How Do I Get Paid to be a Family Caregiver?

Medicaid Self-Direction Programs

If the person you care for has a disability or chronic condition and is eligible for Medicaid, they may qualify for financial assistance that can be used to purchase necessary home and community-based services and supports, including payment to the family caregiver or to pay for respite. Such programs are sometimes known as cash & counseling, consumer or self-directed programs, or other names selected by the state. Every state but South Dakota has Medicaid programs that allow for self-directed services.  Some states may require you to become a certified Medicaid provider or meet other state requirements. The care recipient must meet income and other eligibility requirements set by the state. Most often these services will be provided through a Medicaid Waiver offered by your state, but they may be offered through other Medicaid state plan options.  For more information, contact Applied Self Direction. This organization maintains a list of State Self-Direction programs.

Veterans Services

If the person you care for is a veteran, you may be eligible for Veteran Directed Care Program, Veterans Pensions, and/or the Aid and Attendance benefit, all of which have the potential to provide some financial and other supports. Veterans and their caregivers may be eligible for the Program of Comprehensive Assistance for Family Caregivers. In addition to respite, mental health services, travel expenses, and access to health care insurance for family caregivers, the program offers caregiver stipends.  Call the VA Caregiver Support line at 1-855-260-3274 or visit www.caregiver.va.gov.   See the ARCH Fact Sheet, Nine Steps to Respite for Military and Veteran Caregivers.

Structured Family Caregiving

A number of states have been approved by the Centers for Medicare and Medicaid Services to offer Structured Family Caregiving where the family caregiver can be paid and receive additional supports. To qualify, the individual needing care must be eligible for Medicaid, need 24-hour care and supervision, and require help from a caregiver with one or more daily personal care needs, (i.e. bathing, dressing, walking, transferring, eating, and toileting).  As of 10/2022, seven states offer this Medicaid benefit for older adults, adults with physical disabilities, and their family caregivers: Connecticut, Georgia, Indiana, Louisiana, Missouri, North Carolina, and South Dakota. Check with your State Medicaid agency to see if your state offers this program or something similar, such as Adult Foster Care. For more information, see Medicaid Structured Family Caregiving: Enabling Family Members to Make Caregiving Their Primary Focus from the National Academy for State Health Policy.

Adult Foster Care in the Homes of Family Members

The following states allow relatives as paid foster care providers: Connecticut, Louisiana, Indiana, Massachusetts, Ohio, Rhode Island, and Texas. In most states, spouses are excluded from being paid. Regulations may require formal training for family caregivers; 24/7 availability of a backup caregiver; periodic safety inspections; and licensing fees. Read more at Paying for Senior Care: Adult Foster Care it How it Works, Financial Assistance and Payment Options.

Paid Caregiver Program Locator

This tool was created and is maintained by the American Elder Care Research Organization.

Family and Medical Leave Act

If you work for an employer with more than 50 employees, you may be eligible for up to 12 weeks of unpaid leave to provide care while you protect your job.  For more information, see Department of Labor Fact Sheet.  Eleven states—California, Colorado, Connecticut, Delaware, Massachusetts, Maryland, New Jersey, New York, Oregon, Rhode Island, and Washington—and the District of Columbia have enacted laws that provide paid family leave for employees who need time off to care for family members who are ill or have a disability, or for a new child.

Helpful Articles

• American Council on Aging (Feb. 28, 2022). How to Receive Financial Compensation via Medicaid to Provide Care for a Loved One
• Next Avenue (Aug 5, 2020) Where Family Caregivers Can Get Financial Assistance,
  Advice about state and local programs, some created due to the pandemic by Margie Zable Fisher
• Consumer Reports (Jan 2018). How to Get Compensation When Caring for Aging Parents
  Five ways to offset the cost and loss of income.
• United Hospital Fund, by Carole Levine.  Can You Get Paid to Take Care of Your Mom?
• The Caregiver Space.  See the article Can I get paid to be a family caregiver?
• Agingcare.com. See the article  “How Can I Get Paid for Taking Care of My Elderly Parents?”  
• AARP Caregiver Resource Center.  Can I get Paid as a Caregiver?