What is the waitlist time for CAP/DA in North Carolina?
A: It depends on the county, but the waitlists can be as short as a couple of weeks or as long as a few months. ABloom can assist you with early applications and temporary caregivers.
Q: Under the waiver, can I pick my home care agency?
A: Yes. After approval, families can select a provider, such as ABloom Home Care, that meets Medicaid certification to provide these services.
Q: If I’m a family caregiver, am I paid under the CAP/DA waiver?
A: Depending on the care plan, family members (not spouses) may be compensated for care (Family & Caregiver Support Benefits).
Q: Are any of them willing to guide you through the application process?
A: Absolutely. We have written articles on Medicaid eligibility, documentation, and waiver applications.
Scientific Support: Why Home-Based Care Matters
A wealth of evidence is accumulating in support of aging in place with the assistance of in-home care services:
- One recent 2022 Health Affairs study found that seniors receiving home-based care had fewer hospitalizations and a higher quality of life than their institutional counterparts.
- According to the National Institute on Aging, home care helps decrease isolation and enhances cognitive and emotional well-being among seniors with dementia and Alzheimer’s.
Programs such as the Medicaid waiver allow care to occur at home, where one can retain one’s dignity and, in many cases, improve the long-term health outcome.
Your Next Step: Talk to Us About Medicaid Waiver & Home Care
Guide with ABloom Home Care Through the Process
Medicaid waiver eligibility can seem daunting, but you don’t have to figure it out yourself. Here at ABloom Home Care, we’re ready to help you through every step, answer your questions, and offer the high-quality in-home care services that your loved one deserves.
Whether you are caring for an elderly parent in Raleigh, a spouse in Wake Forest, or a relative recovering from surgery in Apex, we are here to help.
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