How to Get Paid to Care for a Family Member in Pennsylvania

If someone you love needs daily help — getting dressed, bathing, eating, managing medications, or simply getting through the day safely — you may already be providing that care. What many Pennsylvania families don’t realize is that Medicaid-funded programs can actually pay you to keep doing what you’re already doing.

Pennsylvania offers several waiver programs that allow eligible family members to become paid caregivers for their relatives. Through models like Community HealthChoices and the Agency with Choice program, thousands of Pennsylvania families are receiving compensation for the care they provide at home — and you could be one of them.

This guide walks you through every program, every eligibility requirement, and every step of the application process.

How Pennsylvania Pays Family Members to Provide Home Care

Pennsylvania’s Medicaid long-term care system is built around a simple idea: most people would rather receive care at home than in a nursing facility, and family members are often the best people to provide that care. Several Medicaid waiver programs make this possible by allowing participants to choose their own caregivers — including relatives.

The primary vehicle for this is Participant-Directed Services (PDS), a care model where the person receiving services (the “participant”) has the power to select, hire, and manage their own caregiver. When a family member is chosen, they become an employee through a structure called Agency with Choice (AWC), which handles payroll, taxes, and workers’ compensation.

Here’s an important distinction: the family member doesn’t just volunteer and receive a stipend. They are employed. They receive a paycheck, have taxes withheld, earn workers’ compensation coverage, and in many cases can access benefits. This is a real job — one that happens to be caring for someone you love.

Programs That Allow Paid Family Caregiving in PA

Community HealthChoices (CHC)

Community HealthChoices is Pennsylvania’s Medicaid managed care program for people who need long-term services and supports. It replaced the older fee-for-service waiver system and is now the primary pathway for most home care services in the state.

Under CHC, participants who qualify for home and community-based services can opt into Participant-Directed Services. This means they choose who provides their care. If they choose a family member, that person is hired through the Agency with Choice model.

CHC covers the following services through PDS: Personal care and assistance with activities of daily living (bathing, dressing, toileting, eating, mobility), homemaker services such as light housekeeping and meal preparation, companion services, respite care, and community integration support.

Who manages CHC in your area? In the Southeast Zone — which includes Philadelphia, Bucks, Chester, Delaware, and Montgomery counties — three Managed Care Organizations (MCOs) administer the program: AmeriHealth Caritas, Keystone First Community HealthChoices, and PA Health & Wellness. Your MCO is your primary point of contact for service authorizations and care coordination.

OBRA Waiver

The OBRA (Omnibus Budget Reconciliation Act) Waiver serves individuals with physical disabilities who need long-term care services. It uses the same Participant-Directed Services model as CHC, allowing family members to serve as paid caregivers.

The OBRA Waiver is particularly relevant for younger adults (under 60) with physical disabilities who want to remain in their homes and communities. If your family member has a physical disability and qualifies for nursing-facility-level care, this waiver may be an option.

COMMCARE Waiver

The COMMCARE (Community Care) Waiver is designed for individuals who require nursing-facility-level care but choose to receive services at home. Like CHC and OBRA, COMMCARE supports Participant-Directed Services, meaning family caregivers can be hired and paid.

This waiver is often the right fit for families considering nursing home placement but wanting to explore home-based alternatives first. The services available are comprehensive and can include personal care, home modifications, assistive technology, and skilled nursing supervision alongside the family caregiver’s daily support.

Attendant Care Waiver

The Attendant Care Waiver gives participants the ability to self-direct their attendant care services. Participants hire, train, schedule, and supervise their own attendants — which can include qualifying family members.

This waiver is well-suited for individuals who want maximum control over their care, including choosing the specific hours, tasks, and people involved.

Independence Waiver

Administered by Pennsylvania’s Office of Developmental Programs (ODP), the Independence Waiver serves individuals with intellectual disabilities. Family members can serve as paid attendants under this waiver’s participant-directed options.

Who Is Eligible?

Eligibility has two sides — the person receiving care and the family member who wants to provide it.

For the Person Receiving Care

Your loved one may qualify for paid home care services if they meet these general criteria. They must be a Pennsylvania resident. They must be enrolled in or eligible for Medical Assistance (Medicaid). They must require a nursing-facility level of care, as determined through a functional eligibility assessment. And they must be able to live safely in a home or community setting with appropriate supports.

The functional eligibility assessment evaluates your loved one’s ability to perform activities of daily living (ADLs) like bathing, dressing, eating, and mobility, as well as instrumental activities of daily living (IADLs) like managing medications, preparing meals, and using transportation. The assessment is conducted by the appropriate agency — for CHC participants in the Southeast Zone, this is often coordinated through the MCO or the local Area Agency on Aging.

Financial eligibility is also required. For most programs, the individual’s countable monthly income must fall within Medicaid limits. Pennsylvania has expanded Medicaid eligibility, and some programs allow for spend-down provisions or special income trusts.

For the Family Member Providing Care

Not every family relationship qualifies. Here are the general rules across Pennsylvania’s waiver programs.

Eligible family caregivers typically include adult children, parents of adult children, siblings, grandchildren, grandparents, aunts, uncles, nieces, nephews, and cousins. Spouses are generally not eligible to be paid caregivers under most Pennsylvania Medicaid waiver programs. Legal guardians of minor children are also typically excluded from being paid as that child’s caregiver.

The family member must also meet basic employment requirements: they must pass a criminal background check (including Pennsylvania State Police, FBI fingerprinting, and ChildLine clearances), they must be at least 18 years old, they must be legally authorized to work in the United States, and they must be physically and mentally capable of providing the required care.

How Much Do Paid Family Caregivers Earn in PA?

Pay rates for family caregivers in Pennsylvania vary depending on the specific waiver program, the MCO, and the services authorized. As a general framework, hourly rates for personal care attendants through Participant-Directed Services typically range from approximately $13.50 to $18.00 per hour, though rates can vary and are subject to change based on state budget decisions and MCO contracts.

The number of authorized hours depends entirely on your loved one’s care plan. Some participants may be approved for 20 hours per week; others with more intensive needs might receive 40 or more. The care plan is developed collaboratively with the participant, the family caregiver, the service coordinator, and the MCO.

It’s worth noting that paid family caregivers are typically W-2 employees through the Agency with Choice or Financial Management Service. This means taxes are withheld, and the caregiver may be eligible for employment protections and benefits depending on the arrangement.

How to Apply: Step-by-Step

Step 1: Determine Medicaid Eligibility

If your loved one is not already enrolled in Medical Assistance (Medicaid), the first step is applying. In Pennsylvania, you apply through COMPASS — the Commonwealth of Pennsylvania Application for Social Services. Visit compass.state.pa.us to create an account and submit an application online, or call your local County Assistance Office for help.

Step 2: Request a Functional Eligibility Assessment

Contact your local Area Agency on Aging (AAA) or, if your loved one is already enrolled in a CHC plan, contact their MCO directly. In Philadelphia, the Philadelphia Corporation for Aging (PCA) is the designated AAA. Call PCA at (215) 765-9040 or visit pcaCares.org.

Step 3: Enroll in Community HealthChoices (or Applicable Waiver)

If your loved one is found functionally eligible, they will be enrolled in Community HealthChoices (if not already) and given the option to choose a Managed Care Organization. In the Philadelphia area, the options are AmeriHealth Caritas, Keystone First CHC, or PA Health & Wellness.

Step 4: Choose Participant-Directed Services

During care planning, your loved one (or their representative) should request Participant-Directed Services and indicate that they want to select their own caregiver. This is the moment to name the family member who will provide care.

Step 5: Complete the Agency with Choice Process

The family member chosen as caregiver will need to complete the onboarding process through the Agency with Choice or Financial Management Service. This includes background checks and clearances, completing employment paperwork (I-9, W-4, direct deposit), and any required orientation or training modules.

Step 6: Begin Providing Care and Receiving Payment

Once the family member is cleared and the care plan is finalized, services begin. The caregiver logs their hours according to the program’s requirements, and payment is issued through the FMS — typically on a biweekly basis via direct deposit.

Common Questions Philadelphia Families Ask

Can I get paid to care for my parent who lives with me?
Yes, in most cases. As long as the care recipient qualifies for Medicaid-funded home care services and the family member meets the caregiver requirements, living in the same household does not disqualify you.

What if my family member doesn’t speak English well?
Pennsylvania’s Medicaid programs are required to provide language access services. Applications, assessments, and service coordination should be available in your preferred language. CareChoice works with families across Philadelphia’s diverse communities and can help navigate language barriers.

How long does the application process take?
The timeline varies, but families should generally plan for four to eight weeks from initial application to receiving the first paycheck. Delays can occur with background check processing or Medicaid eligibility determination.

Can I keep my other job while being a paid family caregiver?
In many cases, yes. The caregiving hours are flexible and determined by the care plan. Many family caregivers work part-time outside the home while providing authorized care hours. However, you cannot bill for care hours at the same time you are working another job.

What if my loved one’s needs change over time?
Care plans are reassessed regularly, and the number of authorized hours can be adjusted as needs change. If your loved one’s condition worsens, contact the service coordinator or MCO to request a reassessment.

How CareChoice Helps Your Family

Navigating Pennsylvania’s Medicaid waiver system can feel overwhelming. The acronyms alone — CHC, PDS, AWC, MCO, OLTL — are enough to make anyone’s head spin. That’s where CareChoice comes in.

CareChoice is a home care agency that specializes in helping Philadelphia-area families access the paid caregiving programs they’re entitled to. Whether you need help with the initial Medicaid application, understanding which waiver program fits your situation, completing the Agency with Choice enrollment, or managing the ongoing requirements of being a paid caregiver, CareChoice’s team walks you through every step.

We’ve helped thousands of families across Philadelphia, Bucks, Chester, Delaware, and Montgomery counties connect with the care their loved ones need — and get compensated for the care they’re already providing.

Ready to find out if your family qualifies? Contact CareChoice today →

This guide was last updated in 2026. Medicaid program details, pay rates, and eligibility criteria are subject to change. Contact CareChoice or your local Area Agency on Aging for the most current information.

How to Get Paid to Care for a Family Member in Pennsylvania — The Complete 2026 Guide