New York caregiver pay guide
Last checked: May 18, 2026
Yes, some family caregivers can be paid in New York. The most common path is New York Medicaid through Consumer Directed Personal Assistance Program, called CDPAP, if the person needs approved home care and meets Medicaid rules.
New York also has Paid Family Leave for many workers who need time off to care for a seriously ill family member. Veterans may have other paths through VA Aid and Attendance, PCAFC, or Veteran Directed Care.
Quick answer
A family member may be paid in New York if the person receiving care qualifies for a program that allows it. The main route is Medicaid CDPAP, which lets eligible Medicaid members choose and hire a personal assistant. A spouse cannot be paid as the CDPAP personal assistant. Adult children, siblings, friends, and some live-in relatives may be allowed if they meet the rules and are not the person’s designated representative.
New York Paid Family Leave is different. It can pay an eligible worker during approved time off, but it does not make that worker a paid home care aide. VA programs may help veterans and some family caregivers, but each VA program has its own rules.
Start here
- Write down the care needs. List help with bathing, dressing, toileting, walking, transfers, meals, medicine reminders, supervision, and unsafe times of day.
- Check Medicaid first. If the person is not on Medicaid, call the New York Medicaid Helpline or the local Department of Social Services. In New York City, ask HRA about Medicaid home care.
- Ask for the right route. Say: “I need to ask about Medicaid home care, CDPAP, MLTC or PACE, and the New York Independent Assessor.” If the person is a veteran, also call the VA care team or VA social worker.
For a broader overview, see Can I Get Paid to Be a Caregiver? and the paid caregiver quiz.
New York rules can change
New York Medicaid home care rules are detailed. Counties, New York City HRA, managed care plans, waiver contractors, and fiscal offices may use different names. CDPAP also changed to a statewide fiscal intermediary model. Confirm current steps with New York State Department of Health, your local Department of Social Services, HRA if you live in New York City, your managed care plan, or Public Partnerships LLC if you are already in CDPAP.
Main programs and where to start
| Program or route | Who it may help | Can it pay a family caregiver? | Where to start |
|---|---|---|---|
| Medicaid CDPAP | Medicaid members who need approved home care and can direct care, or have a designated representative who can direct care | Often yes for adult children, siblings, friends, and some live-in relatives. No for a spouse, designated representative, or parent of a CDPAP consumer under 21. | Local Department of Social Services, HRA in New York City, Medicaid managed care plan, MLTC plan, or Public Partnerships LLC for CDPAP fiscal steps |
| Medicaid personal care services | People who need help with daily tasks at home | Usually pays an agency aide, not a family member. Ask if CDPAP is a better fit. | Local Department of Social Services, HRA, or Medicaid plan |
| Managed Long Term Care, Medicaid Advantage Plus, or PACE | Adults who need long-term services at home or in the community | May include CDPAP if the person is approved and the plan authorizes it. | New York Medicaid Choice, MLTC plan, PACE plan, or local Medicaid office |
| NHTD Medicaid waiver | Medicaid-eligible seniors and people with physical disabilities who need a community option instead of nursing home care | Not a simple family paycheck route. It may support services that help the person stay in the community. | Ask the local Medicaid office or NHTD regional staff about referral steps |
| New York Paid Family Leave | Eligible workers who need job-protected paid time off to care for a close family member with a serious health condition | Pays the worker during approved leave. It does not pay them as a Medicaid aide. | Employer, employer’s insurance carrier, or New York Paid Family Leave forms |
| VA Aid and Attendance | Qualified veterans or survivors who get VA pension and need help with daily activities, are housebound, have very limited eyesight, or live in a nursing home because of disability | Money is added to the VA pension. It is not usually paid straight to the caregiver. | VA.gov, VA pension office, accredited representative, or VA regional office |
| VA PCAFC or Veteran Directed Care | Eligible veterans who meet VA program rules | PCAFC may include a caregiver stipend. Veteran Directed Care may let the veteran hire help, including some family, if available locally. | VA Caregiver Support Program, VA primary care team, or VA social worker |
Main ways a family caregiver may be paid in New York
1. Medicaid CDPAP
CDPAP stands for Consumer Directed Personal Assistance Program. It is a New York Medicaid program. It lets an eligible Medicaid member choose, hire, train, and direct a personal assistant.
This is the main New York route when a family asks, “Can I get paid to care for my parent?” The person who needs care must qualify for Medicaid home care services. The care must be approved in a care plan. The caregiver must be allowed under CDPAP rules and must complete the hiring and payroll steps.
CDPAP may help when the person needs hands-on help with daily tasks. This can include help with bathing, dressing, toileting, walking, transfers, eating, or other approved personal care tasks. CDPAP can also include some skilled tasks when allowed and directed under the program.
New York’s CDPAP fiscal intermediary changed. Public Partnerships LLC, often called PPL, is the statewide fiscal intermediary. A fiscal intermediary handles payroll and employment records. If the person is already in CDPAP, ask PPL, the Medicaid plan, or the local Department of Social Services what still needs to be done so the personal assistant can be paid.
CDPAP is not automatic. A doctor saying “family help is needed” is not enough by itself. The person must go through Medicaid and home care assessment steps.
2. Medicaid home care, MLTC, MAP, and PACE
New York Medicaid can cover home care for people who meet financial and care rules. Some people receive services through a local Department of Social Services or HRA. Others receive services through a Medicaid managed care plan or Managed Long Term Care plan.
Managed Long Term Care, called MLTC, is for people who are chronically ill or disabled and need long-term services at home or in the community. Covered services can include home health aide services, personal care services, adult day health care, private duty nursing, therapies at home, nursing at home, and CDPAP.
PACE stands for Program of All-Inclusive Care for the Elderly. In New York, PACE is part of the managed long-term care system. It is generally for people age 55 or older who meet PACE rules and need a nursing-home level of care, but can live safely in the community with PACE services.
These routes do not always pay a family member directly. If the goal is for a family member to be the paid aide, ask specifically about CDPAP.
3. NHTD Medicaid waiver
The Nursing Home Transition and Diversion waiver, called NHTD, is a New York Medicaid home and community-based waiver. It helps some Medicaid-eligible seniors and people with physical disabilities live in the community instead of a nursing home or other institution.
NHTD can be useful if the person is leaving a nursing home, at risk of nursing home placement, or needs waiver services to stay safely at home. It is not the same as a simple family caregiver paycheck program. Ask the local Medicaid office or waiver contact if NHTD fits the person’s needs.
For a plain-English guide to waiver basics, see Medicaid HCBS waivers explained.
4. New York Paid Family Leave
New York Paid Family Leave is for many employees who work in New York State. It can provide paid, job-protected time off to care for a close family member with a serious health condition.
This is not the same as Medicaid caregiver pay. It does not make you the person’s paid home care aide. It can help replace part of your wages while you take approved time off from your job.
Covered family members include a spouse, domestic partner, child, parent, parent-in-law, grandparent, grandchild, and sibling. New York says eligible employees can receive up to 12 weeks of paid leave. For 2026, the benefit is 67% of average weekly wage, up to the state cap.
To request leave for family care, New York uses forms for family care, including PFL-1, PFL-3, and PFL-4. Ask your employer or the employer’s insurance carrier for the correct forms.
5. Respite and caregiver support
Respite care may give the caregiver a break. In New York, respite services may be available through local offices for the aging and state-funded respite programs. This usually does not pay the family caregiver as wages. It may pay for temporary substitute care or support services.
Ask your local Office for the Aging about respite, caregiver counseling, caregiver training, and help finding services. Also see respite care for caregivers.
6. Family care or adult foster-style programs
Some states have a Medicaid Structured Family Caregiving program. I did not verify a broad New York Medicaid program by that exact name for older adults caring for relatives at home.
New York does have other residential care models, such as OPWDD Family Care for people with developmental disabilities and family-type homes for adults. These are licensed or certified provider paths. They are not the same as getting paid quickly to care for your own parent in their home.
If the person has an intellectual or developmental disability, contact OPWDD and ask about the right service path. If the person is an older adult who needs residential care, ask the local Department of Social Services or New York State Department of Health about adult care options.
Can a spouse be paid?
Usually not through CDPAP. New York CDPAP rules do not allow a consumer’s spouse to be the paid personal assistant for that consumer.
A spouse may still have other options:
- New York Paid Family Leave: An eligible worker may take paid leave to care for a spouse with a serious health condition.
- VA programs: A spouse may qualify as a VA family caregiver in some cases if the veteran and caregiver meet VA rules.
- Respite or support services: These may help the spouse get a break, even if they do not create wages.
If a Medicaid office, plan, or agency says a spouse can be paid under a different program, ask for the program name and written rule. Do not rely on a phone answer alone.
Can an adult child be paid?
Yes, an adult child may be able to be paid through CDPAP if the parent qualifies for Medicaid home care and CDPAP is approved. The adult child must be allowed under the rules. They must also finish the hiring, onboarding, timesheet, and payroll steps.
The adult child should not also serve as the person’s designated representative if they want to be the paid personal assistant. A designated representative is the person who directs care when the Medicaid member cannot do it. New York rules do not allow the designated representative to also be the paid CDPAP aide.
A sibling, adult grandchild, friend, or other adult relative may also be considered if allowed by the program. A live-in family member is not automatically disqualified. But the services must match the approved care plan, and the person must follow CDPAP employment rules.
A parent cannot be paid as the CDPAP aide for their child if the CDPAP consumer is under age 21. Rules for parents or guardians of adult consumers can be more detailed. Ask the Medicaid plan, local Department of Social Services, HRA, or PPL for written confirmation before assuming the caregiver can be paid.
What if the person is a veteran?
If the person needing care is a veteran, ask about VA options as well as Medicaid. The best first call is often the veteran’s VA primary care team, VA social worker, or local VA caregiver support staff.
VA Aid and Attendance
VA Aid and Attendance can add money to a VA pension for qualified veterans or survivors who need help with daily activities, are housebound, have very limited eyesight, or live in a nursing home due to disability. This money is usually paid to the veteran or survivor, not straight to the family caregiver. Families often use it to help cover care costs.
VA PCAFC
The VA family caregiver program called PCAFC may provide extra caregiver support for eligible veterans and eligible family caregivers. In some cases, it can include a monthly stipend for the primary family caregiver. Approval depends on VA rules and a VA review.
Veteran Directed Care
Veteran Directed Care lets some veterans choose and direct home and community-based services. The VA says it is for veterans who need personal care services and help with activities of daily living. It is not available in every location. Ask the veteran’s VA care team if Veteran Directed Care is offered through that VA medical center.
For more detail, see VA Aid and Attendance.
How to apply step by step
Step 1: Decide which door fits your situation
If the person is not on Medicaid, start with a Medicaid application. New York says where you apply depends on your eligibility category. Some people apply through NY State of Health. People age 65 or older, people with disabilities, people seeking community-based long-term care, and people using spenddown often work through the local Department of Social Services or HRA in New York City.
If income is too high, ask about the Medicaid Excess Income Program, also called spenddown or surplus income. See Medicaid spend-down and Medicaid look-back period for related planning issues.
Step 2: Ask for Medicaid home care assessment
Do not only ask, “Can I get paid?” Ask for a home care assessment. Say the person needs help at home with daily tasks and you want to ask about personal care services, CDPAP, MLTC, MAP, or PACE.
For many adults, New York uses the New York Independent Assessor for initial assessments for personal care, CDPAP, and MLTC eligibility. Ask the local Medicaid office, plan, or New York Medicaid Choice how the assessment is scheduled.
Step 3: Ask specifically about CDPAP
If the family wants the caregiver to be paid, ask this exact question:
“If home care is approved, can we request CDPAP so the care recipient can choose a family member as the personal assistant?”
Also ask whether the planned caregiver is allowed. Give the relationship. Say whether the caregiver lives with the person. Say whether the caregiver is a spouse, adult child, sibling, parent, legal guardian, or designated representative.
Step 4: Complete plan, enrollment, and payroll steps
Approval for hours and approval for the caregiver to be paid are not the same thing. The care plan must approve services. Then the personal assistant must complete employment paperwork, identity steps, tax forms, training or orientation if required, timekeeping, and payroll steps.
For CDPAP, PPL is the statewide fiscal intermediary. If there is a pay problem, ask PPL and the Medicaid plan or local Department of Social Services what is missing.
Step 5: If you work, check Paid Family Leave
If you are employed in New York and need time off to care for a close family member, ask your employer for New York Paid Family Leave forms. For family care, the forms may include PFL-1, PFL-3, and PFL-4. Keep copies of everything you submit.
Step 6: If the person is a veteran, ask the VA in writing
Ask the VA care team about Aid and Attendance, PCAFC, Veteran Directed Care, homemaker/home health aide services, respite, and other home care supports. Ask which programs are available at that VA medical center.
What to ask on the phone
Before you call, write down the person’s Medicaid status, county, age, diagnoses, care tasks, and the family caregiver’s relationship.
If the person is not on Medicaid
Call the New York Medicaid Helpline at 800-541-2831 or the local Department of Social Services. In New York City, ask HRA about Medicaid home care.
“I am caring for my family member in New York. They need help at home with daily tasks like bathing, dressing, toileting, transfers, meals, and safety. We need to apply for Medicaid and ask about long-term home care. Which office handles this in our county, and what forms do we need?”
If the person already has Medicaid
Call the Medicaid plan, local Department of Social Services, HRA, or New York Medicaid Choice at 800-505-5678 if MLTC plan choice or enrollment is involved.
“The person already has Medicaid and needs long-term help at home. I want to ask about personal care services, CDPAP, MLTC, MAP, PACE, and the New York Independent Assessor. How do we request an assessment?”
If you want CDPAP
“If home care is approved, we want to request CDPAP. The caregiver would be the person’s [adult child/sibling/friend/other relationship]. They [do/do not] live in the home. They are not the spouse and not the designated representative. What are the next steps to approve the personal assistant and payroll?”
If CDPAP payroll or registration is the problem
Call Public Partnerships LLC at 1-833-247-5346 and also contact the Medicaid plan or local Department of Social Services if care is at risk.
“We are approved for CDPAP, but the personal assistant has not been paid or cannot finish registration. Please tell me exactly what is missing, the date it was requested, and how to fix it. Please also tell me who can confirm the service authorization.”
If you need Paid Family Leave
Ask your employer or the employer’s insurance carrier. You can also contact the New York Paid Family Leave Helpline at 844-337-6303.
“I need Paid Family Leave to care for a family member with a serious health condition. Please give me the family care forms and the name of the insurance carrier that handles claims.”
For more scripts, see caregiver phone scripts.
Documents to gather
You may not need every item. Start a folder now so you are ready.
- Photo ID for the person needing care
- Social Security number or proof of application, if requested
- Medicare, Medicaid, and insurance cards
- Proof of New York address
- Proof of income, such as Social Security, pension, wages, or benefits letters
- Bank statements and asset records if Medicaid asks for them
- Recent medical records, hospital discharge papers, diagnosis list, and medication list
- Doctor contact information
- List of daily care needs and unsafe times of day
- Any Medicaid, MLTC, CDPAP, PACE, waiver, or HRA notices
- Power of attorney, health care proxy, guardianship papers, or representative forms, if any
- For Paid Family Leave: employer forms and the health care provider certification
- For VA: DD214 or service records, VA pension or disability letters, marriage record if the claimant is a spouse, and VA medical records
Use caregiver checklists to keep records in one place. Use the care cost calculator if you need to compare unpaid hours, paid help, and missed work.
If you are told no
A “no” on the phone is not always the final answer. Ask for the reason and ask for it in writing.
Ask these questions
- Was the person denied Medicaid, home care, CDPAP, MLTC, PACE, or only a certain number of hours?
- Was the denial based on income, assets, missing papers, medical need, assessment results, safety at home, or caregiver eligibility?
- Is there a written notice?
- What is the appeal or fair hearing deadline?
- Can services continue while the appeal is pending? If yes, what deadline applies?
- Who can send a copy of the assessment and care plan?
Common delay or denial reasons
- The person has not applied for the right Medicaid category.
- Spenddown or surplus income has not been handled.
- The New York Independent Assessor assessment has not been completed.
- The care need was not explained clearly during the assessment.
- The person does not meet the minimum need rules for the requested service.
- The family asked for CDPAP, but the person was only assessed for agency personal care.
- The proposed caregiver is the spouse, designated representative, or another disallowed person.
- The personal assistant did not finish PPL onboarding, timekeeping, or payroll steps.
- Paid Family Leave forms were incomplete or sent to the wrong place.
- The VA program is not available at that location or the veteran does not meet the VA clinical rules.
For Medicaid and many public benefit decisions, New York uses the Fair Hearing process through the Office of Temporary and Disability Assistance. A Fair Hearing lets you tell an administrative law judge why you think the agency or plan decision is wrong. Read the notice closely. Deadlines can be short, especially if services are being reduced or stopped.
Related CaregiverBenefits.org guides
Caregiver pay and Medicaid
Work, tax, and planning
Veterans
FAQ
Does New York pay family caregivers?
Sometimes. The main path is Medicaid CDPAP. The person receiving care must qualify for Medicaid home care and be approved for CDPAP. The caregiver must also be allowed under the program rules.
Can I get paid to care for my mother in New York?
Possibly. If your mother qualifies for Medicaid home care and CDPAP, you may be able to be her paid personal assistant if you are allowed under the rules and complete the payroll steps.
Can I get paid to care for my husband or wife in New York?
Not through CDPAP. New York CDPAP does not allow a spouse to be the paid personal assistant. A spouse may still check New York Paid Family Leave, VA caregiver benefits, respite, or other supports.
Can a sibling be paid through CDPAP?
A sibling may be allowed if the person receiving care qualifies for CDPAP and the sibling is not the spouse, designated representative, or another disallowed person. Ask for written confirmation before relying on it.
Can a live-in family member be paid?
Living in the same home does not automatically block a family member from CDPAP. The relationship still matters. A spouse cannot be paid as the CDPAP aide, and the designated representative cannot also be the paid aide.
Does Medicare pay family caregivers in New York?
Usually no. Medicare may cover certain home health services when Medicare rules are met, but it does not pay for ongoing long-term custodial care when that is the only care needed. For long-term home care, families usually need to check Medicaid, VA, private pay, or other local supports.
What if the person has too much income for Medicaid?
Ask about New York’s Excess Income Program, often called spenddown or surplus income. This can help some people qualify after medical bills or pay-in rules are met. Get the rule in writing from the local Medicaid office.
Resumen en espanol
En Nueva York, algunos familiares pueden recibir pago por cuidar a una persona en casa. La ruta principal suele ser Medicaid CDPAP, si la persona que necesita cuidado califica para Medicaid y para servicios de cuidado en el hogar.
Un esposo o esposa no puede ser el asistente pagado por CDPAP. Un hijo adulto, hermano, amigo u otro familiar adulto puede ser permitido en algunos casos. Llame a Medicaid, HRA si vive en la Ciudad de Nueva York, el plan de Medicaid, o PPL si ya esta en CDPAP. Pida la respuesta por escrito.
Official sources used
- New York State Department of Health: Consumer Directed Personal Assistance Program (CDPAP)
- New York State Department of Health: CDPAP family member clarification
- New York Codes, Rules and Regulations: 18 NYCRR 505.28 Consumer Directed Personal Assistance Program
- New York State Department of Health: Managed Long Term Care
- New York State Department of Health: Overview of Managed Long Term Care
- New York State Department of Health: Personal Care Services Program
- New York State Department of Health: Nursing Home Transition and Diversion Medicaid Waiver
- New York State Department of Health: PACE
- New York State Department of Health: How to Apply for NY Medicaid
- New York State Department of Health: Local Departments of Social Services contact listing
- New York State Department of Health: Medicaid Excess Income Program
- New York Paid Family Leave: Family care
- New York Paid Family Leave: 2026 updates
- New York Paid Family Leave: Form package for family care
- New York State Office for the Aging: Respite Program
- New York State Office for People With Developmental Disabilities: Family Care
- Medicare.gov: Long-term care coverage
- VA.gov: Aid and Attendance benefits and Housebound allowance
- VA Caregiver Support Program: PCAFC
- VA.gov: Veteran Directed Care
- Administration for Community Living: Veteran Directed Care Program
- New York Office of Temporary and Disability Assistance: Request a Fair Hearing
About this guide
This guide was written for family caregivers who need a practical first path in New York. Program rules, forms, plan names, and phone routing can change. Always confirm current steps with the official agency, plan, or VA office that handles the person’s case.
Disclaimer
This is general information, not legal, tax, medical, or financial advice. For legal or tax questions, talk with a qualified professional in your state.
