Caring for a parent can be full time work. It can also be expensive. The good news: you may be able to get paid for some or all of that care. Whether you qualify depends on who your parent is, where you live, and which programs they can use. This guide lays out the main pathways and the steps you can take next.
Who might pay family caregivers?
- Medicaid programs in many states may allow a family member to be paid. These are often called self-directed or consumer-directed programs.
- The Department of Veterans Affairs (VA) offers several programs that can help veterans hire family caregivers or provide caregiver supports.
- Some long-term care insurance policies let a family member be paid.
- A few states and D.C. have paid family leave laws that can replace some lost wages while you care for a family member.
- Local Area Agencies on Aging (AAAs) and state caregiver support programs may offer reimbursements, respite, or other help.
Each option has rules and limits. Read on to learn how they work and what to check first.
Medicaid and “self-directed” care
Medicaid is run by each state. That means rules vary a lot. Many states offer home- and community-based services (HCBS) or Medicaid personal care programs that can pay for help with bathing, dressing, meal prep, and similar daily tasks.
Some of these programs include a “consumer-directed” or “self-directed” option. That lets the person who receives care choose their caregiver. In some states that caregiver can be a family member. In other states there may be limits. For example, programs sometimes exclude spouses or legal guardians. Some also limit payment when the caregiver lives in the same house.
If you want to explore this route:
- Contact your state Medicaid office and ask about self-directed care, personal care services, and HCBS waivers.
- Have your parent’s medical information ready. Many programs require a medical assessment and a written plan of care.
- Ask who can be hired, how much the pay rate is, and whether the caregiver will be treated as an employee for payroll and taxes.
Veterans benefits to pay or support caregivers
If your parent is a veteran, the VA has options that may help:
- Veteran-Directed Home and Community-Based Services (VD-HCBS) gives veterans a flexible budget. With this program, veterans can sometimes hire a family member to provide care.
- Respite care gives short-term relief to family caregivers so they can take a break while the veteran still gets covered care.
- Aid and Attendance is an added monthly payment (on top of a VA pension) for eligible veterans or survivors. This money can help pay for caregiver services.
To learn what’s available, contact the VA pension management center or a VA benefits counselor. Local veteran service organizations can also help you apply.
Paid family leave and long-term care insurance
Some states and D.C. have paid family leave programs that cover caring for a seriously ill family member. These programs are not the same everywhere. They differ in:
- Who is eligible
- How much pay you receive
- How long you can take leave
Check your state labor office to see if your state offers paid family leave and what the rules are.
If your parent has long-term care insurance, review the policy. Some policies include payments to “informal caregivers” (which can include family). Contact the insurer or agent and ask for written confirmation of benefits and any required paperwork.
Local and state caregiver support programs
Area Agencies on Aging (AAAs) and state caregiver programs offer help that might not be direct wages, but can still reduce your costs. They can help with:
- Care planning and counseling
- Referrals for services
- Respite care and adult day programs
- Meal delivery and other supportive services
- Reimbursement for certain caregiving expenses (in some state programs)
As an example, Pennsylvania’s Caregiver Support Program provides care management, education, respite, and financial reimbursement for caregiving-related expenses. Reimbursement levels there are based on the care recipient’s household income and a sliding scale tied to the federal poverty level. In that program, people at or below certain income levels can get a higher percentage of reimbursement, while higher incomes receive less or no reimbursement, though non-monetary services may still be available.
Check your local AAA directory or your state’s aging department website to find programs near you.
Practical next steps
- Make a clear list of the care tasks you do now and estimate hours per week. Include medication help, bathing, errands, and supervision.
- Check if your parent is eligible for Medicaid or already enrolled. If so, call your state Medicaid office and ask about self-directed options.
- If your parent is a veteran, contact the VA or a veterans’ service officer about VD-HCBS, respite, and Aid and Attendance.
- Call your local Area Agency on Aging. Ask about caregiver programs, respite, and any reimbursement options.
- Review any long-term care insurance policy and contact the insurer for written details.
- If you or your parent live in a state with paid family leave, check your state labor office for eligibility and filing steps.
- Before you accept payment, ask how you’ll be paid and whether you’ll be treated as an employee. Make sure you get program rules in writing.
If you can’t get paid
If none of the programs will pay a family caregiver in your situation, look for other supports:
- Respite services give you short breaks.
- Training and caregiver education can make care safer and less stressful.
- Local nonprofits, churches, and community groups sometimes offer help with meals, transportation, or companionship.
- Even small reimbursements for supplies can reduce your out-of-pocket costs.
Final thoughts
Getting paid to care for a parent is possible, but it depends on many rules. Start by checking Medicaid, the VA, long-term care insurance, paid family leave in your state, and your local Area Agency on Aging. Ask questions. Get answers in writing. If you need help, local agencies and veteran service organizations can often walk you through the steps.
If you’d like, we can help you find your local Area Agency on Aging or walk through questions to ask state agencies. You don’t have to figure this out alone.
