How to Pay for In-Home Nursing Care in Colorado: Medicare, Medicaid, and Other Options
Denver Home Care Editorial TeamFebruary 24, 2026
How to Pay for In-Home Nursing Care in Colorado
Cost is often the first question families ask when considering home health care. The good news is that Colorado offers more payment pathways than most states, and many families qualify for coverage they do not realize is available. Between Medicare, Medicaid, HCBS waivers, VA benefits, private insurance, and long-term care policies, there are real options for reducing or eliminating out-of-pocket expenses.
This guide covers every major payment source available to Denver metro families in 2026, including eligibility requirements, what each source covers, and how to apply.
Understanding the Costs
Before exploring payment options, it helps to know what home health care actually costs in the Denver area.
Class B personal care (non-medical) services typically range from $25 to $38 per hour. This covers help with bathing, dressing, meal preparation, companionship, and other activities of daily living. Most agencies require a minimum of 2 to 4 hours per visit. If you are sorting out exactly what counts as non-medical care, see our personal care services guide.
Class A skilled nursing services range from $45 to $75 per visit for standard nursing assessments. Specialized services like IV therapy, wound care, or ventilator management may cost more. Physical therapy, occupational therapy, and speech therapy home visits typically fall in the $150 to $250 range per session before insurance.
For families needing full-time care, monthly costs can add up quickly. A client receiving 40 hours per week of Class B personal care at $30 per hour would pay roughly $5,200 per month. This is why identifying the right payment source matters so much.
Families thinking about concierge nursing in Denver should plan for private-pay pricing, while agency-based private duty nursing may sometimes be a lower-cost middle ground when more clinical oversight is still needed.
Medicare Home Health Benefits
Medicare is the single largest payer of home health services in Colorado. If your loved one is 65 or older, or qualifies for Medicare due to disability, home health may be covered at no cost to the patient.
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To qualify for Medicare home health coverage, all four of these conditions must be met. The patient must be under the care of a physician who certifies the need for home health services. The patient must need at least one of the following: skilled nursing care, physical therapy, speech-language pathology, or continued occupational therapy. The patient must be homebound, meaning leaving home requires considerable effort. And the agency must be Medicare-certified.
What Medicare Covers
Skilled nursing visits
Physical therapy
Occupational therapy
Speech-language pathology
Medical social work
Limited home health aide services (only when also receiving skilled care)
What Medicare Does Not Cover
Medicare does not cover 24-hour home care, homemaker services when that is the only care needed, personal care (bathing, dressing) when the patient does not also need skilled services, or meal delivery. This is an important distinction. If your loved one only needs help with daily activities and does not have a skilled nursing need, Medicare will not pay for home health care. Families planning overnight or continuous coverage should also review our guide to 24-hour home care in Denver.
How to Access Medicare Home Health
Start with the patient's primary care physician. The doctor must create a home health plan of care and certify that the patient meets homebound criteria. The doctor can refer you to a specific Medicare-certified agency, or you can choose your own. In the Denver metro area, approximately 55 agencies hold Medicare certification. You can confirm certification and compare quality ratings through Medicare Care Compare.
Colorado Medicaid (Health First Colorado)
Colorado's Medicaid program, called Health First Colorado, covers home health services for eligible residents. The Health First Colorado program site is the best official overview of benefits and eligibility. Medicaid often fills gaps that Medicare does not, particularly for long-term personal care.
Standard Medicaid Home Health
Health First Colorado covers skilled nursing visits, therapy services, and home health aide services for members who meet medical necessity criteria. A physician order is required, similar to Medicare.
HCBS Waivers: The Key to Long-Term Personal Care
Colorado's Home and Community-Based Services (HCBS) waivers are the most important Medicaid benefit for families needing ongoing, non-medical home care. These waivers allow Medicaid to pay for services that keep people in their homes instead of nursing facilities.
The Elderly, Blind, and Disabled (EBD) waiver covers personal care, homemaker services, adult day programs, respite care, and non-medical transportation for adults 18 and older who meet nursing facility level of care. This is the most commonly used waiver for seniors needing Class B home care services.
The Community Mental Health Supports (CMHS) waiver provides personal care, life skills training, and community integration for adults with serious mental illness.
The Supported Living Services (SLS) waiver covers personal care, mentorship, assistive technology, and community participation for people with intellectual and developmental disabilities.
The Children's Extensive Support (CES) waiver provides in-home support for children with intellectual and developmental disabilities.
The Children's Home and Community-Based Services (Children's HCBS) waiver covers respite care, personal care, and therapeutic services for children who would otherwise need institutional care.
How to Apply for HCBS Waivers
Contact your local Single Entry Point (SEP) agency. In the Denver metro area, the SEP agencies are Denver Regional Council of Governments (DRCOG) for Denver, Adams, Arapahoe, Broomfield, Douglas, and Jefferson counties. The SEP will conduct a functional assessment to determine eligibility and connect you with available waiver slots. Be aware that some waivers have waiting lists, so apply as early as possible.
Private Health Insurance
Most commercial health insurance plans in Colorado cover some home health services, but coverage varies significantly between plans. Skilled nursing and therapy services ordered by a physician are generally covered with a copay or coinsurance. Personal care and homemaker services are usually not covered by commercial insurance.
Major insurers operating in the Denver market include Blue Cross Blue Shield, Aetna, United Healthcare, Cigna, and Humana. Before choosing an agency, call your insurance company to verify which agencies are in-network and what services are pre-authorized.
Long-Term Care Insurance
If your loved one purchased a long-term care insurance policy, it is often the most flexible payment source for home health care. Most LTC policies cover both skilled nursing and personal care services at home.
Key Terms to Check
Review the policy for the elimination period, which is the number of days you must pay out-of-pocket before benefits begin (commonly 30, 60, or 90 days). Check the daily or monthly benefit maximum. Check whether the policy requires care from a licensed agency or allows independent caregivers. And check the benefit trigger, which is usually the inability to perform 2 of 6 activities of daily living.
Filing a Claim
Contact the insurance company as soon as home care is being considered. Many policies require advance notification. The insurer will typically send an assessor to evaluate the patient's care needs before approving benefits.
Veterans Benefits
Veterans in Colorado have access to several home care benefit programs through the VA Eastern Colorado Health Care System (ECHCS), headquartered in Aurora.
VA Home Health Care provides skilled nursing and home health aide services through VA-contracted agencies for veterans enrolled in VA health care.
The Aid and Attendance Pension is a monthly cash benefit for wartime veterans (or their surviving spouses) who need help with daily activities. In 2026, the maximum monthly benefit is approximately $2,300 for a single veteran and $1,500 for a surviving spouse. This money can be used to pay for any home care services.
The Veteran Directed Care program lets veterans manage their own care budget, hiring caregivers of their choosing, including family members.
Respite Care provides temporary relief for family caregivers of veterans, covering up to 30 days per year.
For families with children who need home health care, Colorado's CHP+ program provides coverage for children in households that earn too much for Medicaid but cannot afford private insurance. CHP+ covers skilled nursing, therapy, and some personal care services for eligible children.
Private Pay Strategies
If insurance coverage is limited or unavailable, there are ways to manage private pay costs.
Start with fewer hours and increase as needed. Many families begin with 3 to 4 visits per week rather than daily care, then adjust based on how the patient responds.
Ask about package rates. Some agencies offer discounts for clients committing to a minimum number of weekly hours, typically 20 hours or more.
Consider a mix of professional and family care. A professional caregiver for 4 hours during the day combined with family caregiving in the evenings can cut costs significantly while preventing caregiver burnout.
Use the right level of care. If your loved one needs personal care but not skilled nursing, a Class B agency will cost significantly less than a Class A agency.
Combining Multiple Payment Sources
Many families use more than one payment source. A common combination is Medicare covering skilled nursing visits after a hospital discharge, then transitioning to Medicaid HCBS waiver-funded personal care for ongoing support. Or a veteran might use VA Aid and Attendance benefits alongside Medicaid waiver services.
A good home health agency will help you navigate payment options and work with your insurance. When contacting agencies in our directory, ask what insurance they accept and whether they have staff who can help with Medicaid waiver applications or VA benefit coordination.
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