Pennsylvania family caregiver pay
Last checked: May 18, 2026
Yes, some family caregivers can be paid in Pennsylvania. The main path is usually Medicaid long-term services and supports through Community HealthChoices, often called CHC.
CHC may allow some relatives to be paid for approved home care tasks. But Pennsylvania’s current CHC waiver rules do not pay a spouse, legal guardian, representative payee, or power of attorney for those services. Adult children, siblings, and other relatives may qualify if they meet worker rules and the care is approved in the care plan.
Quick answer
A family member may be paid in Pennsylvania if the person who needs care qualifies for the right program and the caregiver meets worker rules. The most common route is Community HealthChoices, Pennsylvania’s Medicaid long-term care program for many adults who need help at home.
Adult children, siblings, and other relatives may be able to work as paid caregivers through approved services. A spouse usually cannot be paid through CHC for personal assistance, respite, or participant-directed community supports. Veterans may also have VA routes, including Aid and Attendance, VA PCAFC, or Veteran Directed Care.
Start here
- Call the PA Independent Enrollment Broker at 1-877-550-4227 if the person may need Medicaid long-term services at home.
- Ask for a CHC long-term services and supports assessment. Say the person needs help with bathing, dressing, toileting, meals, transfers, memory, or safety.
- Ask about participant direction or Services My Way. Say you want to know whether a family member can be hired as the paid worker after the service plan is approved.
If the person is age 60 or older and may not qualify for Medicaid, call the local Area Agency on Aging and ask about the OPTIONS Program and the Caregiver Support Program.
Pennsylvania rules can change
Rules can change. Counties, managed care plans, waiver contractors, Area Agencies on Aging, and service coordinators may use different names for the same type of help. Always confirm the current rule with Pennsylvania DHS, the PA Independent Enrollment Broker, the CHC managed care plan, or the local Area Agency on Aging before you make work or money plans.
Main programs and where to start
| Program or route | Who it may help | Where to start |
|---|---|---|
| Community HealthChoices (CHC) | Adults who qualify for Medicaid long-term services and supports. This may include people age 21 or older who need nursing facility level of care at home. | Call the PA Independent Enrollment Broker at 1-877-550-4227. You can also apply through COMPASS or call 1-866-550-4355 for Medicaid. |
| Participant direction and Services My Way | People approved for certain home and community-based services who want more control over hiring workers. | Ask the CHC service coordinator, the managed care plan, or the Independent Enrollment Broker. |
| Pennsylvania Caregiver Support Program | Primary caregivers of certain older adults, people with Alzheimer’s disease or a related disorder, grandparents or older relatives raising children, and some older relatives caring for adults with disabilities. | Call the local Area Agency on Aging. This is usually reimbursement for approved costs, not an hourly paycheck. |
| OPTIONS Program | Pennsylvania residents age 60 or older with unmet needs that affect daily function. | Call the local Area Agency on Aging or the Pennsylvania Department of Aging. |
| LIFE, also called PACE in other states | People age 55 or older who meet nursing facility level of care, live in a LIFE service area, and can be safely served in the community. | Call the PA Independent Enrollment Broker or a local LIFE provider. |
| VA Aid and Attendance, VA PCAFC, and Veteran Directed Care | Veterans, surviving spouses, and family caregivers who meet VA rules. | Start with the VA health care team, VA caregiver support team, VA social worker, or an accredited veterans service officer. |
Main ways a family caregiver may be paid in Pennsylvania
1. Community HealthChoices Medicaid long-term care
In Pennsylvania, Medicaid is also called Medical Assistance. Community HealthChoices is the main Medicaid long-term services and supports program for many older adults and adults with physical disabilities.
CHC can cover help at home when the person meets medical and financial rules. The person may need help with daily tasks such as bathing, dressing, using the bathroom, eating, moving around the home, meals, safety, or other approved needs.
CHC services may include personal assistance services, respite, home delivered meals, home adaptations, service coordination, participant-directed community supports, and participant-directed goods and services. The exact services must be in the person’s approved service plan.
For family caregiver pay, the key issue is not just whether the person has Medicaid. The person must be approved for the right long-term services, and the family member must be allowed to work under the service plan.
2. Participant direction and Services My Way
Participant direction means the person receiving care can have more say in who provides the approved services. Pennsylvania also uses the name Services My Way for a self-directed option in long-term care.
Under participant direction, the person may be able to hire a worker instead of using only an agency worker. A fiscal employer agent helps with payroll and tax steps. The care plan still controls what tasks are covered and how many hours are approved.
This is the route to ask about if you are an adult child, sibling, or other relative who wants to become the paid worker. Ask the service coordinator which model is open to the person and what steps the family caregiver must complete.
3. Family members allowed under CHC
Pennsylvania’s current CHC waiver rules say family members can provide respite, personal assistance services, and participant-directed community supports if they meet the same worker standards as non-family workers.
But there are important exclusions. CHC will not pay for those services if they are provided by the participant’s spouse, legal guardian, representative payee, or power of attorney.
That means an adult child may be allowed in one case but not in another. For example, an adult child who is also the person’s power of attorney may be treated differently from an adult child who has no legal decision role. Ask the CHC plan before you assume.
Workers may need background checks, enrollment steps, training, timesheets, and approval before pay can start. Do not assume payment will be backdated for care you already gave.
4. Pennsylvania Caregiver Support Program
The Pennsylvania Caregiver Support Program is run through local Area Agencies on Aging. It can help caregivers with care management, benefits counseling, caregiver education, training, respite, and reimbursement for approved out-of-pocket caregiving costs.
This program is not the same as a regular paycheck for caring at home. It is often a reimbursement program. Covered costs may include respite, supplies, supportive services, home changes, and assistive devices when approved in the plan.
There is no financial eligibility rule to enter the program. But the reimbursement percentage is based on the care receiver’s gross income and household size. People over the income cap may still get care management and other non-reimbursement help.
A key limit matters: Pennsylvania says a caregiver or care receiver is not eligible for this program if enrolled in Medicaid long-term services and supports through Community HealthChoices or LIFE.
5. OPTIONS Program
The OPTIONS Program helps Pennsylvania residents age 60 or older stay in their home. It can include care management, adult day services, personal care services, in-home meals, home support, medical equipment, home changes, and other supports when available.
OPTIONS does not have an income requirement to take part. But a person may have to pay part of the cost on a sliding co-payment scale.
OPTIONS should not be treated as a sure family paycheck route. It may still lower costs or bring in services that give the caregiver relief. Ask the local Area Agency on Aging whether any service can be self-directed or whether only approved providers are used in that county.
6. LIFE for people age 55 or older
LIFE is Pennsylvania’s name for the Program of All-Inclusive Care for the Elderly. It provides medical and support services for people who meet the rules and live in a service area.
LIFE can cover in-home support, personal care, adult day health, meals, transportation, nursing, primary care, therapy, drugs, and other services. It is not usually the first route for paying a family member directly. But it may reduce care costs and fill gaps.
Ask the PA Independent Enrollment Broker whether LIFE is open where the person lives and how it compares with CHC for the person’s needs.
7. Structured family caregiving or adult foster care models
Some states have a Medicaid structured family caregiving stipend model. I did not find a current statewide Pennsylvania Medicaid page showing that CHC uses a separate structured family caregiving stipend for family members.
Pennsylvania and some counties may use terms such as domiciliary care or adult foster care for people who live in another person’s home and receive support there. That is not the same as paying a spouse or adult child to care for someone in the person’s own home.
Ask the local Area Agency on Aging if any adult foster care or domiciliary care option exists in your county. Ask what living arrangement is required and whether relatives can be providers.
Need a broader overview?
For a national guide, see Can I Get Paid to Be a Caregiver?. For a quick screening tool, see the paid caregiver quiz.
Can a spouse be paid?
Usually not through Pennsylvania CHC for personal assistance, respite, or participant-directed community supports. The current CHC waiver says the waiver will not pay for those services when they are furnished by the participant’s spouse.
A spouse may still have other options. If the person is a veteran, the spouse may be able to apply as the VA caregiver under VA PCAFC if both the veteran and caregiver meet the rules. Aid and Attendance may also increase a VA pension payment, but that money is paid to the veteran or survivor, not directly to the caregiver as wages.
A spouse can also ask the Area Agency on Aging about the Caregiver Support Program if the care receiver is not enrolled in CHC or LIFE. This may help with approved costs, but it should not be viewed as hourly pay.
Can an adult child be paid?
Yes, an adult child may be able to be paid in Pennsylvania if the care receiver is approved for CHC services and the adult child is allowed under the worker rules.
The adult child must meet worker standards. The care must be approved in the service plan. Hours must be authorized. Timesheets must be submitted. The CHC managed care plan and fiscal employer agent must process the worker correctly.
One warning is important. If the adult child is also the person’s legal guardian, representative payee, or power of attorney, CHC may not pay that adult child for the covered services listed above. Ask the CHC plan before changing any legal document. For legal questions, talk with a qualified Pennsylvania attorney.
What about a sibling, grandchild, friend, or live-in caregiver?
A sibling, grandchild, other relative, friend, neighbor, or live-in caregiver may be able to work as a paid caregiver if the program allows it and the person meets worker rules.
Living in the same home does not automatically stop pay under CHC. But it also does not create pay by itself. The person must qualify for services, the worker must be approved, and the service plan must authorize the care.
Ask whether the worker can be hired through participant direction, Services My Way, a home care agency, or another approved provider route. Ask what background checks, training, forms, and start date apply.
What if the person is a veteran?
Veterans may have more than one route. The right path depends on VA health care enrollment, service-connected disability rating, pension status, care needs, and local VA program availability.
VA Aid and Attendance
Aid and Attendance can add money to a VA pension for a qualified veteran or survivor who needs help with daily activities, is in bed much of the day due to illness, is in a nursing home due to disability, or has very limited eyesight.
This is not a caregiver paycheck. It is an added pension payment to the veteran or survivor. The household may use it to help pay for care.
VA PCAFC
VA PCAFC may pay a monthly stipend to an approved Primary Family Caregiver. The caregiver must be at least 18. A spouse, adult child, parent, stepfamily member, extended family member, or full-time live-in caregiver may fit the caregiver relationship rule.
The veteran must meet VA rules. Current VA pages list key rules such as a VA disability rating of 70% or higher, a need for at least six months of in-person personal care services, and VA health care enrollment.
Veteran Directed Care
Veteran Directed Care may allow an eligible veteran to manage a budget and hire workers, including some family members or neighbors. It is for veterans who need help with personal care and daily activities.
This program depends on VA clinical approval and local availability. Ask the veteran’s VA social worker if Veteran Directed Care is open in the veteran’s area.
For more help, see VA Aid and Attendance. Also ask a county veterans office or accredited veterans service officer for help with VA forms.
How to apply step by step
Step 1: Write down the care needs
Before you call, make a simple list of what the person cannot do safely alone. Include bathing, dressing, toileting, eating, transfers, walking, medication reminders, memory issues, wandering, falls, meal prep, laundry, and overnight safety.
Step 2: Call the PA Independent Enrollment Broker
Call 1-877-550-4227 and say you want to apply for long-term services and supports at home. Ask for a nursing facility level of care assessment and Medicaid long-term care screening.
Step 3: Complete the Medicaid financial application
The Independent Enrollment Broker may help with the Medicaid application. The County Assistance Office may ask for more financial papers. You can also apply through COMPASS or call the Consumer Service Center at 1-866-550-4355.
If the person has assets, transfers, a spouse, a home, or a recent gift, read Medicaid spend down and the Medicaid look-back period before making changes.
Step 4: Ask about the CHC service plan
If CHC is approved, the managed care plan will create a person-centered service plan. Ask for personal assistance services, respite, participant-directed community supports, or other services that match the care needs.
Step 5: Ask how the family caregiver can become the worker
Ask whether the caregiver can be hired through participant direction, Services My Way, or an approved agency. Ask for the worker packet, background check steps, training rules, payroll process, timesheet rules, and the first date paid work can start.
Step 6: If Medicaid is not the right fit, call the Area Agency on Aging
If the person is age 60 or older, ask the local Area Agency on Aging about OPTIONS and the Caregiver Support Program. These may not pay you wages, but they may pay for respite, supplies, home changes, or other help.
Step 7: If the person is a veteran, call VA
Ask the VA social worker or caregiver support team about Aid and Attendance, VA PCAFC, Veteran Directed Care, respite, and home-based services. Do not assume one VA program blocks another. Ask VA to screen for each one.
What to ask on the phone
Script for the PA Independent Enrollment Broker:
“Hi, I am caring for my family member in Pennsylvania. They need help at home with daily tasks like bathing, dressing, meals, transfers, and safety. I want to apply for Medicaid long-term services and supports through Community HealthChoices. Can we start the assessment for nursing facility level of care? Also, can you tell me how to ask about participant direction or Services My Way so a family member may be hired if the service plan allows it?”
Script for the CHC service coordinator:
“I want to review the service plan. We need help with personal care and safety at home. Which services are approved, how many hours are authorized, and can a family member be hired as the worker? Please tell me if the caregiver’s relationship or legal role blocks payment.”
Script for the Area Agency on Aging:
“I am caring for an older adult at home. They may not qualify for Medicaid long-term care, or we are still waiting. Can you screen us for OPTIONS and the Caregiver Support Program? I want to know what costs can be covered or reimbursed and what papers you need.”
Documents to gather
You may not need every item. But these papers often help prevent delays.
- Photo ID for the person who needs care
- Social Security card or number
- Proof of Pennsylvania address
- Medicare, Medicaid, and other insurance cards
- Doctor names, diagnoses, medication list, and recent hospital or rehab papers
- A list of daily tasks the person cannot do safely alone
- Fall records, memory concerns, wandering notes, or safety concerns
- Bank statements, income proof, pension proof, Social Security letters, and retirement account records
- Life insurance, burial account, vehicle, home, deed, mortgage, or lease papers
- Records of large gifts, transfers, or property sales from the past 60 months
- Marriage certificate if spousal Medicaid rules may apply
- Power of attorney, guardianship, representative payee, or other legal papers
- Caregiver ID, work authorization papers if needed, and background check information
- For veterans: DD214, VA rating letters, VA health care information, pension papers, and doctor forms
For printable planning help, see caregiver checklists and phone scripts.
Common reasons for delay or denial
- The person has not applied for Medicaid long-term services, only regular health coverage.
- The assessment does not show nursing facility level of care.
- The County Assistance Office needs more bank, income, or asset records.
- A transfer or gift from the past 60 months must be reviewed.
- The family caregiver is the spouse, legal guardian, representative payee, or power of attorney.
- The service plan does not include the service or enough approved hours.
- The worker has not finished required background checks, forms, or training.
- Timesheets are late, unsigned, or for hours not approved.
- The family expects payment for care given before the worker start date.
- The person is enrolled in CHC or LIFE, which can block Caregiver Support Program reimbursement.
If you are told no
Ask for the reason in writing. A phone denial is not enough. Ask which program denied the request, what rule was used, and whether more records could change the answer.
If Medicaid or CHC denies, lowers, or stops services, read the notice right away. Pennsylvania says CHC participants may file a complaint or grievance when they disagree with a CHC managed care plan decision. Some complaints and grievances have short time limits.
If the plan is stopping or reducing a service the person already gets, ask right away whether filing within the listed deadline can keep the service in place while the dispute is reviewed. Do not wait if care is already in the home.
If the CHC complaint or grievance decision is still not right, ask about a fair hearing with the Bureau of Hearings and Appeals. Follow the instructions on the written notice. For legal help, contact Pennsylvania Legal Aid or a qualified attorney.
If you are told a family member cannot be paid, ask whether the issue is the relationship, a legal role, missing worker steps, lack of approved hours, or a program limit. Then ask what other services can help now, such as agency care, respite, OPTIONS, LIFE, VA services, or adult day services.
Work, taxes, and household costs
Paid caregiver income can affect taxes, benefits, rent, SNAP, or other household rules. Ask the payroll agency how wages will be reported. If you are unsure, talk with a tax professional before you depend on the income.
For general planning, see caregiver tax deductions, the care cost calculator, and respite care for caregivers.
FAQ
Does Pennsylvania pay family caregivers directly?
Sometimes. The most common route is Medicaid long-term services through CHC when the person qualifies and the family caregiver is an allowed worker. Pennsylvania does not have one simple program that pays every family caregiver.
Can I get paid for care I already gave?
Usually no. Payment normally starts only after the person is approved, the service is in the care plan, the worker is approved, and hours are authorized. Ask the plan for the exact start date.
Can a power of attorney be paid as the caregiver?
Under the current CHC waiver language checked for this guide, CHC will not pay for certain services furnished by a power of attorney. Ask the CHC plan for the current rule before making decisions about legal papers.
Can a live-in adult child be paid?
Maybe. Living in the home is not the only issue. The adult child must be allowed under the program rules, meet worker standards, and provide services approved in the care plan.
What if my parent does not qualify for Medicaid?
Call the Area Agency on Aging and ask about OPTIONS and the Caregiver Support Program. Also ask about adult day services, respite, meals, transportation, and local programs. These may not create a paycheck, but they may reduce the cost and workload.
Does Pennsylvania have paid family leave for caregivers?
The official Pennsylvania caregiver and Medicaid pages checked for this guide did not list a broad statewide paid family leave benefit for all workers. Some workers may have federal FMLA job-protected unpaid leave, employer paid leave, union leave, or local leave rights. Ask your employer for the written leave policy.
Resumen en español
En Pennsylvania, algunos familiares pueden recibir pago por cuidar a una persona en casa. La ruta principal suele ser Medicaid, llamado Medical Assistance, por medio de Community HealthChoices.
Un hijo adulto, hermano u otro familiar puede calificar si la persona necesita servicios aprobados y el cuidador cumple las reglas de trabajador. Pero las reglas actuales de CHC no pagan al esposo o esposa, tutor legal, representante de pagos, o persona con poder legal por ciertos servicios.
Llame al PA Independent Enrollment Broker al 1-877-550-4227 y pida una evaluación para servicios de largo plazo en casa. Si la persona tiene 60 años o más, llame también a la Agencia local sobre Envejecimiento y pregunte por OPTIONS y Caregiver Support Program.
Official sources used
- Pennsylvania DHS: Apply for Long-Term Care Services
- Pennsylvania DHS: Apply for Community HealthChoices
- Pennsylvania DHS: Participant-Directed Services
- Pennsylvania DHS: 2026 CHC Waiver Appendix C
- Pennsylvania Department of Aging: Apply for the Caregiver Support Program
- Pennsylvania Department of Aging: Apply for the OPTIONS Program
- Pennsylvania DHS: LIFE
- Pennsylvania DHS: Hearings and Appeals
- VA: Aid and Attendance and Housebound benefits
- VA: PCAFC caregiver support benefits
- VA: Veteran Directed Care
- U.S. Department of Labor: FMLA for family caregivers
About this guide
This guide was written for family caregivers who need a clear first path in Pennsylvania. It focuses on benefit routes that may pay for care, reimburse costs, cover services, or protect appeal rights.
Disclaimer
This is general information, not legal, tax, medical, or financial advice. Program rules can change. For legal or tax questions, talk with a qualified professional in your state.
