Guide to In-Home Care Services

What Is In-Home Care?
Who Provides In-Home Care?
Who Pays for In-Home Care?
How Do I Find a Private In-Home Care Provider?
How Do I Choose an In-Home Care Provider?

What is In-Home Care?

In-home care refers to services that help you stay in your home. You may need in-home care if you:
  • have a disability
  • need to recuperate from an illness or surgery
  • have difficulty caring for yourself or your home

There are three major categories of in-home care:

  • Home health care – services provided by nurses, physical therapists, and occupational and speech therapists.
  • Personal care – assistance with bathing, dressing, toileting, mobility, etc.
  • Support services – housekeeping, laundry, meal preparation, etc.

Sometimes, one or more of these services are provided by the same agency. For instance, an aide from a home health care agency may provide personal care under a nurse’s supervision.

In-home care providers are sometimes called companion aides, personal care aides, certified home health aides and nursing aides.

Who Provides In-Home Care?

Private home health care agencies, individual providers and the county provide in-home care.

Sometimes, nurses, private geriatric care managers, or county social workers coordinate and supervise in-home care services.

Who Pays for In-Home Care?

This depends on the care you need, the type of insurance you have, and whether you are eligible for certain government programs.

  • Private Pay and Insurance

People who use in-home care services often pay most of the cost themselves.

However, some private health insurance and long-term care insurance policies cover certain in-home care services. Policies vary in their coverage.

Read your policy carefully. Contact your insurance company if you have questions. If you have coverage, be sure to ask the in-home care agency if they accept your insurance. Other questions to ask include:

    • What services are covered?
    • How long are services covered?
    • What are the restrictions? (Prior hospitalization? Level of care?)
    • Who must supervise the care?

  • Government Programs

Fairfax County Department of Family Services/Adult and Aging Division provides in-home support services to people who meet eligibility requirements. To request an assessment by a county social worker, call 703-324-7948, TTY 711.

Medicare helps pay for home health care if you are a Medicare beneficiary only when a doctor certifies a plan that includes one or more of the following services:

    • skilled nursing care
    • physical therapy
    • speech-language services
    • occupational therapy

Additional requirements include:

    • The agency must be Medicare-certified.
    • You must be unable to leave your home without great difficulty.

The Medicare & You Handbook, mailed every fall, discusses these benefits in detail. You can also go the Medicare website or call 1-800-633-4227, TTY 1-877-486-2048 for more information.

Medicaid helps pay the cost of in-home care for eligible low-income people. Sometimes services are paid by a combination of Medicare and Medicaid.

If you think you may qualify for Medicaid, call 703- 324-7948, TTY 711 to arrange for a pre-screening interview.

How Do I Find a Private In-Home Care Provider?

First, determine how you will pay for the service and then identify your service needs.

The In-Home Care Guide Checklist may be helpful.

Next, decide if you want to hire an in-home care agency or an individual provider (a provider who is not affiliated with an agency).

  • Finding In-Home Care Agencies

    Good places to look for private in-home care agencies include:
    • Senior Navigator, a search engine of local services.
    • Web searches using the keywords: "Fairfax County" and "home care" or "home health care."
    • Phone book under "home care" or "home health care."
    • Home health care agencies are often chosen during a hospital stay with the assistance of a nurse or social worker. This is because many people need home health care services to recuperate.

  • Finding Individual In-Home Care Providers

    • To find an individual in-home care provider (not affiliated with an agency), check the Fairfax County Home Care Registry. You can also request a copy at 703-324-7948, TTY 711.
    • County staff interviews private independent providers, conducts reference and background checks and updates the list each month.

How Do I Choose an In-Home Care Provider?

Once you have a list of providers, contact them to determine if they can provide for your needs and meet your time requirements.

Find out their hourly rates and if they require a minimum number of hours to work. Then ask a few additional questions.

You may want to ask agencies:

  • Will you provide a written contract that identifies all services and costs?
  • Do you accept my insurance?
  • What training do the service providers have? Are they licensed and bonded and have references been checked?
  • How is care monitored and by whom?
  • Who is the primary agency contact?

If you are interested in doing a little more research, compare home health care agencies by service, type and quality.

You may want to ask individual providers:

  • What is your experience providing care?
  • What training, certifications, or licenses related to caregiving do you have?
  • Do you have reliable transportation?
  • If you need the provider to provide transportation: Do you have a driver’s license and car insurance?

Whether interviewing an individual provider or agency, be sure to request references and then check the references.


For information on
additional services contact:

Aging, Disability and Caregiver Resources Line
TTY 711

Monday – Friday
8 a.m. to 4:30 p.m.

Or apply for services online

Online Request for
Service Information


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[ 12011 Government Center Parkway, Fairfax, VA 22035 ]
[ 703-324-7500 ]

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