How care at home is paid for in Minnesota.
Most families reach this question having been told three different things by three people who were each partly right. The routes below are the real ones.
Which applies depends on age, on assets, on the kind of help needed and on where somebody lives, and more than one can apply at once. Nobody has to work that out alone, and the county is better placed to than any provider.
| Route | Who it is for | Who decides | Start with |
|---|---|---|---|
| Private pay | Anybody. No eligibility test, no waiting for a determination. | You and the provider, directly. | A written quote showing the rate basis, the visit minimums and what is not included.How Abloom quotes in-home care |
| Long-term care insurance | Somebody who bought a policy, usually years before they needed it. | Your insurer, under the terms of that specific policy. | Ask the insurer for the eligibility rules, the waiting period and what documentation they need. Policies differ enormously. |
| Medical AssistanceMinnesota's Medicaid | People who meet the income and asset rules. Almost every public route to paying for care runs through it. | The state, through your county or your health plan. | The county, or your health plan if you are enrolled in one.The official rules |
| The home and community-based waiversElderly Waiver, CADI, BI | People on Medical Assistance who also meet a nursing-facility level of care and want to stay in the community. | Your county lead agency, or your health plan. | A MnCHOICES assessment, which is the gate to all three.The three programmes, and Abloom's residence |
| CFSSCommunity First Services and Supports, which Minnesota has been moving to from PCA | People who need hands-on help with daily activities and qualify through Medical Assistance. | The county or your health plan. | Ask the county which of the two programmes currently applies to you. The transition has run in stages, so the answer depends on where you are in it.The official rules |
| CDCSConsumer-Directed Community Supports | People already on a waiver who want to direct their own budget and choose their own workers. | Through the waiver, with a case manager. | Your case manager. It is an option within a waiver, not a separate application.The official rules |
| VA Aid and Attendance | Veterans and surviving spouses who need help with daily activities and meet the service and financial rules. | The US Department of Veterans Affairs. | The VA directly, or an accredited representative. It is a pension supplement rather than a care programme.The official rules |
| Medicare | Short-term skilled home health after an illness or a hospital stay. Not ongoing help with daily life. | Medicare, through a certified home health agency. | A physician. It starts with an order, not with a phone call to a provider.Why these are two different servicesThe official rules |
The order that saves the most time
- Find out whether Medical Assistance is in play, because almost every public route runs through it.
- If it might be, ask the county for an assessment now rather than later. It is the gate to the waivers and it takes time that cannot be recovered.
- While that is running, ask providers for their private-pay basis in writing. It is both your fallback and the only way to compare two agencies honestly.
- If there is a long-term care policy, ask the insurer for its eligibility rules before assuming it pays.
The expensive mistake is doing these in the opposite order: choosing a provider first, then discovering the assessment has a wait.
Two things families are told that are not right
The first is that Medicare pays for a caregiver. For ongoing help with washing, dressing and meals it generally does not, and finding that out after a discharge is the worst time to find it out.
The second is that the assessment and choosing a provider are one step. They are not. The county decides what somebody is eligible for; you decide who comes to the house. Running them together is how families end up feeling they were assigned a provider rather than choosing one.
What a provider can tell you, and what it cannot
Any provider can tell you what it accepts, what it charges and what it is able to deliver, and should put all three in writing. None of them decides your eligibility. That is the county's determination, or your health plan's, or your insurer's.
If somebody selling care answers an eligibility question with certainty, ask which agency told them.
Start with the county, then call us
We can tell you what we accept and what care would cost, and we would rather do that alongside an assessment already in motion than instead of one.
Checked against Minnesota DHS and the federal sources on 13 September 2026. Programme rules change; the linked pages are the authority, not this one.