Discover which states pay family members to care for loved ones, how programs work, eligibility, payment methods, and practical advice for getting started.
When you care for a parent, spouse, or child with a disability or chronic illness, you’re doing essential work—work that often goes unpaid. But in some parts of the U.S., states that pay family caregivers, programs that provide financial compensation to relatives who provide in-home care. These aren’t charity cases—they’re structured programs, often funded through Medicaid waivers, designed to keep people out of nursing homes and in the comfort of their own homes. This is called home and community-based services, state-run programs that offer alternatives to institutional care. They let family members act as paid caregivers, giving them a paycheck while helping their loved ones stay safe and supported.
Not every state does this, and the rules vary wildly. In Medicaid waiver programs, flexible funding options that let states customize long-term care services, some states pay $15 an hour or more. Others give a flat monthly stipend—sometimes under $500. You can’t just sign up; you usually need to qualify based on the care recipient’s medical needs, income, and whether they’re enrolled in Medicaid. And yes, you have to be approved as a caregiver, sometimes with training or background checks. States like California, New York, and Pennsylvania have well-known programs. Others, like Mississippi or Alabama, have very limited options. The key isn’t just where you live—it’s whether the person you’re caring for meets the state’s criteria for needing long-term support.
These programs exist because institutional care is expensive. A nursing home can cost over $100,000 a year. Paying a family member $20,000 to stay home is a win for everyone: the person gets familiar care, the state saves money, and the caregiver gets some financial relief. But it’s not automatic. You have to dig for it. Call your state’s Medicaid office. Ask about consumer-directed care, a model where the person receiving care hires and manages their own caregiver. It’s often the gateway to getting paid as a family member. Some states let you hire your own child, spouse, or sibling. Others ban spouses from being paid. Some require you to quit your job first. There’s no national rule—just a patchwork of policies.
Below, you’ll find real guides and resources that explain how these programs work in practice—what paperwork you need, how to apply, and what to do if you’re turned down. These aren’t theoretical articles. They’re written by people who’ve been through the system, and they’ll help you cut through the confusion. If you’re caring for someone at home and wondering if you can get paid for it, this collection is your starting point.