What PCA Covers

PCA services are focused on helping individuals perform the personal care tasks they cannot do independently due to a physical, cognitive, or developmental disability. A personal care assistant (also called a PCA, home care aide, or personal attendant) provides direct, hands-on assistance.

• Bathing, showering, and personal hygiene
• Dressing and undressing
• Grooming — hair, nails, oral hygiene
• Toileting and continence care
• Eating and feeding assistance
• Mobility — moving around the home, transfers, positioning
• Medication reminders (not administration, in most programs)
• Light housekeeping and meal preparation (in many programs)

What PCA Does Not Cover

PCA services are distinct from skilled nursing or medical services. A personal care assistant is not a nurse and is not authorized to perform medical tasks such as wound care, injections, or medication administration (in most states). These tasks require a licensed home health aide or nurse.

PCA also typically does not cover transportation, companionship without a care task, or services for household members other than the care recipient.

Who Provides PCA Services?

PCA services can be provided through a home care agency or through a consumer-directed model. In the agency model, the agency recruits, trains, and assigns a caregiver. In the consumer-directed model, the care recipient selects and manages their own caregiver — which can be a family member in many states.

Consumer-directed PCA programs give individuals more control over who provides their care and how it is delivered, which many people prefer.

How Medicaid Pays for PCA

Medicaid covers PCA services through two main pathways. The first is as a State Plan benefit — some states include personal care services as a standard Medicaid benefit available to all eligible individuals. The second is through HCBS waiver programs, which may have waiting lists.

The number of PCA hours authorized is determined by a needs assessment and varies based on the individual's level of need and the state's program rules.

How to Access PCA Services

To access PCA services through Medicaid, you first need to be enrolled in Medicaid and meet the functional eligibility criteria for home care. Contact your state's Medicaid office or a local Area Agency on Aging to ask about personal care services and how to request an assessment.

• Confirm Medicaid enrollment or apply if not yet enrolled
• Request a referral for personal care services from your Medicaid case manager
• Complete a functional needs assessment
• Choose between agency-directed and consumer-directed care if both are available
• Begin services according to your approved care plan