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Get Paid to Care for a Family Member Through Medicaid

By CalculateBenefits Editorial Team · Mark Phaneuf, Publisher
AI-assisted source check: November 3, 2026. What these dates mean.

Yes, in many states Medicaid can pay a family member or friend to care for someone at home. This works through "self-directed" care, where the person who needs care hires their own worker. That person must be on Medicaid and meet their state's rules, and the rules differ by state. To start, contact their state Medicaid office or call the Eldercare Locator at 1-800-677-1116.

November is National Family Caregivers Month. If you look after a mom, dad, or other loved one, here is how paid family care works, based on official government pages. CalculateBenefits is not a government office. We cannot sign anyone up or tell you if a person can get this.

Can I get paid to take care of a family member?

Maybe. It depends on the state, the program, and the person who needs care. Medicaid has a way to do this called self-directed care. Some states call it consumer-directed care.

A group that advises Congress on Medicaid, called MACPAC, looked at these programs in 2024. It said, "Many states allow family caregivers." It also found that when people get the chance, more than half hire a relative or someone they know.

But each state sets its own limits on who can be the paid worker. So paid family care is real, but it is not part of every program. Not everyone can use it, either.

What is self-directed Medicaid care?

In most home care, an agency picks the worker and sends them. Self-directed care is different. Medicaid.gov calls it "an alternative" to that agency model.

Here, the person who needs care is the boss. Medicaid.gov says people can "recruit, hire, train and supervise" their own workers. The federal agency that runs Medicaid calls this "employer authority." In some programs, people can also decide how a set Medicaid budget for their care gets spent.

Help comes with it. Medicaid.gov says states must provide or arrange support. This can include training. It can also include help with pay and taxes.

Who can get paid family care through Medicaid?

It is the person who needs care who must qualify, not the caregiver. First, they must be on Medicaid. Next, they must meet their state's rules for how much care they need.

Many of these programs run on Medicaid "waivers." A waiver is a special state program. For one common type, Medicaid.gov says a person must need enough care to qualify for care in an institution. Each state sets that rule. States also choose "the maximum number of people" a waiver will serve. So a program in your state may have limits.

Is the person not on Medicaid yet? Read our guide on who can get Medicaid and how to apply.

Can I be paid to care for my mom or dad?

Maybe. States decide who can be the paid worker, and many states allow family caregivers. Ask the program if a grown son or daughter can be hired. Every state makes its own rules about this.

Hiring a spouse or a parent can be a separate case. Under one federal option, Medicaid.gov says states may choose to let people "hire legally liable relatives (such as parents or spouses)." That choice is up to each state. Rules on hiring a spouse, parent, or legal guardian differ by state.

Workers may have to meet some state rules, too. MACPAC said states must set rules for who can do the work. It also said a "representative" "generally cannot serve as a paid" worker. That is a person who helps run the care.

Helping a parent with the forms? See our tips on helping an aging parent apply for benefits.

How much does Medicaid pay a family caregiver?

There is no single answer. Pay and hours are not set by one national rule, so we do not list a pay rate here. Each state program works it out.

Ask the program these questions:

• How many hours of care will it pay for?
• What is the pay rate for a family worker?
• Who runs payroll and takes out taxes?
• Is there a wait to get in?

How do I start?

1. Talk with the person who needs care. They, or their legal helper, apply for the program. They would also be the one to hire you.
2. Contact their state Medicaid agency. Medicaid.gov has a page where you pick a state to get its contact details.
3. Ask: "Do you have a self-directed or consumer-directed care program? Can a family member be the paid worker?"
4. Or call the Eldercare Locator at 1-800-677-1116, or go to eldercare.acl.gov. It is a public service of a U.S. health agency. It can help you find local help, like your Area Agency on Aging.
5. Write down who you spoke with, the date, and what they said.

Can a veteran's family caregiver get paid?

Maybe. VA has its own programs, apart from Medicaid.

Program of Comprehensive Assistance for Family Caregivers (PCAFC): VA says a Primary Family Caregiver gets "a monthly stipend (payment)." VA ties the stipend to a federal pay rate where the Veteran lives, at one of two levels. Other help can include training, counseling, and "at least 30 days of respite care per year." Some caregivers can also get health coverage through CHAMPVA.

VA's page lists rules for the Veteran. These include a VA disability rating of 70% or higher, being enrolled in VA health care, and a discharge from the military. The Veteran also needs at least 6 months of continuous, in-person personal care.

Caregivers must be at least 18. VA says a caregiver must be a family member, such as a spouse, son, daughter, or parent, or live full time with the Veteran. To apply, use VA Form 10-10CG online, by mail, or in person.

Call the VA Caregiver Support Line at 1-855-260-3274, Monday to Friday, 8 a.m. to 8 p.m. Eastern time. Not sure how ratings add up? Read how VA combined ratings work.

Veteran Directed Care: This one works more like Medicaid self-direction. VA says Veterans get help hiring workers, "which might include their own family member or neighbor." VA also says, "Services may vary by location." Ask the Veteran's VA social worker if it is offered nearby.

Is this the same as a home-care job or family leave?

No. A job with a home-care agency is a regular job. With an agency, the agency picks who you care for. In self-directed care, the person getting care picks the worker.

Family leave is different, too. The FMLA lets some workers take "unpaid, job-protected leave" to care for a spouse, child, or parent with a serious health condition. That gives time off, not pay.

How do I avoid caregiver scams?

Watch out for ads or websites that charge a fee to "certify" you or sign you up as a paid family caregiver. No one should charge you for that. Get the real steps from the state Medicaid office, the Area Agency on Aging, or VA.

Never pay anyone to help you get this. Keep private facts safe, too. Do not give a Social Security or bank number to someone who calls out of the blue.

CalculateBenefits is an independent site. We are not Medicaid, VA, or a state agency. This is not legal advice.

Worried about paying for care later on? See will Medicaid take your house for how nursing home rules work.

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