How Much Do Family Members Get Paid for Caregiving? Complete State-by-State Guide

You're already doing the work. The midnight medication reminders. The doctor's appointments. The meals, the cleaning, the emotional support that never clocks out.

The question isn't whether you deserve compensation. You do. The question is how to get it.

Here's the good news: multiple programs exist that pay family members to care for aging parents, disabled spouses, or relatives who need daily assistance. The challenging part? Navigating which programs you qualify for and how much you can actually earn.

This guide breaks it all down—state by state, program by program, dollar by dollar.

Can You Get Paid to Care for a Family Member?

Yes—Here's How It Works

The short answer: absolutely. Federal and state governments recognize that family caregivers save the healthcare system billions annually. Paying you to provide care at home costs significantly less than nursing home placement.

But let's be real about something first.

Many family caregivers feel guilty about accepting payment. You might wonder if it's appropriate to receive money for caring for someone you love. Here's the truth: professional caregivers get paid for this exact work. Your relationship to the person doesn't make your labor less valuable—if anything, you're providing better, more personalized care than a stranger could.

The work you're doing has economic value. Period.

Now, the practical reality: not every family caregiver qualifies for compensation. Payment programs typically require that the care recipient meets certain criteria—usually related to income level, disability status, or veteran status. The caregiver may also need to meet requirements, though these are generally less restrictive.

Here's how the main pathways break down:

Medicaid-funded programs are the most common route. Most states offer some version of self-directed care or consumer-directed services that allow the care recipient to hire family members as paid caregivers.

Veteran-focused programs provide additional options if your family member served in the military. The VA offers several caregiver support initiatives with different payment structures.

Long-term care insurance sometimes covers family caregivers, depending on the policy. If your family member purchased coverage years ago, it's worth reviewing those documents.

Private pay arrangements allow families to create their own compensation structure using the care recipient's personal funds. This requires more planning but offers the most flexibility.

Programs That Pay Family Caregivers

Let's get specific about your options.

Medicaid Self-Directed Services Available in most states under different names. The care recipient must qualify for Medicaid and meet functional requirements demonstrating they need assistance with daily activities. Once approved, they receive a budget to hire caregivers—including family members in most states.

State names for this program vary wildly:

California: In-Home Supportive Services (IHSS)
New York: Consumer Directed Personal Assistance Program (CDPAP)
Texas: Community First Choice
Florida: Statewide Medicaid Managed Care Long-Term Care Program

Veteran-Directed Care If your family member is a veteran enrolled in VA healthcare, they may qualify for this program. It provides a flexible budget for purchasing services, including paying family caregivers.

Program of Comprehensive Assistance for Family Caregivers (PCAFC) This VA program specifically compensates caregivers of post-9/11 veterans with serious injuries. Stipends can be substantial—sometimes exceeding $3,000 monthly.

Aid and Attendance Benefit A VA pension enhancement that provides additional monthly income to veterans who need help with daily activities. While not a direct caregiver payment, families often use these funds to compensate the caregiver.

State-Specific Programs Some states have created their own caregiver payment programs outside of Medicaid. These vary significantly in availability and generosity.

State-by-State Caregiver Payment Programs

Understanding what's available in your state is essential. Programs, rates, and eligibility requirements differ dramatically depending on where you live.

Medicaid Self-Directed Care Options by State

California: In-Home Supportive Services (IHSS)

California runs one of the nation's most established family caregiver payment programs. IHSS serves over 600,000 recipients and employs more than 500,000 caregivers—many of them family members.

Eligibility: Care recipient must be on Medi-Cal (California's Medicaid) and require assistance with daily activities.

What it covers: Personal care, housekeeping, meal preparation, accompaniment to appointments, protective supervision.

Spouse exception: California is one of the few states that allows spouses to be paid caregivers through IHSS.

Hourly rates: Currently range from $16.00 to $18.00+ depending on county, with ongoing increases in many regions.

New York: Consumer Directed Personal Assistance Program (CDPAP)

New York's CDPAP is notably flexible. It allows family members—including spouses and parents of adult children—to receive payment for caregiving.

Eligibility: Care recipient must qualify for Medicaid and need assistance with activities of daily living or skilled nursing tasks.

Unique feature: CDPAP allows family caregivers to perform tasks that typically require licensed professionals, such as medication administration, after receiving proper training.

Hourly rates: Generally $15.00 to $22.00 per hour depending on region and the fiscal intermediary.

Texas: Community First Choice (CFC)

Texas offers caregiver payment through its Community First Choice program, though with some restrictions on family relationships.

Eligibility: Must qualify for Texas Medicaid and meet functional requirements.

Family member restrictions: Spouses cannot be paid caregivers. Parents can be paid to care for adult children with disabilities. Other relatives may qualify.

Hourly rates: Approximately $8.00 to $15.00 per hour, depending on the service type.

Florida: Statewide Medicaid Managed Care Long-Term Care (SMMC LTC)

Florida's managed care system includes personal care services that can sometimes be provided by family members.

Eligibility: Must qualify for Florida Medicaid and meet nursing home level of care requirements.

Family member policy: Varies by managed care organization. Some allow family caregivers; others restrict payment to non-relatives.

Hourly rates: Typically $10.00 to $14.00 per hour.

Pennsylvania: Act 150

Pennsylvania allows certain family members to receive payment through its attendant care programs.

Eligibility: Adults with physical disabilities who require assistance and meet income requirements.

Family restrictions: Cannot pay parents of minor children. Spouses face restrictions. Adult children and other relatives may qualify.

Hourly rates: Generally $12.00 to $16.00 per hour.

Ohio: PASSPORT and Ohio Home Care Waiver

Ohio operates several waiver programs that may permit family caregiver payment.

Eligibility: Care recipient must meet Medicaid requirements and need nursing home level of care.

Family policy: Most relatives except spouses can potentially be paid caregivers.

Hourly rates: Approximately $10.00 to $14.00 per hour.

Washington: Consumer Directed Employer Program

Washington offers a robust consumer-directed option.

Eligibility: Must qualify for Washington Apple Health (Medicaid) and need personal care services.

Family eligibility: Most family members, including spouses in some circumstances, can be paid.

Hourly rates: Around $18.00 to $21.00 per hour—among the highest in the nation.

Georgia: Community Care Services Program (CCSP)

Georgia's waiver program provides home and community-based services.

Eligibility: Must be 65+ or have a disability, qualify for Medicaid, and need nursing home level of care.

Family restrictions: Legally responsible relatives (spouses, parents of minor children) typically cannot be paid.

Hourly rates: Generally $9.00 to $12.00 per hour.

Veteran Programs Across All States

Veteran programs operate federally, meaning they're available regardless of your state—though implementation may vary.

Program of Comprehensive Assistance for Family Caregivers (PCAFC)

This is the most generous VA caregiver program, but eligibility is specific.

Who qualifies: Caregivers of veterans who incurred or aggravated a serious injury in the line of duty on or after September 11, 2001. As of October 2022, this expanded to include veterans from all eras.

Monthly stipend: Based on the care hours needed and your geographic location. Stipends can range from approximately $1,800 to over $3,300 monthly.

Additional benefits: CHAMPVA health insurance for the caregiver, mental health counseling, travel expenses when accompanying the veteran to appointments, access to caregiver support line, and respite care.

Veteran-Directed Care (VDC)

Veterans enrolled in VA healthcare who need personal care services may access this program.

How it works: The veteran receives a flexible budget based on their care needs and can hire family members as caregivers.

Monthly budgets: Vary significantly based on assessed care hours. Can range from a few hundred to several thousand dollars monthly.

Aid and Attendance Pension Enhancement

This isn't technically a caregiver payment—it's additional pension money for veterans who need help with daily activities.

Basic requirements: Veteran must have wartime service, limited income/assets, and need assistance with daily activities.

Monthly amounts (2024):

Veteran alone: Up to $2,229
Veteran with spouse: Up to $2,642
Surviving spouse: Up to $1,432

Many families use these funds to pay a family caregiver, creating an informal payment arrangement.

Other State-Specific Options

State-Funded Caregiver Support Programs

Some states offer caregiver payment programs outside Medicaid:

Minnesota: Offers paid family leave for caregiving through its Paid Leave program (beginning 2026)
New Jersey: Family Leave Insurance provides partial wage replacement when taking leave to care for family
Oregon: Paid Family and Medical Leave includes family caregiving

Respite Care Funding

Nearly every state offers some respite funding through Medicaid waivers or state programs. While not ongoing payment, respite grants can provide occasional financial relief.

Structured Family Caregiving Programs

A few states (North Carolina, Georgia, and others) operate Structured Family Caregiving programs through Medicaid waivers. These provide monthly payments plus support services to families caring for adults with disabilities or seniors.

How Much Can You Earn as a Family Caregiver?

Let's talk real numbers. Understanding potential earnings helps you plan and evaluate whether pursuing compensation makes sense for your situation.

Average Caregiver Rates by State

Hourly rates for paid family caregivers through Medicaid programs vary dramatically:

Highest-Paying States:

Washington: $18.00–$21.00/hour
California: $16.00–$18.50/hour
Massachusetts: $16.00–$19.00/hour
New York: $15.00–$22.00/hour
Oregon: $15.00–$18.00/hour
Connecticut: $15.00–$17.50/hour

Mid-Range States:

Pennsylvania: $12.00–$16.00/hour
Ohio: $10.00–$14.00/hour
Michigan: $11.00–$15.00/hour
Illinois: $14.00–$16.00/hour
New Jersey: $13.00–$16.00/hour
Colorado: $13.00–$17.00/hour

Lower-Paying States:

Texas: $8.00–$15.00/hour
Florida: $10.00–$14.00/hour
Georgia: $9.00–$12.00/hour
Alabama: $8.00–$11.00/hour
Mississippi: $8.00–$10.00/hour
Arkansas: $9.00–$12.00/hour

Monthly Earning Potential

Your monthly income depends on approved hours times the hourly rate. Here's what that could look like:

Example 1: California IHSS

Approved hours: 195 per month (moderate care needs)
Hourly rate: $17.00
Monthly gross: $3,315

Example 2: New York CDPAP

Approved hours: 120 per month (personal care needs)
Hourly rate: $18.00
Monthly gross: $2,160

Example 3: Texas Community First Choice

Approved hours: 160 per month
Hourly rate: $10.00
Monthly gross: $1,600

Example 4: VA PCAFC (High-need veteran)

Monthly stipend at Tier 2 level
Amount: $2,800 (varies by geographic location)

Factors That Affect Your Pay

Several variables determine your actual compensation:

1. Care Recipient's Assessed Needs

This is the biggest factor. Programs authorize hours based on an assessment of what help the care recipient requires. Someone needing minimal assistance might qualify for 40 hours monthly. Someone requiring constant supervision might qualify for 283+ hours (California's maximum).

2. Your State's Rate Structure

Some states have flat rates; others have tiered rates based on service type. California counties set their own rates. New York rates vary by fiscal intermediary.

3. Whether You're Caring for a Spouse

Many states prohibit paying spouses through Medicaid programs. Others allow it with restrictions. California and New York are notably spouse-friendly.

4. The Specific Program

Even within a state, different programs have different rate structures. Medicaid waiver programs might pay differently than state plan options.

5. Geographic Location

Rates often vary by county or region within a state. Urban areas sometimes have higher rates than rural regions.

6. Union Representation

In some states (California notably), home care workers are unionized, which has led to higher wages and better benefits.

Benefits Beyond Hourly Pay

Some programs offer additional benefits:

Health insurance: California offers health coverage to IHSS workers. The VA's PCAFC includes CHAMPVA coverage.

Paid time off: Certain programs or fiscal intermediaries provide PTO or sick leave.

Workers' compensation: Most programs provide coverage if you're injured while caregiving.

Training opportunities: Some states offer free training that can increase your skill level and sometimes your pay rate.

Getting Started: Application Process

You've decided to pursue compensation. Now what? Here's a practical roadmap.

Step 1: Determine Program Eligibility

Before investing time in applications, confirm basic eligibility:

For Medicaid programs, the care recipient typically must:

Meet income and asset limits for Medicaid (varies by state)
Require assistance with activities of daily living (bathing, dressing, eating, toileting, mobility, transferring)
Be at risk for nursing home placement without support

For VA programs, the veteran must:

Be enrolled in VA healthcare (for Veteran-Directed Care)
Have a serious injury incurred or aggravated during service (for PCAFC)
Need assistance with daily activities (for Aid and Attendance)

For the caregiver:

Be at least 18 years old
Pass a background check (most programs)
Not be the care recipient's spouse (in many states)
Be legally authorized to work in the United States

Step 2: Contact the Right Agency

For Medicaid programs:

Contact your state's Medicaid office or aging/disability services department
In many states, you can start at the Area Agency on Aging
Some states have dedicated websites for self-directed care enrollment

For VA programs:

Contact the VA Caregiver Support Line: 1-855-260-3274
Reach out to your local VA Medical Center's Caregiver Support Coordinator
Visit www.caregiver.va.gov for online applications

Step 3: Complete Required Assessments

Most programs require an assessment of the care recipient's needs:

Functional assessment: A nurse or case manager evaluates what daily activities the person needs help with.

Care planning: Based on the assessment, authorized hours are determined.

Home visit: Many programs require at least one in-person visit to verify the living situation and care needs.

Step 4: Complete Caregiver Requirements

Once the care recipient qualifies, you'll need to:

Background check: Expect criminal and abuse registry screening. Minor offenses don't always disqualify you, but felonies often do.

Training: Some programs require specific training hours before you can begin paid caregiving. Others offer optional training.

Employment paperwork: You'll typically work for a fiscal intermediary (a third-party employer) rather than being directly employed by your family member. You'll complete tax forms, direct deposit setup, and similar documentation.

Step 5: Begin Paid Caregiving

Once approved:

You'll receive authorization for specific hours
Submit timesheets documenting your work
Receive payment through direct deposit (usually biweekly)
Participate in periodic reassessments of care needs

Required Documentation

Gather these documents before starting:

For the care recipient:

Government-issued ID
Social Security card
Proof of income (tax returns, Social Security statements, pension documentation)
Asset documentation (bank statements, property deeds)
Medical records documenting conditions requiring care
Medicare and Medicaid cards (if applicable)
VA documentation (for veteran programs)

For the caregiver:

Government-issued ID
Social Security card
Proof of address
Employment authorization (if not a U.S. citizen)
Bank account information for direct deposit

Timeline Expectations

Be prepared for a wait:

Medicaid applications: 45-90 days for initial Medicaid eligibility determination. Additional weeks or months for self-directed care program enrollment.

VA PCAFC: 90+ days from application to approval is common. Can take longer.

Veteran-Directed Care: Generally faster than PCAFC—often 30-60 days once the veteran is enrolled in VA healthcare.

Tips to speed things up:

Submit complete applications with all documentation
Respond promptly to information requests
Follow up regularly (but politely) on application status
Ask about expedited processing if there's an urgent need

Frequently Asked Questions

Can I get paid to take care of my elderly parent?

Yes, in most states. Medicaid self-directed care programs allow adult children to be paid caregivers for their parents. The parent must qualify for Medicaid and meet functional requirements demonstrating they need assistance with daily activities. Spouse restrictions are common, but adult child restrictions are rare. Contact your state's Medicaid office or Area Agency on Aging to explore options.

Will getting paid as a caregiver affect my family member's benefits?

Caregiver payments through Medicaid programs don't count as income to the care recipient—the money goes directly to you as wages. However, any private pay arrangement could potentially affect their benefits if not structured carefully. Always consult with a benefits counselor before creating informal payment arrangements that involve transferring money between family members.

Do I have to pay taxes on caregiver income?

Usually, yes. Payments through Medicaid programs or VA stipends are considered taxable income in most cases. However, there's an important exception: if you live with the person you're caring for and they're on Medicaid, your wages may be excluded from federal and state income tax under IRS Notice 2014-7. Consult a tax professional to understand your specific situation.

Can I work another job while being a paid caregiver?

Yes, nothing prevents you from having additional employment. However, consider the practical limitations—you're committing to specific care hours, and your family member's needs don't follow a 9-to-5 schedule. Some caregivers work part-time jobs during hours when another family member can provide coverage. Others use respite care to create time for outside work.

What happens if my family member's needs increase after I'm already enrolled?

Programs typically allow for reassessment when care needs change. You'd request a new functional assessment, and if the evaluation shows increased needs, your authorized hours can be adjusted upward. Don't wait until you're overwhelmed—request reassessment as soon as you notice significant changes in your family member's condition.

Taking the Next Step

You've been doing this work—the real, exhausting, valuable work of caring for someone who needs you. Whether you pursue formal compensation or not, that work matters.

But if compensation could ease your financial stress, allow you to reduce outside work hours, or simply acknowledge the economic value of what you're providing—it's worth pursuing.

The application process takes time. Bureaucracy moves slowly. You'll probably face frustrations along the way.

Start anyway.

Contact your state's Medicaid office or the VA Caregiver Support Line this week. Request the applications. Begin gathering documents.

And while you're navigating this process, don't forget to take care of yourself, too. Caregiver burnout is real. Your body holds onto the stress of caring for others, whether you realize it or not.

Ready to get organized? Download our free checklist: "Essential Questions to Ask Aging Parents Before You Need the Answers." It covers finances, healthcare wishes, legal documents, and daily care preferences—everything you'll need whether you're applying for caregiver programs or simply planning ahead.

[Download Your Free Checklist →]

Last updated: January 2026. Program rates and eligibility requirements change frequently. Always verify current information with your state Medicaid office or the VA directly.

Last updated: February 2, 2026