Yes — often through state Medicaid consumer-direction, VA caregiver programs, or other pathways. Amounts, who can be hired, and waitlists vary by state and program, so verify with the official program before you count on the income. This page is navigation and pre-screening only; program administrators decide eligibility and payment.
State-by-state consumer-directed details live on the wiki benefits directory and in interactive form at GiveCare Benefits. For the wider map of caregiver supports (not just pay), see What Benefits Can Family Caregivers Use?. If the person you care for is on Medicare and you need plan navigation, see So, what exactly is covered under all these Medicare plans?.
There are three main routes to getting paid as a family caregiver: Medicaid self-directed home care, veterans caregiver programs, and — in some states — paid family leave. None of them are automatic.
Medicaid self-directed home care (the most common path)
Self-directed Medicaid services give the person receiving care decision-making authority to recruit, hire, train, and dismiss their own workers, instead of using an agency. That "employer authority" is what allows a specific relative to be put on payroll. States offer self-direction through several authorities, including 1915(c) waivers, 1915(i) and 1915(j) state plan options, 1915(k) Community First Choice, and 1115 demonstrations.
In a 2025 survey of states, every responding state paid family caregivers through one or more Medicaid home-care programs, and among states that authorize self-direction, all let the enrollee select, train, and dismiss their caregiver. Coverage is not unlimited, though: waiver programs are often restricted to specific groups and can have waiting lists, so availability varies widely.
The practical first step is to confirm the care recipient has Medicaid (or check eligibility) and then ask the state Medicaid office or local Area Agency on Aging which self-directed or consumer-directed program is available.
Can a spouse or a parent be paid?
This is where rules diverge most. Whether a spouse — or a parent of a minor child — can be paid is a state option. Some Medicaid programs allow paying these "legally responsible" relatives; many do not. Non-spouse relatives and friends can be the paid worker in most states' self-directed programs. Because this varies so much, contact your state Medicaid office and ask specifically about your relationship.
Veterans: the VA caregiver stipend
If the person you care for is a veteran, check the VA Program of Comprehensive Assistance for Family Caregivers (PCAFC). Eligible primary family caregivers can receive a monthly stipend. The VA sets its own requirements — for example, the veteran generally needs a qualifying disability rating, enrollment in VA health care, and a need for at least six months of continuous in-person personal care, and the caregiver must be at least 18 and a family member or someone who lives with the veteran. The veteran and caregiver apply together, and the VA determines the stipend based on the veteran's assessed care needs.
Paid family leave and other routes
"Getting paid" can also mean income while you take time off work. Some states have paid family leave programs that can pay you while you care for a seriously ill family member; what you get and how long you can take off varies by state. The federal Family and Medical Leave Act (FMLA) provides job-protected leave for eligible workers, but that leave is unpaid. Outside government programs, some long-term care insurance policies allow a family member to be paid — ask the insurer for written confirmation.
What to check before you apply
Before spending hours on forms, write down:
- Your state and county
- Whether the care recipient has Medicaid, Medicare, VA, or private insurance
- The care recipient's age, condition, and level of care need
- Your relationship to the person, and whether you live together
- Whether the care recipient is a veteran
Then confirm the details with the official program. Pay rates, who can be hired, and waiting lists change and vary by state, and the payment decision belongs to the program administrator — not to any general guide.
Common mistakes
- Assuming respite care is the same as getting paid to be a caregiver — see What Help Can I Get as a Caregiver? for the broader help map
- Expecting one national pay rate or one form that works in every state
- Skipping the care recipient's Medicaid or VA status before hunting for "caregiver jobs"
- Counting on income before the program confirms who can be hired and whether there is a waitlist
- Ignoring the wider benefits map when pay is not available yet — start at What Benefits Can Family Caregivers Use?
Where GiveCare can help
GiveCare can help you see which categories to check and prepare before you contact a program. It does not decide eligibility or guarantee payment.
Sources to verify
- Medicaid: Self-Directed Services
- KFF: Medicaid's Home Care Support for Family Caregivers in 2025
- USAGov: Get paid as a caregiver for a family member
- VA: Comprehensive Assistance for Family Caregivers (PCAFC)
- U.S. Department of Labor: FMLA
Common questions
Can a family caregiver get paid in my state?
Often, yes. The most common route is a Medicaid self-directed (consumer-directed) home-care program, which in most states lets the person receiving care hire and pay a family member for personal care. Veterans programs and state paid family leave are other routes. Rules, pay, and availability vary by state, program, and your relationship, so verify with the program administrator.
Can I get paid to care for my spouse or my parent?
Sometimes. Whether a spouse, or a parent of a minor, can be paid is a state-by-state choice — some Medicaid programs allow paying these legally responsible relatives and many do not. Contact your state Medicaid office to check the rule where you live.
How do I get paid to care for a veteran?
Check the VA Program of Comprehensive Assistance for Family Caregivers (PCAFC). Eligible primary family caregivers of qualifying veterans can receive a monthly stipend. The veteran and caregiver apply together and must meet the VA's eligibility requirements.
Is the amount and eligibility the same everywhere?
No. Medicaid home-care pay, who can be hired, and whether there is a waiting list are set at the state and program level. Always confirm current rules and pay with the official program before you count on the income.