Home care · Roanoke County, VA
Home care in Roanoke County
Of the 97,000 people in Roanoke County, about 21,000 are 65 or older — one in five residents. Most of them intend to stay in their own homes, and most of the care that makes that possible happens quietly, in living rooms, without anyone calling it "long-term care."
Below is what we'd tell a friend in Roanoke County: what care costs here, who provides it, what the facility alternative actually looks like, and which programs pay.
Roanoke County, in numbers
Full Virginia guide →Residents 65+
20,967
21.7% of the county.
Live with a disability
12.4%
About 11,726 people — the population most likely to need help at home.
Median household income
$77,010
20 hrs/week of care would run about 47% of it.
Certified agencies
20
Medicare-certified home health agencies serving local ZIPs; 20 rated, averaging 3★.
Sources: CDC/ATSDR Social Vulnerability Index 2022 (ACS 2018–2022), County Health Rankings 2024, and CMS Care Compare provider files.
What home care costs in Roanoke County
Virginia's going rate for agency home care is around $35/hr. Twenty hours a week — four hours a day, five days a week, the most common schedule families start with — comes to roughly $3,000 a month, or $36,400 a year.
Median household income in Roanoke County is $77,010 — that schedule runs about 47% of it. Manageable for some households here, and still worth checking whether a program can carry part of it.
Who provides care in Roanoke County
20 Medicare-certified home health agencies serve ZIP codes in Roanoke County. 20 of them carry a CMS quality star rating, averaging 3 out of 5. 16 report offering home health aide services.
One distinction worth getting straight before you call anyone: those are Medicare-certified home health agencies — skilled, doctor-ordered, intermittent care, usually a nurse or therapist visiting for a few weeks after a hospital stay. That is not the same as the hourly, non-medical help most families are actually looking for: bathing, dressing, meals, driving, company. Medicare pays for the first. It does not pay for the second.
The alternative, locally
There is no Medicare- or Medicaid-certified nursing home in Roanoke County. The closest certified facilities are just over the line in Roanoke city, which has 12.
That changes the arithmetic. In a county with no facility, "moving Mom somewhere" means moving her out of the community she has lived in — away from her church, her neighbors, and the daughter who checks on her on the way home from work. Care at home here isn't only the preference. It is often the only option that keeps a family in the same place.
The Virginia programs that pay for care at home
- Commonwealth Coordinated Care Plus (CCC Plus) Waiver
Virginia runs one Medicaid pathway that pays for care at home instead of a nursing home. Each has its own income, asset, and care-need rules, and approval takes weeks to months — so the application is worth starting before the need becomes urgent.
How each Virginia program works →Caregiver training in VA
75 hrs
Minimum for certified aides (the federal minimum). Agencies are licensed by the VA Dept. of Health.
Choosing an agency in Roanoke County
- Ask for the license. Virginia licenses home care agencies through the VA Dept. of Health. A legitimate agency shows its license without hesitating. One that changes the subject has told you something.
- Ask what the rate covers. Around $35/hr is typical in Virginia. A real agency's rate covers a trained, background-checked, insured caregiver plus supervision and backup staffing when your regular person is sick. A rate well under the local range usually means one of those is missing.
- Start the clock early. Roanoke County is served by 20 certified agencies, so the honest answer to "when can you start?" is often two to three weeks. If you're planning around a discharge date, call before the discharge, not after.
- Ask about Medicaid now, not later. If money is going to be the constraint, ask about Commonwealth Coordinated Care Plus (CCC Plus) Waiver at the first call. Approval takes weeks to months, and private pay is what bridges the gap — so the sooner the application starts, the smaller that bridge is.
Want to talk it through?
We provide care in the Milwaukee, WI area — but we’re glad to help any family think through the options in Roanoke County.
Roanoke County home care questions, answered
How much does home care cost in Roanoke County, VA?
Agency home care in Virginia runs around $35/hr for private pay. At 20 hours a week that is about $3,000 a month. For context, median household income in Roanoke County is $77,010. Rates move with the level of care and the schedule — short daily visits cost more per hour than long shifts.
Does Medicare pay for home care in Roanoke County?
Medicare pays for skilled home health — a nurse or therapist, doctor-ordered, for a limited stretch, usually after a hospital stay. 20 Medicare-certified agencies serve Roanoke County. Medicare does not pay for the hourly, non-medical help most families want — bathing, dressing, meals, driving, company. For that, the money comes from private pay, long-term care insurance, VA benefits, or Virginia Medicaid.
Does Medicaid pay for home care in Roanoke County?
Yes — for people who qualify. Virginia runs a Medicaid program that pays for care at home instead of a nursing home: Commonwealth Coordinated Care Plus (CCC Plus) Waiver. Income, asset, and care-need rules apply, and approval usually takes weeks to months, so apply before you need it.
How are caregivers trained and vetted in Virginia?
Certified home health aides in Virginia complete at least 75 hours of training, the federal minimum. The state licenses home care agencies through the VA Dept. of Health, so ask to see an agency's license before you hire.
Are there nursing homes in Roanoke County?
No — there is no certified nursing home in Roanoke County. Families here who need facility care have to look to a neighboring county, which is part of why home care matters more in places like this than the brochures suggest.
Does Juniper at Home provide caregivers in Roanoke County?
Not directly — our own caregivers serve the Milwaukee area of Wisconsin. This page is a free guide for Roanoke County families: what care really costs here, who provides it, and which programs can help pay.
Bordering counties in Virginia