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Georgia Home-Care Waiver Programs and Ways to Pay for Care at Home
A clear guide to NOW, COMP, GAPP, CCSP, SOURCE, and ICWP—plus private pay, long-term care insurance, short-term care insurance, and VA benefit pathways.
Families often know that help is needed before they know which program, policy, or benefit might help pay for it. The names can be confusing, and two people with similar care needs may qualify for different resources. A useful first step is to separate three questions: What help does the person need? Which funding source might cover that help? Is the chosen agency currently authorized to provide the approved service?
Georgia Medicaid waiver programs are designed to help eligible people receive services in a home or community setting instead of an institution. They are not general discount programs, and they do not automatically pay for every type or amount of home care. Eligibility, available services, level-of-care requirements, an approved service plan, authorization, and provider participation all matter. Waiting lists or limited program capacity may also affect access.
The most important distinction Being eligible for a program is not the same as having a specific service authorized, and authorization is not the same as confirming that a particular agency can accept the referral. Before care begins, verify all three: the person’s eligibility, the approved service and hours, and the provider’s current participation. |
Georgia programs families may encounter
The summaries below are educational starting points. Program rules and approved services can change, and each applicant receives an individual determination. Georgia Medicaid, the Georgia Department of Behavioral Health and Developmental Disabilities, the Aging and Disability Resource Connection, and approved case-management organizations are the authoritative sources for current eligibility and application instructions.
NOW — New Options Waiver
Who it may serve: People with intellectual or developmental disabilities who meet the program’s clinical and Medicaid requirements.
Services may include: Supports that promote community living, which may include personal support, respite, supported employment, behavioral support, specialized equipment, and home or vehicle adaptations when included in the approved plan.
Where to begin: Contact the Georgia Department of Behavioral Health and Developmental Disabilities (DBHDD) regional office for intake, evaluation, and current planning-list information.
COMP — Comprehensive Supports Waiver Program
Who it may serve: People with intellectual or developmental disabilities who need a more comprehensive level of support and meet program requirements.
Services may include: A broader package of home- and community-based supports that may include residential services, personal support, respite, supported employment, behavioral services, and other authorized supports.
Where to begin: Begin with DBHDD. Ask how the person’s needs are assessed, how NOW and COMP differ for that individual, and what documentation or planning-list steps are required.
GAPP — Georgia Pediatric Program
Who it may serve: Medicaid-eligible, medically fragile children and young adults under age 21 whose assessed needs meet program criteria.
Services may include: In-home skilled nursing and personal-care support services for approved needs. The child’s physician, clinical documentation, Medicaid review, and an authorized provider are central to the process.
Where to begin: Contact an enrolled GAPP provider or Georgia Medicaid for current application and prior-authorization instructions. Ask what clinical records and physician orders are required.
CCSP — Community Care Services Program
Who it may serve: Eligible older adults and people with functional impairments or disabilities who meet Medicaid and nursing-facility level-of-care requirements and can be served safely in the community.
Services may include: Depending on the approved plan, services may include case management, personal support, adult day health, alternative living services, home-delivered meals, respite, emergency response, and certain home-health supports.
Where to begin: Contact Georgia’s Aging and Disability Resource Connection (ADRC) for screening and referral. Ask about current eligibility, required assessments, cost sharing, and service availability.
SOURCE — Service Options Using Resources in a Community Environment
Who it may serve: Eligible older or disabled Georgians who meet Medicaid and nursing-facility level-of-care requirements and need coordinated medical and community support.
Services may include: Case management with primary-care involvement, plus authorized community services that may include personal support, adult day health, assisted-living services, meals, emergency response, respite, and extended home health.
Where to begin: Contact the ADRC for screening and referral. Confirm whether SOURCE or another Elderly and Disabled Waiver pathway better fits the person’s needs.
ICWP — Independent Care Waiver Program
Who it may serve: A limited number of eligible adults who apply between ages 21 and 64 and have severe physical disabilities or traumatic brain injury, with an institutional level-of-care need.
Services may include: Authorized services may include personal support, home health, emergency response, specialized medical equipment and supplies, counseling, and home modifications.
Where to begin: Use the current Georgia Medicaid ICWP contact information to request screening. Ask about age at application, level-of-care criteria, financial eligibility, available slots, and required documentation.
Other ways families may pay for home care
Not every person qualifies for a waiver, not every needed hour is authorized, and some families want care to begin while an application or claim is pending. The following options may be used alone or, when program and policy rules allow, alongside another funding source. Never assume that a payer will reimburse care after it starts; obtain written confirmation whenever possible.
1. Private pay
Private pay means the client, family, trust, or other responsible party pays the home-care agency directly. It is often the most flexible route because the family and agency can build a schedule around assessed needs and caregiver availability without waiting for a third-party authorization. Private pay may be helpful for companionship, personal care, respite, transportation support, overnight supervision, or additional hours beyond an approved benefit.
Before signing, request a written service agreement and confirm:
Hourly or visit rates, minimum visit length, deposits, billing frequency, accepted payment methods, and late-payment terms.
Charges for weekends, holidays, overtime, transportation, mileage, cancellations, or last-minute schedule changes.
Exactly which tasks are included, which tasks require a licensed clinician, and how the care plan will be updated.
Whether itemized invoices and attendance records can be provided if the family later submits a claim to an insurer or benefit program.
2. Long-term care insurance
Long-term care insurance may cover qualifying care provided at home, in assisted living, or in another setting, but every policy is different. Many policies begin paying only after the insured meets a benefit trigger—commonly a need for help with a stated number of activities of daily living or qualifying cognitive impairment—and after any elimination or waiting period. Policies may set daily or monthly maximums, a total benefit pool, covered-provider requirements, exclusions, or limits on informal family care.
Call the insurer using the number on the policy. Ask for the current schedule of benefits and a written explanation of home-care coverage. Confirm whether the policy pays the insured or the agency, whether preapproval is required, what proof of loss is needed, and whether the agency must hold a particular license. Keep the policy, claim forms, care plan, invoices, visit records, and insurer correspondence together. An agency can supply service records it controls, but only the insurer can decide whether a claim is payable.
3. Short-term care insurance
Short-term care insurance is intended to provide a limited period of care benefits under the terms of a specific policy. It may have a shorter benefit period or different waiting period than traditional long-term care insurance. Some policies may cover home care, while others focus on facility care or use narrow definitions of covered services. Review the contract—not just the product name—to learn what is actually included.
Short-term care insurance should not be confused with short-term, limited-duration medical insurance. A temporary medical plan may cover certain doctor, hospital, or medical expenses but generally should not be assumed to pay for ongoing non-medical help with bathing, dressing, meals, housekeeping, or supervision. Ask the insurer to identify the exact policy type and confirm in writing whether home-care services are covered.
4. VA benefit pathways
Veterans and surviving spouses may have more than one possible pathway. VA Homemaker and Home Health Aide services can help eligible enrolled Veterans with personal care and activities of daily living when clinical criteria are met, community care requirements are satisfied, the service is locally available, and care is arranged through the VA. Veteran-Directed Care, where available, provides an assessed budget and counseling so an eligible Veteran or representative can direct approved home- and community-based supports.
Aid and Attendance is different: it is an additional monthly amount for certain Veterans or survivors who already qualify for a VA pension and meet added need-based requirements. It is not an automatic authorization for an agency, and eligibility rules are specific. A VA social worker, care team, or VA-accredited benefits representative can help a family identify the appropriate route.
Do not schedule services on the assumption that VA will pay later. VA states that its homemaker/home health aide program uses organizations that contract with VA, and non-VA-approved services generally are not payable as VA-purchased home care. Confirm the authorization, dates, approved service, hours, copay if applicable, and provider before the first visit. Wescastle Healthcare can explain private-pay arrangements while a family explores VA benefits and can confirm whether VA-authorized services are currently available through Wescastle before scheduling.
A side-by-side payment guide
Payment path | Best understood as | What to confirm | Important limitation |
Georgia Medicaid waiver | Authorized services for an eligible person enrolled in a specific program | Program eligibility, approved plan, service authorization, and enrolled provider | Approval is not automatic; available services and providers may be limited |
Private pay | The client or family pays the agency directly | Rate, minimum visit, schedule, deposit, cancellation, holidays, and billing | Payment usually is not reimbursed unless another benefit expressly allows it |
Long-term care insurance | Policy benefits for qualifying extended-care needs | Benefit trigger, elimination period, covered setting, limits, and claims documents | Coverage is policy-specific and may reimburse after services are received |
Short-term care insurance | Limited-duration care benefits under a specific policy | Home-care coverage, benefit period, daily limit, waiting period, and provider rules | It is not the same as short-term medical insurance; benefits may be narrow |
VA benefits | VA-authorized services or qualifying pension-related payments | Enrollment, clinical eligibility, local availability, authorization, and provider participation | VA generally does not pay a non-VA-approved provider selected without authorization |
Can families combine payment sources?
Sometimes. A family might use an authorized waiver or VA service for covered hours and private pay for additional hours or tasks. A long-term or short-term care policy might reimburse part of an eligible expense while the family pays deductibles, elimination-period costs, or amounts above the policy limit. Coordination must be transparent: the same service should not be billed twice, and each payer’s rules must be followed.
Ask the case manager, insurer, VA representative, and agency to explain how other coverage affects the plan. Keep a calendar showing which payer covers each visit, retain invoices and authorization notices, and report changes in eligibility, hospitalization, address, care needs, or other coverage promptly.
A practical step-by-step plan
1. Write down the person’s needs. Include help with bathing, dressing, toileting, mobility, meals, medication reminders, nursing tasks, supervision, transportation, behavior, and caregiver relief.
2. Identify possible programs. Consider age, disability, diagnosis, Medicaid status, military service, existing insurance policies, income and resource rules, and the level of care required.
3. Contact the authoritative program or insurer. Request screening, application instructions, policy documents, or a written coverage explanation. Record the representative’s name, date, and reference number.
4. Complete the required assessment. Be accurate about what happens on difficult days—not only what the person can do on a good day—and provide requested medical or functional documentation.
5. Wait for written eligibility and authorization decisions. Read the approved services, dates, hours, limits, cost sharing, appeal rights, and renewal requirements.
6. Confirm the provider. Verify that the chosen agency is currently enrolled, contracted, or otherwise acceptable for the specific payer and authorized service.
7. Create the care plan and schedule. Make sure the written plan matches the authorized tasks and clearly identifies any private-pay additions.
8. Review the arrangement regularly. Reassessment may be needed after a hospitalization, fall, new diagnosis, major functional change, caregiver loss, or change in insurance or benefits.
Questions to ask before care begins
Has eligibility been approved, or is the application still pending?
Which exact service, number of units or hours, dates, and tasks are authorized?
Is prior authorization required, and who issued it?
Is Wescastle—or any agency under consideration—currently approved for this program and service?
Will the payer reimburse the family, pay the provider, or require assignment of benefits?
What expenses remain the client’s responsibility, and could copays, cost sharing, exclusions, or rate caps apply?
What documentation must be submitted, by whom, and by what deadline?
What happens if hours are exhausted, a claim is denied, eligibility changes, or care is needed before approval?
How Wescastle Healthcare can help
Wescastle Healthcare provides personal care, companion care, and skilled nursing based on assessment, applicable orders, staffing, and the agreed care plan. Our team can help a family describe daily needs, prepare a workable schedule, understand which services are non-medical or clinical, coordinate with authorized representatives, and organize agency-generated documentation such as care plans, invoices, and visit records when appropriate.
We can also explain private-pay options and confirm our current participation for a particular Medicaid waiver, insurance arrangement, or VA-authorized referral. Program eligibility, authorization, benefit interpretation, and claim payment remain the responsibility of the applicable government agency, case-management organization, or insurer. We will not promise payment before the responsible payer confirms it.
Start with a clear conversation Call Wescastle Healthcare at 470-737-0171 or visit www.wescastlehealthcare.com to discuss your loved one’s needs. Bring any authorization notice, insurance policy, VA referral, care plan, and current medication or diagnosis information you are permitted to share. We will help identify practical next steps and confirm available service and payment arrangements before care is scheduled. |
Sources and verification
The following official resources were reviewed while preparing this article. Because ratings, accreditation, licensing, and agency information can change, readers should verify current information directly.
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