Medicaid Programs for Caregivers

Medicaid programs help family members get paid for providing care to loved ones who need daily support. These programs allow people with disabilities, chronic illnesses, or age-related needs to receive care at home instead of moving into a nursing home. For caregivers, Medicaid offers financial help, training, and access to health services.

This guide explains how Medicaid programs for caregivers work, who qualifies, and how each state supports family caregivers through waivers, allowances, and home care options.

Understanding Medicaid’s Role in Caregiver Support

Medicaid is a joint federal and state health insurance program. It helps people with limited income and assets access essential care. Many states use Medicaid to fund home and community-based services (HCBS). These services allow people to live at home while getting personal care, help with meals, and assistance with daily activities.

Medicaid recognizes that family members often provide this care. Through specific programs and waivers, states can use Medicaid funding to pay relatives who serve as caregivers. These programs vary by state but share the same goal: support aging in place and reduce the need for nursing home care.

Types of Medicaid Programs That Pay Family Caregivers

There are three main ways Medicaid supports caregiver pay:

1. Home and Community-Based Services (HCBS) Waivers

HCBS waivers are the most common way family caregivers get paid. Each state designs its own waiver to help people remain in their homes. The care recipient must qualify for Medicaid and need a nursing-home level of care. Once approved, they can choose a family member or friend as their paid caregiver.

Waivers often cover:

• Personal care assistance

• Meal preparation

• Housekeeping

• Transportation

• Respite care

• Help with activities of daily living (bathing, dressing, grooming)

Every waiver has its own rules. Some allow spouses or legal guardians to be paid, while others exclude them.

2. Self-Directed Services Programs

Also called “consumer-directed” or “participant-directed” care, these programs let the care recipient decide who provides their care. Medicaid gives the person a care budget, and they can hire a relative or friend as their caregiver.

This model gives flexibility and control to the care recipient. It also helps caregivers receive wages directly, similar to an employee. Some states manage these payments through a fiscal intermediary who handles taxes and payroll paperwork.

3. Community First Choice (CFC) Program

Community First Choice is a federal option available to states under Medicaid. It allows states to provide personal care services to people who would otherwise need institutional care. Under CFC, the person receiving care can hire and supervise their own caregiver, including a family member.

CFC programs are active in states such as California, Oregon, and Texas.

Eligibility Requirements for Medicaid Caregiver Programs

Eligibility rules differ by state, but the general requirements include:

• The care recipient must qualify for Medicaid.

• They must need help with activities of daily living (ADLs) like eating, bathing, or mobility.

• The caregiver must meet background check and training requirements.

• The person receiving care must live at home, not in a nursing home or assisted living facility.

Each state also sets its own income and asset limits for Medicaid. For example, many states cap monthly income for an individual at around $2,829 in 2025, though this varies.

How to Apply for Medicaid Caregiver Programs

To apply, start with your state’s Medicaid office or Department of Social Services. The process usually includes:

• Application for Medicaid: The care recipient must apply for Medicaid coverage and meet financial and medical eligibility criteria.

• Assessment: A caseworker or nurse will assess the person’s daily care needs. This helps determine how many hours of care Medicaid will cover.

• Choosing a Program: The care recipient may choose between agency-directed or self-directed care options, depending on what the state offers.

• Selecting a Caregiver: The person receiving care can name a family member as their paid caregiver.

• Payment Setup: The state or a fiscal management service handles payroll, taxes, and direct deposits for caregiver pay.

States That Pay Family Caregivers Through Medicaid

Every state administers Medicaid differently, so caregiver pay programs vary. Here are examples of how states structure their support:

California

California operates through the In-Home Supportive Services (IHSS) program. Family members can be paid to care for loved ones who qualify for Medi-Cal (California’s Medicaid program). IHSS caregivers earn an hourly wage set by county standards.

New York

New York’s Consumer Directed Personal Assistance Program (CDPAP) lets Medicaid recipients hire, train, and pay family members for caregiving. Even spouses can qualify for pay.

Texas

Texas offers caregiver pay through the Community First Choice (CFC) program and STAR+PLUS Waiver. Both programs fund care at home for people with disabilities or chronic illnesses.

Florida

Florida’s Medicaid Managed Care Long-Term Care program provides personal care services. Family caregivers can be hired through managed care plans after meeting background and training requirements.

Illinois

Illinois operates the Home Services Program (HSP), which lets Medicaid recipients direct their own care and choose family members as paid caregivers.

Pennsylvania

Pennsylvania’s Community HealthChoices (CHC) program covers home-based services. Family caregivers can receive pay for helping with ADLs, meal prep, and mobility support.

What Caregivers Can Be Paid for Under Medicaid

Medicaid reimburses caregivers for services that help maintain the care recipient’s health and independence. These typically include:

• Personal care assistance: Bathing, dressing, toileting, and grooming

• Meal preparation: Cooking, feeding support, and diet management

• Medication reminders: Assisting with medication schedules

• Mobility help: Transferring, repositioning, and walking assistance

• Housekeeping: Cleaning, laundry, and household maintenance

• Transportation: Driving to doctor appointments or therapy

• Companionship: Providing social interaction and emotional support

• Respite care: Temporary relief for the primary caregiver

These services are covered under Medicaid’s personal care or attendant care categories.

Caregiver Pay Rates Through Medicaid

Pay rates depend on the state, the care recipient’s level of need, and the type of Medicaid program. Most states pay caregivers between $13 and $25 per hour in 2025.

For example:

• California IHSS averages around $17–$20/hour.

• New York CDPAP ranges from $16–$23/hour depending on county and managed care plan.

• Texas STAR+PLUS caregivers earn between $12–$18/hour.

In some states, caregivers may also earn overtime, receive health benefits, or qualify for paid sick leave.

Medicaid Waivers and Aging in Place

A key goal of Medicaid caregiver programs is to promote aging in place. Instead of sending seniors or people with disabilities to institutional care, Medicaid waivers support them at home.

This approach helps maintain family connection and reduces costs for the state. Nursing home care can exceed $100,000 per year, while home-based care under Medicaid costs a fraction of that.

For caregivers, these programs provide a legal and structured way to earn income for the essential work they already do.

Caregiver Responsibilities Under Medicaid

Caregivers paid through Medicaid must meet program rules and reporting standards. Responsibilities include:

• Completing required training or certification

• Logging hours accurately through timesheets or online portals

• Following care plans created by case managers

• Reporting health changes or incidents promptly

• Maintaining privacy and professional boundaries

Some programs may also require annual recertification to confirm that the care recipient still qualifies for Medicaid-funded services.

Other Benefits for Medicaid Caregivers

In addition to hourly pay, caregivers may qualify for:

• Respite care to prevent burnout

• Health insurance coverage under certain state programs

• Training and education in home care and safety

• Employee benefits such as paid time off in select states

• Tax credits for family caregivers under federal and state programs

Medicaid also partners with organizations such as the Family Caregiver Alliance and AARP to provide ongoing support, information, and financial guidance.

How Medicaid Helps Families Manage Care Costs

Medicaid caregiver programs reduce financial stress for families. Without these programs, many caregivers would need to leave employment to provide unpaid care. This can lead to lost income and benefits.

Through Medicaid:

• Caregivers can receive a stable wage.

• Families avoid expensive nursing home costs.

• The care recipient stays in a familiar home setting.

For low-income families, Medicaid serves as both a health insurance plan and a caregiver payment solution.

Common Challenges Caregivers Face in Medicaid Programs

While Medicaid provides vital support, challenges still exist:

• Complex applications: Many families struggle to understand eligibility rules.

• Limited funding: Some states have waiting lists for HCBS waivers.

• Paperwork: Tracking hours and complying with reporting requirements can be time-consuming.

• Uneven pay: Hourly rates vary widely between states and even counties.

• Policy changes: Medicaid rules may shift yearly, impacting pay and services.

To manage these issues, caregivers can work closely with case managers or local aging agencies to stay informed and compliant.

The Future of Medicaid Caregiver Programs

Across the U.S., states are expanding caregiver pay programs as demand for home care rises. The aging population and caregiver shortages have led to new investments in Medicaid funding.

Future policy trends include:

• Raising caregiver pay rates to match minimum wage increases.

• Expanding eligibility for spouses and legal guardians.

• Offering more training and employee benefits for caregivers.

• Improving technology for timesheets, care monitoring, and communication.

Programs like the Medicaid Waiver Modernization Act and HCBS Workforce Development initiatives are expected to make it easier for caregivers to access payment and support.

Final Thoughts

Medicaid programs for caregivers are essential for keeping families together and supporting independent living. They turn unpaid labor into sustainable employment while improving the quality of life for both the caregiver and the person receiving care.

By applying through your state’s Medicaid office, you can explore options to get paid for caregiving, receive training, and access vital resources. Each program helps ensure that care provided at home is recognized, compensated, and supported.

For more information about caregiver pay programs in your state, visit Paid.Care — a trusted resource that explains how to apply, qualify, and earn income as a family caregiver.

FAQs

• 1. Can family members get paid through Medicaid for caregiving?

  Yes. In many states, Medicaid allows family members to be paid caregivers through Home and Community-Based Services (HCBS) waivers or self-directed care programs. Depending on the state, Medicaid can pay parents, adult children, or other relatives to provide daily care for loved ones who qualify for assistance.

• 2. How much does Medicaid pay caregivers?

  Caregiver pay rates vary by state and program. Most Medicaid caregiver programs pay between $13 and $25 per hour. Factors such as county wage standards, hours approved, and the recipient’s level of need determine the final rate. Some programs also include overtime, paid leave, or other employee benefits.

• 3. Can a spouse be paid as a caregiver under Medicaid?

  Some states allow spouses to receive pay through Medicaid caregiver programs, while others restrict it. For example, New York’s CDPAP and Arizona’s Self-Directed Attendant Care programs pay spouses, but some states do not. It depends on the specific state’s waiver rules and Medicaid policies.

• 4. What are the eligibility requirements for Medicaid caregiver programs?

  To qualify, the person receiving care must meet Medicaid income and asset limits and require help with activities of daily living such as bathing, dressing, or mobility. The caregiver must pass a background check and meet any training requirements. The care recipient must live at home or in a community setting, not in a nursing home.

• 5. How do I apply for Medicaid caregiver pay in my state?

  Start by contacting your state Medicaid office or Department of Social Services. They can guide you through applying for Medicaid, completing a care needs assessment, and enrolling in a program that allows family caregiver pay. Some states also provide online applications through their Medicaid websites.