National Family Caregivers Month: Can a Family Caregiver Get Paid? Programs Worth Asking About

October 28, 2026

An older woman and a younger woman preparing a salad together in a home kitchen

✔ Backed by: Caregiver Action Network · KFF · Medicaid.gov · U.S. Department of Veterans Affairs · Administration for Community Living. Each fact links to its source, and the full list is at the bottom of this post.

November is National Family Caregivers Month. The 2026 theme from the Caregiver Action Network is “Care Connects Us.”[1] It is a good time to talk about something many caregivers wonder about but feel awkward asking: can I get paid for this?

Maybe you cut back your hours to help your dad after his stroke. Maybe you drive your aunt to dialysis three times a week and help her bathe at night. The love is real. So are the lost wages, the gas money, and the missed shifts. The good news is that some public programs can pay family members who give care. The honest news is that the rules are different in every state and every program, and there is often a waitlist or an approval process. This post walks you through the main paths so you know what to ask about.

Path one: Medicaid home and community-based services

Medicaid is the biggest source of paid help at home for people who need daily support. Many states run programs called home and community-based services, often shortened to HCBS. These programs help people get care at home instead of in a nursing home.

A national survey of state Medicaid programs, published by KFF in January 2026, found that every state that responded pays family caregivers in at least some situations.[2] That does not mean every family qualifies. The person getting care usually has to be enrolled in Medicaid and meet the state’s rules for needing a certain level of help. The program they are in also has to allow family members to be paid.

Here is a detail that surprises a lot of people. Spouses and parents of minor children are called “legally responsible relatives.” Under regular Medicaid personal care, federal law does not allow paying them. But under many waiver programs, states can pay them when the care goes beyond what a spouse or parent would normally do. The KFF survey found 44 states allow this through at least one waiver.[2] So if you are caring for your husband or wife, do not assume the answer is no. Ask.

What “self-directed” care means

You will often hear the words “self-directed” or “consumer-directed.” In self-directed Medicaid services, the person getting care, or their representative, gets to make decisions about their own services. That can include hiring, training, and supervising the workers who help them. In some programs it also includes deciding how the Medicaid budget is spent.[3]

This matters because self-direction is often the door that lets a family member become the paid worker. The KFF survey found that nearly every state that responded lets enrollees self-direct home care in at least some cases.[2] If your loved one picks you, you usually go through hiring paperwork, a background check, and sometimes training, just like any home care worker.

Some states also offer something called structured family caregiving, where a family member who lives with the person is paid a daily rate. KFF found 11 states offering this model.[2]

You can say: “My mom is on Medicaid and needs help with bathing, dressing, and meals. Does our state have a home care program where she can choose a family member as her paid caregiver?”

Path two: VA support for caregivers of veterans

If the person you care for is a veteran, the U.S. Department of Veterans Affairs has two programs worth knowing.

The first is the Program of Comprehensive Assistance for Family Caregivers. To qualify, the veteran generally needs a VA disability rating of 70% or higher, must be enrolled in VA health care, and must need at least six months of continuous, in-person personal care. The caregiver must be at least 18 and be a family member or live full time with the veteran. The primary family caregiver may receive a monthly stipend, health coverage through CHAMPVA if they do not already have other coverage, at least 30 days of respite care a year, and other support. The veteran and caregiver apply together using VA Form 10-10CG.[4]

The second is Veteran-Directed Care. It gives eligible veterans a flexible budget for help at home, and they can hire their own aides. That can include a family member or a neighbor. It is only offered in some locations, so the VA says to talk with your VA social worker to find out if it is available near you.[5]

If you are not sure where to start, the VA Caregiver Support Line is 855-260-3274.[6]

Path three: help that is not a paycheck but still saves money

Even if you cannot be paid, there may be help that eases the load. The KFF survey found that every responding state covers some kind of respite care through Medicaid, and many cover caregiver training or counseling.[2] Respite means someone else steps in for a few hours or days so you can rest, work, or handle your own health.

The Eldercare Locator, a public service of the Administration for Community Living, connects older adults and their families to local services. You can call or text 1-800-677-1116, or search by location online.[7]

Questions to ask before you apply

Bring these questions to your Medicaid office, your Area Agency on Aging, or a VA social worker. Write down the name of the person you talk with and the date.

Which programs in our state let a family member be the paid caregiver?
Is there a waitlist, and how do we get on it?
Can a spouse be paid in this program?
What training, background check, or paperwork will the caregiver need?
How many hours of care will be approved, and who decides?
If we cannot get paid care, what respite or support is available?

Tru-Tips: Keep a simple care log for two weeks before you call. Write down each task you do and about how long it takes, like “help with shower, 30 minutes” or “drive to dialysis, 2 hours.” When an assessor asks how much help your loved one needs, you will have real answers instead of guesses.

A quick word about expectations. Getting approved can take time, and pay rates and hours vary widely. Nothing here is a promise that you will qualify. But many caregivers never ask at all, and that is the one way to be sure the answer is no.

One Tru Step: Today, make one call. If your loved one is on Medicaid, call the number on their Medicaid card and ask about home care programs that allow a family caregiver. If they are a veteran, call the VA Caregiver Support Line. If neither, call the Eldercare Locator.

Let’s talk

Have you looked into being paid as a family caregiver? What helped, and what got in the way? If you found a program that made a difference, share it in the comments so another caregiver can find it too.

Sources and further reading

Sources checked October 28, 2026. General education; individual care and coverage questions require an appropriate professional.

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