Paid Family Caregiver Eligibility Checker
Getting paid to care for a family member depends on the care recipient's Medicaid eligibility, not on your income. Spouses and parents of minor children face tighter rules. Answer three questions to see where you stand.
Nearly every state has a Medicaid self-directed or consumer-directed personal care program. It lets a person on Medicaid long-term care hire a relative or friend as a paid caregiver. The name differs by state: CDPAP in New York and IHSS in California are two well-known examples. Eligibility depends on the care recipient's Medicaid status and care needs. The caregiver's income and age do not matter. The exception is a spouse, or the parent of a minor child receiving care. Federal rules generally treat them as "legally responsible relatives" who cannot be paid for ordinary care, although a state can choose to pay them for care that goes beyond what a spouse or parent would normally provide.
Many articles mix up two different things: free support services for caregivers, which do not pay you, and being paid to provide care, which follows different rules. This checker covers paid care.
Check Where You Stand
Program names, rules and pay rates vary by state and change often, so state-specific information online can be out of date. Confirm the details with your state Medicaid agency, and ask for "self-directed" or "consumer-directed" personal care.
The arrangement works the same way in every state. Medicaid pays for personal care for people who qualify for long-term care coverage. Under a self-directed or consumer-directed program, the person receiving care chooses the caregiver, who can be a relative or friend, instead of being sent an aide by an agency. The caregiver is usually paid through a fiscal intermediary, a company that handles payroll and taxes for the program.
What differs by state is the program's name, the pay rate, the training required and how you apply. Call your state Medicaid agency or Area Agency on Aging and ask for "self-directed" or "consumer-directed" personal care.
The steps, in order:
- The person needing care applies for Medicaid long-term care, if not already enrolled.
- The state or a managed care plan assesses how much help the person needs and approves a number of care hours.
- The person chooses self-direction and names you as the caregiver.
- You complete enrollment with the fiscal intermediary, which may include a background check and training.
- You record your hours and are paid for the approved hours at the program's rate.
Spouses and parents of minor children. Medicaid classifies them as legally responsible relatives. The basic federal rule does not allow paying a legally responsible relative for personal care under the standard state plan option. A state can allow it through a waiver, generally for "extraordinary care" only: care well beyond what a spouse or parent would ordinarily provide, and needed to keep the person out of a nursing home. States differ on whether they allow this and how they define it, and their rules change, so ask your state directly.
Everyone else. Adult children, siblings, in-laws, grandchildren and friends are not covered by that restriction. For them the answer depends on the care recipient's Medicaid eligibility and need for care.
Payments can often be excluded from federal taxable income under IRS Notice 2014-7 if you live in the same home as the person you care for. See how caregiver pay is taxed.
Frequently Asked Questions
Can I get paid by Medicaid to take care of a family member?
In most cases, yes, if the care recipient qualifies for Medicaid long-term care and needs a nursing-facility level of help with daily activities. Nearly every state has a self-directed or consumer-directed Medicaid personal care program that lets the recipient hire a relative or friend. Your relationship to the recipient and the recipient's Medicaid eligibility decide it. Your income does not.
Can a spouse get paid as a Medicaid caregiver?
The rules are tighter than for other relatives. Federal Medicaid rules generally treat a spouse, and a parent of a minor child, as a "legally responsible relative" who cannot be paid for ordinary personal care. A state can allow it through a waiver, usually only for "extraordinary care" beyond what a spouse would normally do. Ask your state Medicaid agency whether it does and on what conditions.
What is self-directed or consumer-directed care?
It is a Medicaid option that lets the person receiving care, or their representative, choose and manage their own caregiver, including a relative or friend, instead of using an aide assigned by an agency. The name differs by state. CDPAP in New York and IHSS in California are two examples, so ask your state Medicaid agency what it is called where you live.
Does the caregiver's income or age matter for eligibility?
No. Eligibility depends on the care recipient: Medicaid enrollment, income and asset limits, and need for care. The caregiver does not have to meet an income or age requirement. The National Family Caregiver Support Program works the other way round and looks at the caregiver.
How is this different from the National Family Caregiver Support Program?
NFCSP provides free support services such as respite care, counseling and training, based on the caregiver's age and situation. It never pays the caregiver. This checker covers paid caregiving, which depends on the care recipient's Medicaid eligibility.
This checker applies the federal framework for Medicaid self-directed and consumer-directed personal care, including the restriction on paying spouses and parents of minors. It does not determine your state's program name, pay rate or rules on paying spouses, which vary by state and change over time. It is a general educational starting point, not a Medicaid determination. Confirm your situation with your state Medicaid agency or Area Agency on Aging.