--- title: "Can a Family Member Get Paid to Be a Caregiver? By State" description: "Can a family member get paid to be a caregiver? See how Medicaid, VA programs and insurance may pay a relative, with a table for 9 states and next steps." url: https://homecare.preview.multisites.ai/guides/get-paid-to-care-for-a-family-member/ publisher: HomeCare.com phone: 800-974-3458 start: https://care.homecare.com/?source=homecare.com --- Guide: Paying for care # Can a Family Member Get Paid to Be a Caregiver? A State-by-State Guide Yes, sometimes. Medicaid programs in several states let a person choose a relative as a paid caregiver, though spouses are often excluded or limited. The VA also pays a monthly stipend to some family caregivers of seriously disabled Veterans. Most long-term care insurance policies do not pay family. Rules depend on your state and program. Updated October 15, 20268 min readBy HomeCare.com 01 ## Medicaid is the main route Self-directed Medicaid programs let a person with care needs hire the worker they choose. In some states that can be a relative. 02 ## Spouses face limits Michigan Home Help and Texas do not allow a spouse as the paid worker (Michigan also excludes a parent caring for a minor child). Arizona and Virginia require extraordinary care. 03 ## The VA has two paths The family caregiver program pays a stipend. Veteran-Directed Care gives a Veteran a budget to hire workers, which may include family. 04 ## Insurance rarely pays family The NAIC says most long-term care insurance policies do not pay family caregivers. Read your policy. 05 ## Apply first, then start Payment usually begins only after the person with care needs is approved. Care you give before approval may not be repaid. On this page 1. Can a family member get paid to be a caregiver? 2. How does a self-directed Medicaid program pay a relative? 3. Which states pay family caregivers? 4. What does each state require? 5. What does the VA pay family caregivers? 6. Will long-term care insurance pay a family member? 7. What else should I know before I quit my job? 8. Next step Questions about care for your family? [800-974-3458](tel:+18009743458) ## Can a family member get paid to be a caregiver? Yes, sometimes. Three kinds of programs may pay a relative: Medicaid, VA programs, and a few insurance policies. None of them is automatic. The person who needs care must qualify first, and each program sets its own rules about who can be paid. Here is the short version: - **Medicaid.** Some states let a person with care needs hire a relative through a self-directed program. - **The VA.** One program pays a stipend to a family caregiver of a seriously disabled Veteran. Another gives a Veteran a budget to hire workers. - **Long-term care insurance.** Most policies do not pay family. Some may. Read the policy. - **Other help.** Many states fund respite and training for family caregivers, but these programs do not pay a wage. Be careful with anything that promises quick pay. Payment follows approval. Care you give before approval may not be repaid. If you are unsure, call the program and ask before you quit a job. ## How does a self-directed Medicaid program pay a relative? In a self-directed program, the person receiving care acts as the employer. They choose the worker, set the schedule within program rules, and approve the hours. A fiscal agent usually handles payroll. See our glossary entry on the [participant-directed Medicaid program](https://homecare.preview.multisites.ai/glossary/participant-directed-medicaid-program/). The steps look like this: 1. The person with care needs applies for [Medicaid](https://homecare.preview.multisites.ai/glossary/medicaid/) and a [home and community-based services waiver](https://homecare.preview.multisites.ai/glossary/home-and-community-based-services-waiver/) or personal care program. 2. The state assesses needs and approves a plan with a set number of hours or a budget. 3. The person picks self-direction, if the program offers it. 4. The person names a worker. Ask whether a relative is allowed. 5. The relative completes enrollment, any training and payroll paperwork. 6. The relative is paid for approved hours worked. Programs that pay a relative still keep control over hours and tasks. You may be paid only for personal care tasks listed in the plan. Many programs check the work with timesheets or electronic visit verification. See [electronic visit verification](https://homecare.preview.multisites.ai/glossary/electronic-visit-verification/). ## Which states pay family caregivers? The table below covers the nine states where HomeCare.com serves families. It shows the main program, who qualifies, and whether a family caregiver can be paid. State names link to our state pages. For more detail on each Medicaid program, read [Medicaid home care waivers by state](https://homecare.preview.multisites.ai/guides/medicaid-home-care-waivers-by-state/). State Main program(s) Who qualifies Family caregiver payment [Alabama](https://homecare.preview.multisites.ai/state/alabama/) Elderly and Disabled (E&D) Waiver, Personal Choices Elderly or disabled people at nursing facility level of care. 2026 limits: $2,982 a month income, $2,000 resources. Limited. Personal Choices lets waiver members self-direct. Ask whether a relative can be paid. Alabama CARES gives respite, not pay. [Arizona](https://homecare.preview.multisites.ai/state/arizona/) Arizona Long Term Care System (ALTCS), Self Directed Attendant Care, Agency with Choice Adults with an age-related, physical, or developmental disability at nursing facility level of care who meet financial limits. Yes. Policy lets family be paid. A spouse or parent of a minor must give extraordinary care beyond the normal. [Colorado](https://homecare.preview.multisites.ai/state/colorado/) Community First Choice (CFC) with CDASS or IHSS Health First Colorado members at an institutional level of care who meet financial rules. Yes, with some restrictions. Family, friends or others can be paid attendants. [Maryland](https://homecare.preview.multisites.ai/state/maryland/) Community First Choice, Community Options Waiver, Attendant Care Plus People at an institutional level of care with Medicaid. Attendant Care Plus is for adults 18 to 64 with a severe disability. Limited. Attendant Care Plus lets you choose and manage your caregiver, with a waiting list. Other pages do not confirm family pay. [Michigan](https://homecare.preview.multisites.ai/state/michigan/) Home Help Program, MI Choice Waiver Medicaid fee-for-service members who need hands-on help with an activity of daily living. Yes, in Home Help. The client can choose a relative or friend age 18 or older, but not a spouse, a parent of a minor child, or someone who also gets Home Help. [North Carolina](https://homecare.preview.multisites.ai/state/north-carolina/) CAP/DA Waiver, Home Care Independence Disabled adults 18 or older (CAP/DA). Adults 60 or older in some counties (Home Care Independence). Limited. Participants can hire and supervise their own worker. In Home Care Independence, the person who directs care cannot be the paid worker. [Ohio](https://homecare.preview.multisites.ai/state/ohio/) PASSPORT, Ohio Home Care Waiver Ohioans 60 or older at nursing home level of care (PASSPORT). Medicaid-eligible Ohioans 59 or under (Home Care Waiver). Limited. Both allow self-direction. Ask the agency whether a relative can be hired. [Texas](https://homecare.preview.multisites.ai/state/texas/) Primary Home Care, Community Attendant Services, STAR+PLUS with Consumer Directed Services People with community Medicaid and a personal care need who score at least 24 on Form 2060. Yes. Relatives can generally be attendants, but not the recipient’s spouse. [Virginia](https://homecare.preview.multisites.ai/state/virginia/) Commonwealth Coordinated Care Plus (CCC Plus) Waiver Older adults and people with disabilities at nursing facility level of care who are eligible for Medicaid. Yes. Spouses and parents of minors may be paid for extraordinary personal care, up to 40 hours a week. “Limited” means we could not confirm that a relative can be paid, or the rule has conditions. It does not mean no. Call the program and ask. ## What does each state require? ### Michigan Michigan’s Home Help Program pays for bathing, dressing, eating, grooming, mobility, toileting and transferring. It also pays for light housework, laundry, meal preparation and shopping. An MDHHS adult services worker does an in-home assessment. The client is the employer. A relative or friend age 18 or older can be hired. The caregiver cannot be the client’s spouse, a parent caring for a minor child, or someone who also receives Home Help. Apply at your county MDHHS office. See [Michigan Home Help](https://homecare.preview.multisites.ai/glossary/michigan-home-help-program/). ### Texas Primary Home Care and Community Attendant Services need a score of at least 24 on Form 2060 and at least six hours of service a week, with some exceptions. Through Consumer Directed Services, you hire and manage the attendant. The state handbook says relatives can generally be attendants, but not the recipient’s spouse. Learn more about [Texas Primary Home Care](https://homecare.preview.multisites.ai/glossary/texas-primary-home-care/). ### Arizona AHCCCS policy lets family members be paid caregivers in ALTCS. Members who live in their own home can use Self Directed Attendant Care or Agency with Choice. If the caregiver is a spouse or the parent of a minor, the care must also be extraordinary, beyond what that person would normally do. Apply in Health-e-Arizona Plus or call 602-417-7000. ### Colorado Under Community First Choice, members can self-direct through CDASS or IHSS. Family members, friends and others can be paid attendants, with some restrictions. Your local Case Management Agency starts the process. ### Virginia In the CCC Plus Waiver, members can direct their own personal care and respite. The state lists spouses and parents of minors, called legally responsible individuals, as eligible to be paid for extraordinary personal care, up to 40 hours a week. DMAS’s 2025 fact sheet also lists a soft cap of 56 personal care hours a week, with exceptions. ### North Carolina CAP/DA offers Consumer Directed Services. The participant or a representative acts as employer and hires, supervises and sets pay for a personal assistant. Home Care Independence is a consumer-directed program for adults 60 or older, available in some counties. The older adult may hire family, friends or others. The person who directs the care cannot be the paid caregiver. ### Ohio PASSPORT participant direction is voluntary. The person recruits and hires a provider independent of a personal care agency. The Ohio Home Care Waiver added self-direction on October 1, 2024. The official pages we reviewed do not say whether relatives may be hired, so ask the agency. ### Alabama and Maryland The pages we reviewed for Alabama and Maryland do not say that Medicaid pays relatives. Alabama’s Personal Choices program lets waiver members direct their own services. Maryland’s Attendant Care Plus program lets you choose and manage your caregiver. Ask each program whether a relative can be your paid worker. ## What does the VA pay family caregivers? The VA has two programs that may pay a family caregiver. Both are only for Veterans. See our [VA benefits for home care guide](https://homecare.preview.multisites.ai/guides/va-benefits-for-home-care/) for the full picture. ### Program of Comprehensive Assistance for Family Caregivers This program pays a monthly stipend to an approved Primary Family Caregiver. The Veteran must have a VA disability rating of 70% or higher, need at least 6 months of continuous in-person personal care, and be enrolled in VA health care. The caregiver must be 18 or older and be a spouse, son, daughter, parent, stepfamily member or extended family member, or live full time with the Veteran. Benefits can include training, mental health counseling, travel benefits, CHAMPVA health coverage if the caregiver has no other coverage, free legal and financial planning help, and at least 30 days of respite care a year. VA says it assigns caregivers no later than 90 days after it receives an application. The Caregiver Support Line is 855-260-3274. Veterans who do not qualify may still get help through VA’s Program of General Caregiver Support Services, which is support, not a stipend. ### Veteran-Directed Care Veteran-Directed Care gives a Veteran a budget for services, managed by the Veteran or a representative. With a counselor’s help, the Veteran hires workers. VA says those workers might include a family member or neighbor. All enrolled Veterans are eligible if they are eligible for community care, meet clinical criteria and the service is available. Services vary by location. Ask your VA social worker. ## Will long-term care insurance pay a family member? Usually not. The NAIC’s shopper’s guide says most policies do not pay benefits to family members who provide care. It also says care they provide may not count toward your elimination period. Some policies may differ, so read the exclusions and definitions in your own policy and ask the insurer in writing. Do not plan around payment until the insurer confirms. See [long-term care insurance](https://homecare.preview.multisites.ai/glossary/long-term-care-insurance/) and our guide on [long-term care insurance claims](https://homecare.preview.multisites.ai/guides/long-term-care-insurance-home-care-claims/). ## What else should I know before I quit my job? Paid family caregiving can change your taxes, your own benefits and your relationship. Think it through first. Questions to settle: Question Why it matters Is the person approved and enrolled? Pay starts only after approval. Is a relative allowed to be the paid worker? Rules differ by program and by relationship. How many hours will be approved? The plan, not the need, sets the pay. Who is the employer, and who runs payroll? Self-directed programs usually use a fiscal agent. Ask for a written explanation. What happens to taxes and your own benefits? Talk to a tax professional. Pay may affect your own benefits too. Do you need a written agreement? An [elder law attorney](https://homecare.preview.multisites.ai/paying-for-care/elder-law-attorney/) can explain care agreements. Paid family care can also be hard on the caregiver. See [caregiver burnout](https://homecare.preview.multisites.ai/caregiver-resources/caregiver-burnout/) and [respite care](https://homecare.preview.multisites.ai/respite-care/). ## Next step If you want help for a relative so you can rest or keep working, a HomeCare.com care advisor can talk through payment options that may apply to your situation. Call 800-974-3458 or [request a call](https://homecare.preview.multisites.ai/contact/). HomeCare.com care is non-medical. See [personal care](https://homecare.preview.multisites.ai/personal-care/). ## Frequently asked questions ### Can I get paid to care for my parent? Maybe. If your parent qualifies for a Medicaid program that allows self-direction, your parent may be able to hire you. Arizona, Colorado, Michigan, Texas and Virginia have such programs. Your parent must be approved first. Ask the state program whether a relative can be the paid worker. ### Which states pay family caregivers? In our nine states, Arizona, Colorado, Michigan, Texas and Virginia have Medicaid programs that can pay relatives. North Carolina's CAP/DA and Home Care Independence let participants hire people they choose. Alabama, Maryland and Ohio were not confirmed on their official pages, so ask each program. ### Can a spouse be a paid caregiver? In some programs, only with limits. Michigan Home Help and Texas Primary Home Care do not let the client's spouse be the paid caregiver. Arizona and Virginia can pay a spouse only for extraordinary care beyond what a spouse would normally do. VA's family caregiver program does include spouses. ### How much do paid family caregivers earn? It depends on the program. Medicaid sets the rate or the budget, and states differ. The VA stipend depends on the program's rules. We do not give a single figure because rates change. Ask the program for the current hourly rate or budget before you plan around the income. ### Do I need to be certified? Often not for a self-directed role, but rules vary. Some programs require training, a background check, or enrollment as a worker. The VA requires caregiver education, training and a home care assessment before it assigns a caregiver. Ask the program what you must complete before you start. ## Sources 1. [VA.gov: The Program of Comprehensive Assistance for Family Caregivers](https://www.va.gov/family-and-caregiver-benefits/health-and-disability/comprehensive-assistance-for-family-caregivers/) 2. [VA Geriatrics and Extended Care: Veteran-Directed Care](https://www.va.gov/geriatrics/pages/Veteran-Directed_Care.asp) 3. [AHCCCS: Arizona Long Term Care System (ALTCS)](https://www.azahcccs.gov/Members/GetCovered/Categories/ALTCS.html) 4. [Colorado HCPF: Community First Choice Option](https://hcpf.colorado.gov/community-first-choice-option) 5. [Michigan MDHHS: Home Help Program](https://www.michigan.gov/mdhhs/adult-child-serv/adults-and-seniors/independent) 6. [Texas HHSC: Primary Home Care and Community Attendant Services](https://fhb.hhs.texas.gov/handbooks/community-care-services-eligibility-handbook/4600-primary-home-care-community-attendant-services) 7. [Virginia DMAS: Commonwealth Coordinated Care Plus (CCC Plus) Waiver](https://www.dmas.virginia.gov/for-members/benefits-and-services/waivers/ccc-plus-waiver/) 8. [NAIC: A Shopper's Guide to Long-Term Care Insurance](https://content.naic.org/sites/default/files/publication-ltc-lp-shoppers-guide-long-term.pdf) ## Terms in this guide - [Commonwealth Coordinated Care Plus (CCC Plus) Waiver (Virginia)](https://homecare.preview.multisites.ai/glossary/commonwealth-coordinated-care-plus-waiver/) - [Community Alternatives Program for Disabled Adults (CAP/DA)](https://homecare.preview.multisites.ai/glossary/community-alternatives-program-for-disabled-adults/) - [Home and community-based services (HCBS) waiver](https://homecare.preview.multisites.ai/glossary/home-and-community-based-services-waiver/) - [Arizona Long Term Care System (ALTCS)](https://homecare.preview.multisites.ai/glossary/arizona-long-term-care-system/) - [Participant-directed Medicaid program](https://homecare.preview.multisites.ai/glossary/participant-directed-medicaid-program/) - [Electronic visit verification (EVV)](https://homecare.preview.multisites.ai/glossary/electronic-visit-verification/) - [PASSPORT Medicaid waiver (Ohio)](https://homecare.preview.multisites.ai/glossary/passport-medicaid-waiver/) - [Long-term care insurance](https://homecare.preview.multisites.ai/glossary/long-term-care-insurance/) - [Texas Primary Home Care](https://homecare.preview.multisites.ai/glossary/texas-primary-home-care/) - [Community First Choice](https://homecare.preview.multisites.ai/glossary/community-first-choice/) ## Keep reading - [**Medicaid Home Care Programs in Alabama, Arizona, Colorado, Maryland, Michigan, North Carolina, Ohio, Texas and Virginia**Medicaid can pay for in-home care, but not through one national benefit. Each state runs its own waivers and personal care programs. You usually must need a...](https://homecare.preview.multisites.ai/guides/medicaid-home-care-waivers-by-state/) - [**VA Benefits for Home Care: Aid and Attendance, Caregiver Programs and More**The VA does not have one home care benefit. It has several. Aid and Attendance adds money to a VA pension for wartime Veterans and surviving spouses who need...](https://homecare.preview.multisites.ai/guides/va-benefits-for-home-care/) - [**Using Long-Term Care Insurance for Home Care: Elimination Periods, Proof and Claims**Many long-term care insurance policies cover home care, but you must qualify first. You need to meet the policy's benefit trigger, usually help with two of...](https://homecare.preview.multisites.ai/guides/long-term-care-insurance-home-care-claims/) - [**Caregiver Burnout - Recognizing and Coping with Signs of Caregiver Stress**Are you feeling burned out and run down? Caregiver burnout is a real thing that family caregivers must watch out for. Learn how to manage caregiver stress.](https://homecare.preview.multisites.ai/caregiver-resources/caregiver-burnout/) - [**Companion Care vs Personal Care: What Each Level Does and Does Not Do**Companion care gives company, light housekeeping, meals, rides and reminders. Personal care adds hands-on help with bathing, toileting, dressing and moving...](https://homecare.preview.multisites.ai/guides/companion-care-vs-personal-care/) - [**What is Elder Law and Do You Need an Elder Care Attorney?**Learn what services an elder care attorney provides and how to hire one. They can help you with your long-term care questions and needs.](https://homecare.preview.multisites.ai/paying-for-care/elder-law-attorney/) ## Talk to a care advisor today. Free consultation. No minimums, no contracts. 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