Planning & documents
Can family caregivers get paid?
Sometimes, yes. The most common routes are Medicaid self-directed services, VA caregiver programs for eligible Veterans, and (sometimes) private long‑term care insurance. Medicare usually does not pay for ongoing custodial care.
Quick checklist
- Start by identifying coverage: Medicaid, VA benefits, long‑term care insurance, or other.
- If Medicaid is involved: ask the state Medicaid office about “self-directed” or “consumer-directed” personal care services (often HCBS).
- Confirm whether a family member can be the paid caregiver (rules vary by state and by relationship).
- If the person is a Veteran: contact VA Caregiver Support and ask about PCAFC eligibility and stipend rules.
- If there’s a long‑term care insurance policy: call the insurer and ask if family caregivers are reimbursable and what documentation is required.
- Get key details in writing when possible (eligibility, hours, pay rate, taxes, training, time sheets).
Phone scripts (copy/paste)
Keep it short. You’re trying to get routed to the right program and confirm eligibility rules.
Medicaid (state office / caseworker)
“I’m caring for a family member at home. Do you have a self-directed or consumer-directed personal care program where the person can choose their caregiver?”
Ask:
- What’s the program name and who administers it?
- Can a family member be paid? Any restrictions by relationship?
- How many hours are authorized and what’s the pay rate?
- What paperwork/training/timesheets are required?
VA (if the person is a Veteran)
“We’re caring for a Veteran. Can you connect me to the Caregiver Support Program and explain whether PCAFC applies and what the next steps are?”
Ask:
- What eligibility requirements apply in our case?
- What documentation is needed for the application?
- What supports are available besides a stipend?
Long-term care insurance (if there’s a policy)
“Does this policy reimburse family caregivers or require a licensed agency? If family caregiving is allowed, what documentation do you need?”
Ask:
- Is family caregiver pay covered? Any limits?
- Do we need a care plan, nurse assessment, or pre-approval?
- How do we submit timesheets/receipts and how fast is reimbursement?
Good practice: Write down the person’s name/extension, date/time, and the program name.
If possible, request the rules in writing (email or official webpage link).
Reputable links
- USA.gov: Get paid as a caregiver for a family member
- Medicaid.gov: Self-Directed Services (overview)
- Medicaid.gov: Self-directed personal assistant services (1915(j))
- VA: Comprehensive Assistance for Family Caregivers (PCAFC)
- VA Caregiver Support Program
- Medicare: Long-term care coverage (what Medicare doesn’t cover)
- CMS: Items & services not covered under Medicare (custodial care)
Tip
Payment rules vary by state and program. When possible, confirm details in writing.