How to Get Paid to Care for a Loved One: A Step-by-Step Guide for Family Caregivers

09/11/2025

If you’ve stepped into the role of caregiving for a parent, spouse, or relative, you’re not alone—and you’re not unpaid by default. Many family caregivers are surprised to learn that they may be eligible to receive compensation through state Medicaid programs and other self-directed care options.

Getting started can feel overwhelming, so we’ve broken it down into clear, manageable steps. Whether you’re just beginning the process or looking to formalize the care you’re already providing, this guide will walk you through how to get paid to care for a loved one.

Step 1: Check Your Loved One’s Medicaid Eligibility

To qualify for caregiver compensation through most programs, the person receiving care (your loved one) must be enrolled in Medicaid—which is a needs-based health program.

What to check:

  • Income eligibility (varies by state)
  • Asset limits (homes and cars are often excluded)
  • Age and medical condition (many programs require that the individual needs help with activities of daily living like bathing, dressing, eating, etc.)

How to check eligibility:

  • Visit your state’s Medicaid website (or Medicaid.gov)
  • Use online pre-screening tools (many states offer them)
  • Contact your local Medicaid office or Area Agency on Aging

Tip: If your loved one isn’t currently enrolled, help them apply right away—approval is required before you can move forward with caregiver payment programs.

Step 2: Contact Your State Medicaid Office or Local Area Agency on Aging

Once Medicaid eligibility is confirmed (or in progress), your next stop should be the professionals who know your state’s caregiver support programs.

Who to contact:

  • Your state Medicaid office
  • Your regional Area Agency on Aging (AAA) – they often have care coordinators who can walk you through options.
  • Local disability or aging resource centers

Ask about:

  • Home and Community-Based Services (HCBS)
  • Medicaid Waiver programs
  • Consumer-directed or self-directed care options
  • Eligibility to become a paid caregiver as a family member

Note: Programs and names vary by state. 

Step 3: Apply for Home and Community-Based Services (HCBS)

Once your loved one is Medicaid-eligible, they can apply for services that support in-home care instead of institutional care (like nursing homes).

These are usually offered through HCBS waivers or personal care services programs.

What’s included:

  • Help with bathing, dressing, grooming, toileting
  • Meal prep, laundry, light housekeeping
  • Transportation or mobility support
  • Supervision and safety monitoring

The application process may include:

  • A functional needs assessment (to determine level of care needed)
  • Home visits or interviews
  • Physician documentation or referrals

Step 4: Request the Self-Directed Care Option

Most Medicaid-funded home care programs include a self-directed or consumer-directed care option. This means the care recipient (your loved one) can choose you or another trusted individual to be their caregiver—instead of hiring from an agency.

When requesting this option, be sure to:

  • Specifically ask for self-directed care or participant direction
  • Clarify whether family members can be paid—some states allow spouses, while others do not
  • Learn who the fiscal intermediary or financial management agency is (they handle payment)

Important: If you don’t request the self-directed option, your loved one may be assigned care through a third-party agency where you cannot be hired.

Step 5: Enroll as the Caregiver and Complete Required Forms

Once your loved one is approved for the program and elects you as their caregiver, you’ll go through a simple (but necessary) onboarding process.

Expect to:

  • Pass a background check (required in most states)
  • Fill out employment forms through the program’s fiscal intermediary
  • Complete any training or orientation (some states require basic training on caregiving and safety)

You will likely need:

  • A photo ID and proof of residency
  • A Social Security number (for tax purposes)
  • Bank info for direct deposit

Step 6: Begin Tracking Your Hours and Receiving Payment

Once fully enrolled, you can start providing care and logging hours.

Common practices:

  • You’ll use a timesheet system or electronic visit verification (EVV) system to check in/out
  • Submit hours weekly or biweekly
  • Receive payments via direct deposit or check

Pay rates vary by state and program, but typically range from $10 to $20+ per hour depending on:

  • Care intensity
  • State reimbursement rates
  • Available hours approved in the care plan

Becoming a paid caregiver for a family member through Medicaid isn’t always quick—but it is doable. With persistence and the right support, you can receive compensation for the vital care you’re already giving, and your loved one can remain safely at home with someone they trust. Let us help walk you through the process. Contact us today.