Understanding which state programs compensate family caregivers—and how to access them
You’re helping your parent bathe. Preparing their meals. Managing their medications. Providing companionship. Assisting with appointments. You’re doing the work of a professional caregiver—but you’re doing it unpaid, out of love and family obligation.
But here’s what many families don’t know: you might be eligible to get paid for the care you’re already providing.
Can you actually get paid to take care of your parent at home? The short answer is: yes—sometimes. But it depends on where you live and which state programs you qualify for.
Today, we’re breaking down the main state programs that may pay family caregivers and what you need to know before applying.
The Reality of Family Caregiving in America
According to AARP’s 2020 report on family caregiving, approximately 41.8 million Americans provide unpaid care to an adult age 50 or older. These family caregivers provide an estimated $470 billion worth of unpaid care annually.
The typical family caregiver:
- Spends an average of 24.4 hours per week providing care
- Experiences an average of $7,242 in out-of-pocket costs per year
- Often reduces work hours or leaves employment entirely
- Faces significant financial strain due to caregiving responsibilities
The National Alliance for Caregiving reports that 61% of family caregivers are also working, trying to balance employment with caregiving responsibilities. This “sandwich generation” often faces impossible choices between earning income and providing necessary care.
The question becomes: if you’re providing care that would otherwise require a paid professional, shouldn’t you be compensated?
In many states, the answer is yes—under specific programs designed to support family caregivers.
State Programs That Pay Family Caregivers
Several programs across the United States allow family members to be compensated for providing care to aging parents. Let’s break down the main options.
1. Medicaid Home and Community-Based Services (HCBS) Waivers
Most common option for family caregiver payment
Medicaid Home and Community-Based Services waivers, commonly called HCBS waivers, are the most widespread programs that allow family members to be paid caregivers.
What Are HCBS Waivers?
According to Medicaid.gov, HCBS waivers allow states to provide long-term care services in home and community settings rather than institutional settings. These waivers give states flexibility in how they structure their programs.
Many states use this flexibility to allow Medicaid recipients to choose a family member—including adult children—to be their paid caregiver.
How It Works:
Your parent (the Medicaid recipient) can often select you as their personal care attendant or home care aide. You provide the care, and you’re compensated through the Medicaid program at an hourly rate.
Typical Requirements:
✅ Your parent must qualify for Medicaid – Based on income and asset limits that vary by state
✅ Medical necessity – Your parent must have a documented need for assistance with activities of daily living (bathing, dressing, eating, toileting, transferring, continence)
✅ Enrollment in state-approved program – Both you and your parent must complete enrollment procedures
✅ Assessment – A professional assessment determines the level of care needed and approved hours
✅ Background checks – Family caregivers typically must pass background screening
✅ Training requirements – Some states require basic caregiver training courses
2. Cash and Counseling / Consumer-Directed Care Programs
Gives care recipients control over their care budget
Cash and Counseling programs, also called Consumer-Directed Care or Self-Directed Care programs, take a different approach.
How It Works:
Instead of the state directly hiring and paying caregivers, these programs give your parent (the care recipient) control over a care budget. Your parent can then use that budget to:
- Hire their own caregivers (including you)
- Determine work schedules and responsibilities
- Manage their own care plan with support
Key Features:
Flexibility: Your parent chooses who provides care, when, and how
Family preference: Many participants choose to hire family members because of existing trust and relationship
Budget management: Your parent manages (or co-manages) the care budget with support from a fiscal intermediary
Training and support: Programs typically provide training and ongoing support for both the care recipient and the paid caregiver
Availability:
Cash and Counseling programs exist in many states but aren’t universal. Each state structures its program differently with varying budget amounts, eligibility requirements, and rules about who can be hired.
3. State-Funded Caregiver Support Programs
Supplementary programs that vary by state
Beyond Medicaid programs, some states offer their own caregiver support initiatives funded through state budgets.
These programs vary widely and might include:
Direct payment programs: Some states have created programs specifically to pay family caregivers
Respite care vouchers: Providing funding for temporary relief caregivers so family members can take breaks
Caregiver stipends: Monthly payments to help offset caregiving costs
Tax credits or deductions: State-level tax benefits for family caregivers
Training and support: Free caregiver training programs and support services
According to the Family Caregiver Alliance, these state-specific programs often complement federal programs but have different eligibility criteria and benefit structures.
4. Veterans Benefits for Caregiver Support
For veterans and their family caregivers
If your parent is a veteran, additional options may be available through the Department of Veterans Affairs:
Program of Comprehensive Assistance for Family Caregivers (PCAFC):
- Monthly stipend for primary family caregivers
- Access to health insurance if not already covered
- Mental health services and counseling
- Respite care (up to 30 days per year)
- Caregiver training
Eligibility requires:
- Veteran served after September 11, 2001 (or before May 7, 1975 with certain conditions)
- Veteran has a serious injury incurred or aggravated in the line of duty
- Veteran needs help with activities of daily living
Aid and Attendance Benefit:
- Additional monthly payment for veterans who need help with daily activities
- Can be used to pay for care, including from family members in some circumstances
Program Requirements and Eligibility
While specific requirements vary by state and program, here are common criteria you’ll likely encounter:
For Your Parent (Care Recipient):
Medicaid Eligibility:
- Income below state limits (varies by state, typically around 138% of federal poverty level)
- Assets below state limits (often around $2,000 for individuals, with some exclusions)
- U.S. citizenship or qualified immigration status
Medical Necessity:
- Assessment showing need for assistance with activities of daily living
- Documentation from healthcare provider
- Level of care determination
State Residency:
- Must reside in the state where applying for benefits
- May need to show duration of residency
For You (Family Caregiver):
Age Requirements:
- Typically must be 18 or older
- Some programs have maximum age limits
Background Checks:
- Criminal background screening
- May include fingerprinting
- Child abuse registry checks
- Past employment verification
Training:
- Basic caregiver training courses
- CPR and first aid certification (sometimes required)
- Program-specific orientation
- Ongoing continuing education
Physical Ability:
- Able to perform caregiving tasks required
- May need health screening in some programs
Legal Status:
- Work authorization in the United States
- May need to be legally allowed to work in your state
Relationship Restrictions:
- Some states don’t allow spouses to be paid caregivers
- Some states don’t allow legally responsible relatives
- Rules vary significantly by state
Important Limitations to Know
Before you get too excited about the possibility of getting paid to care for your parent, understand these critical limitations:
1. Not Every State Allows Family Caregivers to Be Paid
State policies vary dramatically. Some states:
- ✅ Allow adult children to be paid caregivers
- ✅ Allow any family member except spouses
- ❌ Don’t allow any legally responsible relatives
- ❌ Have very limited programs with long waitlists
Research by Genworth shows significant variation in long-term care costs and programs across states, reflecting this policy diversity.
2. Pay Rates Are Modest
Don’t expect professional caregiver wages. Typical compensation includes:
Hourly rates: Usually minimum wage to slightly above (often $12-$18 per hour depending on state)
Limited hours: May be capped at 20-40 hours per week even if you provide more care
No benefits: Typically no health insurance, paid time off, or retirement benefits
Tax implications: You’ll be considered an employee with tax withholding
For context, the median cost of a home health aide is approximately $27 per hour according to Genworth’s 2021 Cost of Care Survey—significantly higher than what family caregiver programs typically pay.
3. Hours May Be Limited
The assessed care needs determine approved hours, which might be:
- Less than the actual care you provide
- Insufficient to cover all caregiving responsibilities
- Subject to periodic reassessment and potential reduction
4. Approval Process Takes Time
Expect the process to include:
- Initial application and documentation
- Medical assessments and evaluations
- Background checks and screening
- Training completion
- Processing time by state agencies
Typical timeline: 2-6 months from application to first payment in many states
5. Ongoing Administrative Requirements
Once approved, expect:
- Timesheets and documentation of hours worked
- Regular reassessments of care needs
- Continuing education or training requirements
- Compliance with program rules and reporting
- Potential audits or reviews
6. Impact on Other Benefits
Consider how caregiver income might affect:
- Your parent’s Medicaid eligibility (usually doesn’t, but verify)
- Your own benefits (unemployment, Social Security, etc.)
- Tax obligations and filing requirements
- Estate planning and Medicaid estate recovery
How to Get Started
If you’re interested in exploring paid family caregiver programs, follow these steps:
Step 1: Contact Your State Medicaid Office
Start with your state’s Medicaid program to learn:
- What programs exist in your state
- Whether family caregivers can be paid
- Eligibility requirements for your parent
- Application process and timeline
Step 2: Connect with Your Area Agency on Aging
The Eldercare Locator (1-800-677-1116) can connect you with your local Area Agency on Aging, which can provide:
- Information about state and local programs
- Application assistance
- Connection to additional resources
- Guidance on eligibility and process
Step 3: Consult a Local Home Care Agency
A Medicaid-certified home care agency familiar with your state’s programs can:
- Explain what options are available locally
- Guide you through the application process
- Provide required training
- Help with paperwork and documentation
- Answer questions about your specific situation
At Enchanted Hearts Homecare, we’re Medicaid-certified and familiar with caregiver payment programs. We can help you understand your options and navigate the process.
Step 4: Gather Documentation
You’ll likely need:
- Your parent’s medical records and assessments
- Proof of income and assets (for Medicaid eligibility)
- Your identification and work authorization
- Records of care currently being provided
- Contact information for your parent’s doctors
Step 5: Complete Applications and Training
Follow through on all required steps:
- Submit complete applications
- Attend required training sessions
- Pass background checks
- Complete any additional requirements
- Follow up regularly on application status
Step 6: Understand Your Responsibilities
Once approved, you’ll need to:
- Accurately track and report hours worked
- Provide quality care according to the care plan
- Maintain required training and certifications
- Comply with all program rules
- Communicate changes in your parent’s condition
Frequently Asked Questions
Can I get paid to care for my spouse?
Some states allow spouses to be paid caregivers under certain programs, but many don’t. Check your specific state’s policies, as this varies widely. Spousal caregiver payment is generally less common than adult child caregiver payment.
Will this income affect my parent’s Medicaid eligibility?
Generally no—payments made to you as the caregiver typically don’t count as income to your parent. However, verify this with your state program to be certain.
Can I still work another job while being a paid caregiver?
Yes, in most cases, as long as you can fulfill the caregiving hours and responsibilities required. However, consider the time commitment and potential conflicts.
What if my parent’s condition changes?
The care plan and approved hours will be reassessed. If more care is needed, you may receive additional hours. If less care is needed, hours might be reduced.
Do I need to quit my job to be a paid family caregiver?
Not necessarily. Depending on approved hours and your work schedule, you might be able to do both. However, some caregivers do reduce work hours or leave employment to provide care.
What if my state doesn’t allow family caregivers to be paid?
Explore other options:
- Veterans benefits if applicable
- Tax deductions or credits for caregiving expenses
- Private pay arrangements with your parent
- Respite care to provide you with breaks
- Other family support programs
How much can I realistically expect to earn?
Highly variable, but typically:
- $12-$18 per hour (depending on state)
- 20-40 hours per week approved (sometimes more)
- Monthly income might range from $1,000-$3,000
- Remember this is taxable income with withholding
Can siblings share caregiving and split payment?
Some programs allow multiple family members to be paid caregivers with allocated hours for each. Others designate one primary caregiver. Check your state’s specific rules.
The Bottom Line
Yes, you can get paid to care for your parent at home—but the rules depend on your state.
If you’re already providing care, exploring these programs could provide financial relief and recognition for the valuable work you’re doing. However, it’s not a simple process, and not everyone will qualify.
The key is to:
- Research your state’s specific programs
- Understand eligibility requirements
- Be realistic about compensation and limitations
- Get help navigating the application process
- Stay patient through the bureaucratic process
Remember: even if you don’t qualify or your state doesn’t offer these programs, you’re still providing invaluable care that makes it possible for your parent to remain at home. Explore all available resources—respite care, caregiver support groups, tax benefits, and community services—to support yourself in this important role.
How Enchanted Hearts Homecare Can Help
At Enchanted Hearts Homecare, we understand the challenges family caregivers face. We’re Medicaid-certified and knowledgeable about state caregiver payment programs.
We Can Help You:
✅ Understand your state’s specific programs – We know local Medicaid policies
✅ Navigate the application process – We can guide you through paperwork and requirements
✅ Provide respite care – Even if you become a paid caregiver, you’ll need breaks. We can provide temporary relief.
✅ Offer training and support – We provide caregiver training that may meet program requirements
✅ Explore all your options – Whether family caregiver payment, home care services, or home health services
Our Services Include:
Home Care Services:
- Personal care assistance
- Companionship
- Meal preparation
- Light housekeeping
- Medication reminders
- Transportation
Home Health Services:
- Skilled nursing
- Medication management
- Wound care
- Chronic disease monitoring
Schedule Your Free Consultation
We’ll discuss:
- Your current caregiving situation
- State programs you might qualify for
- The application process and timeline
- How we can support you
- All your care options
No cost. No obligation. Just honest guidance from professionals who understand family caregiving.
The landscape of family caregiver payment programs is complex and constantly evolving. While we strive to provide accurate information, always verify current policies with your state Medicaid office or a local expert. At Enchanted Hearts Homecare, we’re here to help you navigate these options and find the best solution for your family.