District of Columbia State Plan Personal Care Aide (PCA) Services
DC Medicaid covers personal care aide (PCA) services as a regular state plan benefit. A home care agency sends an aide to help with bathing, dressing, eating and similar activities. It sits alongside our District of Columbia Long-Term Care Medicaid guide, which covers the nursing home rules.
Figures change periodically. Double-check current amounts before relying on them.
At a glance
| Item | Details |
|---|---|
| Type of program | Medicaid state plan personal care benefit |
| Who runs it | DC Department of Health Care Finance (DHCF) |
| Age | Medicaid members of any age |
| Care need | Needs hands-on help with activities of daily living |
| District of Columbia 2026 income rule (long-term care) | $2,982 a month (special income standard) |
| District of Columbia 2026 asset limit (single applicant) | $4,000 |
| Waiting list | No. It is a state plan benefit |
DC PCA services in brief
In short, DC PCA services is run by DC Department of Health Care Finance (DHCF). Its target group is medicaid members of any age; on care need, the rule is: Needs hands-on help with activities of daily living. As for waiting: No. It is a state plan benefit. Each of these points is covered in more depth below, alongside the general District of Columbia rules from our state guide. Other District of Columbia programs, and general guides on care at home, are linked at the end of this page for comparison with DC PCA services.
What the program is
To get PCA services in DC, a person must have DC Medicaid and be assessed by DHCF’s assessment contractor, which sets the number of hours. A home care agency enrolled with DC Medicaid then provides the aide. People in a Medicaid managed care plan may receive PCA through the plan.
Because DC PCA services is a state plan service, it works differently from a waiver. State plan benefits generally cannot have enrollment caps, so a person who has full Medicaid and an assessed need for hands-on help can get the service without waiting for a slot. What it covers is limited mainly to hands-on help with daily activities. See In-home care.
Who qualifies in 2026
A person generally must meet all of these conditions:
- Has DC Medicaid
- Is assessed as needing help with at least one activity of daily living
- Has a prescription or order for PCA services from a doctor or nurse practitioner
- Lives in DC
Income and assets. The person must have DC Medicaid. DC’s income and asset rules are in our state guide. Figures shown above are the 2026 District of Columbia long-term care limits from our state guide. The home (up to the equity limit, when the person or a spouse lives there or plans to return), one vehicle, belongings and a small burial fund are generally not counted by DC DHCF. If only one spouse needs DC PCA services, spousal impoverishment rules protect assets and income for the other. See Spousal impoverishment rules.
How the care assessment works. DC DHCF’s assessment covers daily activities, from bathing and dressing to toileting and medications, plus memory and safety. For DC PCA services, an assessor, usually a nurse or social worker, visits the person at home, in the hospital or in the facility. Have a relative present to describe the hard days, and keep a medication and diagnosis list handy. See Nursing home level of care and Activities of daily living.
What services it can pay for
What a participant receives under DC PCA services follows the care plan. Possible services include:
- Help with bathing and grooming
- Help with dressing
- Help with eating
- Help with toileting
- Help with walking and transfers
- Some household tasks linked to care
No program pays for everything. DC PCA services services are based on assessed need, and a family caregiver who is already helping is usually counted when the plan is written. When needs grow, request an updated assessment.
How to apply
Getting DC PCA services means passing a money test and a care test. Step by step:
- Make sure the person has DC Medicaid.
- Get an order for PCA services from the person’s doctor.
- DHCF arranges the assessment that sets hours.
- Choose a home care agency to provide the aide.
For the paperwork, use our documents checklist before applying for DC PCA services; Applying for a waiver explains the general process.
Waiting lists
There is no waiting list for state plan PCA services.
See Waiver waiting lists for general tips.
How it relates to nursing home Medicaid
PCA services do not require a nursing home level of care, so they can help earlier. People who need more help may qualify for the EPD Waiver.
What is the same as nursing home Medicaid. District of Columbia’s financial rules for DC PCA services track the nursing home rules closely. Gifts and below-value transfers in the five-year look-back can trigger a penalty period for home care as well as nursing home care. After death, estate recovery can reach services paid from age 55 on. People who keep income above a set allowance may have to pay part of it toward their care each month.
Income in a nursing home. In 2026, District of Columbia lets a nursing home resident keep $109 a month for personal needs; the rest of their income mostly pays toward care. Details are in our state guide.
Tips for families
- Begin before it is urgent. Every step of DC PCA services takes time, and an early request protects your place.
- Keep copies of every DC PCA services form, notice and letter, and write down the name of each person you speak with and the date.
- Watch the deadlines on notices. A denial or cut can be appealed through a fair hearing, and a timely request can keep services going meanwhile.
- Tell DC DHCF about changes in money, address or household as they happen.
- Plan for renewals. Medicaid and the care assessment are both renewed, usually once a year. See Renewals.
- Protect a spouse at home. Spousal protections must be claimed; a certified Medicaid planner or legal aid office can explain them for your family.
Common questions
How many hours can I get? Hours depend on the assessment and DC Medicaid limits.
Can I choose the agency? Yes, from agencies enrolled with DC Medicaid.
Can a family member be the aide? Under agency-based PCA, the agency employs aides. Family hiring is generally done through the EPD Waiver’s self-directed option.
Related pages
- District of Columbia Long-Term Care Medicaid guide
- DC EPD Waiver
- In-home care
- Three kinds of Long-Term Care Medicaid
- PACE programs
Last updated for 2026. General information only, not legal or financial advice. Medicaid Answers is a free educational resource published by Medicaid Answers Foundation.