How to get paid to care for a family member: Medicaid self-directed care, home care agencies and the VA

How to get paid to care for a family member in 2026: Medicaid self-directed care, home care agencies that employ family caregivers, the VA's caregiver stipend and Veteran-Directed Care, what each asks of you and of the person you care for, and how the work can become a caregiving career.

Many people already do the work of a caregiver for a parent, a spouse, a child or another relative, unpaid. In the United States there are a few real ways to be paid for it, and each depends less on you than on the person you care for: the program they qualify for, and the rules of the state they live in. This guide sets out each way from the agencies' own words, and every caregiver figure in it opens the live list it comes from on CareJobs.Now, where 36,205 caregiver and home health aide jobs are open today, each read from the employer's own job board.

Contents

1. The short answer
2. Medicaid self-directed care
3. Through a home care agency
4. If the person you care for is a veteran
5. What the work asks of you
6. From family caregiver to a caregiving career
7. What to ask
8. A checklist

1. The short answer

There are three main ways, and the first question for each is about the person you care for, not about you:

• Medicaid self-directed care. If your relative gets home care through Medicaid, many states let them choose and employ their own caregiver, and some let that caregiver be a family member.
• A home care agency that employs family caregivers. Some agencies hire a family member to care for their own relative, paid through the relative's program, and train them.
• The VA, for a veteran. The VA pays a monthly stipend to the primary family caregiver of a veteran who qualifies, and its Veteran-Directed Care program lets a veteran hire their own workers, family included.

Each needs the person you care for to qualify first. None is a job you can apply for on your own; each starts with their eligibility.

2. Medicaid self-directed care

Medicaid calls it self-direction. In its own words, self-direction "promotes personal choice and control over the delivery of waiver and state plan services", and participants can "recruit, hire, train and supervise the individuals who furnish their services". States offer it under several parts of the Social Security Act: home and community-based services waivers (section 1915(c)), the state plan option (1915(i)), the self-directed personal assistance option (1915(j)) and Community First Choice (1915(k)).

Whether that worker can be you is the state's choice. The federal rule for the self-directed personal assistance option says: "States have the option to permit participants, or their representatives, if applicable, to hire any individual capable of providing the assigned tasks, including legally liable relatives, as paid providers" (42 CFR 441.478(a)). A legally liable relative is someone state law obliges to care for the person, such as the parent of a minor child, and in many states a spouse. So in some states a spouse or a parent can be paid, in others only other relatives, and the programs carry different names from one state to the next (consumer-directed, participant-directed or self-directed care).

The step to take: ask your relative's Medicaid case manager, or the state Medicaid agency, whether their program offers self-direction and whether a family member of your relationship can be the paid caregiver. The state sets the hours it approves and the pay rate.

3. Through a home care agency

Some home care agencies employ family members to care for their own relative, paid through the relative's Medicaid program, and their postings say so in plain words, for example "Get Paid to Care for Your Family Member" or "Already caring for a family member? We can get you paid through Medicaid for that too". The agency handles the payroll and the paperwork, and usually trains you.

You can find such an agency among the caregiver jobs and home health aide jobs open today: read the posting for a family caregiver program, or call the agencies near your relative and ask whether they employ family caregivers in your state. The caregiver job statistics show what caregiver postings state about pay, schedules and training.

4. If the person you care for is a veteran

The Program of Comprehensive Assistance for Family Caregivers (PCAFC). The VA pays "a monthly stipend" to an eligible primary family caregiver, paid directly to the caregiver by direct deposit, and offers health coverage through CHAMPVA to one who has none. By the VA's own page, the veteran must have a VA disability rating of 70% or higher, have been discharged (or have a date of medical discharge), need at least 6 months of continuous, in-person personal care, and be enrolled in VA health care. The caregiver must be at least 18 and either a spouse, son, daughter, parent, stepfamily or extended family member, or live full time with the veteran (or be willing to). A veteran can name one primary family caregiver and up to two secondary family caregivers.

Family caregivers of veterans who do not qualify can still get support (training, counseling and other help, but no stipend) through the VA's Program of General Caregiver Support Services.

Veteran-Directed Care. Here the veteran gets a budget for services and, with a counselor's help, hires their own workers, which, in the VA's words, "might include their own family member or neighbor". The veteran must be enrolled in VA health care, be eligible for community care and meet the program's clinical criteria, and the program is not offered everywhere. The veteran's VA social worker or caregiver support team can say whether it is available where the veteran lives.

5. What the work asks of you

Once you are paid, you are a caregiver like any other, and the program or agency sets the rules. Expect a background check, often a tuberculosis test, and in some states training before you start: our home health aide certification by state page gives each state's own rule and the training hours it states. The pay is the program's or the agency's rate for the hours approved for your relative, not for every hour you spend with them, and the approved hours are often fewer than the care a family gives.

Keep a record of the hours and tasks you are paid for, as the program asks: self-directed programs and agencies both review them.

6. From family caregiver to a caregiving career

Caring for a relative is real experience, and many employers count it. Some caregiver postings say so in words like "caring for a loved one counts" or "professional or familial" experience, and many home care employers hire people with no paid experience and train them ( caregiver jobs that need no experience). If you want to keep caregiving after your relative no longer needs you, or beside the hours your program approves, our how to become a caregiver guide takes the steps in order, and the caregiver pay page shows what open caregiver jobs post by state and by employer.

7. What to ask

• Does my relative's Medicaid program offer self-direction, and can a family member of my relationship be the paid caregiver in this state?
• How many hours a week will the program approve, and at what rate?
• Is there an agency near my relative that employs family caregivers?
• What training, checks and paperwork are required before I am paid?
• For a veteran: does the veteran meet the PCAFC requirements, and is Veteran-Directed Care offered where they live?

8. A checklist

1. Find out which programs your relative is enrolled in or eligible for (Medicaid home care, VA health care).
2. Ask the Medicaid case manager or the state Medicaid agency about self-direction and family caregivers.
3. Ask home care agencies near your relative whether they employ family caregivers: caregiver jobs open today.
4. For a veteran, ask the VA caregiver support team about the PCAFC stipend and Veteran-Directed Care.
5. Check your state's training rule: home health aide certification by state.
6. Keep a record of your paid hours and tasks from the first day.