Family caregiver pay rate: A guide to pay, programs, and eligibility

Family caregiving can quickly feel like a full-time job as you wear many hats. You may need to be a cook, nurse, driver, companion, or advocate. And while the care is given out of love, it’s not always sustainable without some financial help.

Fortunately, depending on your state and your loved one’s health coverage, there are programs that offer compensation. But how much exactly do family home caregivers get paid?

In this guide, we’ll break down the family caregiver pay rate and explain what impacts the compensation. We’ll also discuss the primary ways family caregivers can receive compensation.

What does it mean to be a family caregiver?

Being a family caregiver means stepping in to support a loved one who can’t fully care for themselves due to illness, injury, disability, or aging. They often serve as informal extensions of the healthcare system, providing hands-on assistance with basic daily tasks such as preparing meals, bathing, dressing, and transportation. Caregivers also offer emotional support by being present, offering comfort, and ensuring the person feels secure. In many cases, they assist with medical needs, such as managing medications, attending appointments, and providing support with equipment and treatment plans.

A family caregiver can reside with the individual receiving care or live apart, and may be a spouse, parent, child, sibling, close friend, neighbor, or community member.

Nowadays, more families are choosing home care for their loved ones instead of turning to nursing facilities, as this allows them to offer a better quality of life, more control over routines, and a stronger sense of dignity and connection. It's also a response to rising concerns about the cost, quality, and emotional toll of institutional care.

Can a family member be a paid caregiver?

Yes, a family member can be a paid caregiver. In fact, there are programs at the federal, state, and even private levels that make this possible. These include Medicaid Self-Direction Programs, Area Agencies on Aging (AAAs), and the Veteran-Directed Care Program for caregivers of eligible veterans.

Many of these programs are built around the idea of self-directed care, which allows the person receiving care to choose who provides that care, including a trusted family member.

Eligibility varies depending on the specific program and the individual's needs. However, there are non-negotiable requirements. For instance, individuals must demonstrate a medical or functional need for in-home support to qualify for Medicaid, veterans' benefits, or other forms of assistance. Some states have training or background check requirements for caregivers, depending on the program.

Families often pursue paid caregiving arrangements not only for financial reasons, but also for emotional ones. Caring for a loved one can be deeply personal and rewarding, but it also comes with sacrifices, especially when it impacts a caregiver’s ability to work or earn income. Receiving payment eases that burden while allowing the family to continue providing care in a familiar, trusted environment.

How to be a paid caregiver for a family member

The process typically begins by determining whether your loved one is eligible for financial assistance through Medicaid, a state-funded non-Medicaid program, or veterans’ caregiving support services. Most of these programs require the person receiving care to have a documented medical or functional need and meet specific income, age, or disability-related criteria. If they qualify, the next steps involve working with a caseworker or care coordinator to complete paperwork, create a care plan, and officially designate a caregiver. In some cases, the caregiver may also need to attend training, pass background checks, or enroll with a third-party agency before becoming officially recognized and approved for payment.

Medicaid and state-level programs

Each state runs its own Medicaid program with specific requirements and available services. Still, many offer ways for family caregivers to receive payment through Home and Community-Based Services (HCBS) waivers or similar self-directed care models. These waivers enable Medicaid recipients to receive care in their homes rather than in an institution, and in many states, a family member can provide the necessary care.

For example, Colorado offers a Family CNA (Certified Nursing Assistant) program, which allows family members to become certified and receive compensation for providing care to a loved one who qualifies for Medicaid. In Pennsylvania, the Medicaid Waiver Program enables relatives to become paid caregivers. California’s In-Home Supportive Services (IHSS) program also pays family members who provide in-home care to eligible individuals.

Adults over 65 or people with disabilities may qualify for Medicaid if they meet strict income and asset limits set by their state.

To become a paid caregiver:

• Check if your family member is eligible for Medicaid and whether their state allows payment to family caregivers.
• Work with a case management agency or care coordinator to assess care needs and start the enrollment process.
• Submit the required paperwork to apply for the self-directed care option. This often includes a doctor’s order for in-home care with you chosen as the caregiver.
• Complete any training or certification your state program may require—for example, CNA training in Colorado.

Once approved, you’ll be able to provide home care for family and get paid through the state’s Medicaid system.

Alternatives for non-Medicaid eligibility

If your loved one isn’t eligible for Medicaid, there are other ways to get financial support for caregiving.

• Long-term care insurance: Some long-term care insurance policies cover in-home care, including care provided by a family member or caregiver.
• Veterans programs: If your family member is a veteran, they may be eligible for assistance through the Aid and Attendance benefit, which provides additional funds to a VA pension to cover in-home care expenses. The Veteran-Directed Care program also allows eligible veterans to hire their family members as caregivers.
• Paid family leave: Few states offer paid family leave, allowing you to take time off work and still receive a portion of your paycheck while caring for a relative. Programs and rules vary by state, so check with your state’s labor department to see if this is available in your area.
• Area Agencies on Aging (AAA) and community support services: Your local AAA office can connect you to free or low-cost services, such as respite care, meal delivery, or transportation. Some community programs also offer small stipends or caregiver support grants.

What impacts family caregiver compensation?

The amount paid to a family member caregiver depends on these key factors:

• Local wage rates and cost of living: Caregiver pay is often tied to the general wage standards in your area. States and counties with a higher cost of living, like California or New York, tend to offer higher compensation to match local expenses. In rural or lower-cost areas, the pay may be lower, even if the caregiving duties are the same. State-set reimbursement rates and funding levels also play a role in determining the earnings of caregivers.
• Type and complexity of care provided: The more specialized or demanding the care, the higher the potential pay. For example, helping with basic tasks like dressing and cooking results in lower compensation compared to caring for someone with a severe disability, cognitive decline, or complex medical needs.
• Experience, training, and certifications: Certain states require training before a caregiver is approved for employment.  Even when not required, having formal training, prior knowledge, or certifications, such as a CNA (Certified Nursing Assistant), can lead to increased compensation.
• Market demand for family home caregivers in the area: In areas where there is a shortage of professional caregivers, the demand for family-based care may drive up compensation. States may also offer higher reimbursement rates to retain caregivers in these regions.

How much does a family caregiver get paid?

On average, caregivers earn between $13 and $20 per hour. It depends on the location, the complexity of care provided, the caregiver’s training or certification, and the specific program through which they are being paid.

Family caregiver pay rate per hour vs. monthly salary

For family caregivers providing full-time care, typically around 35 to 40 hours a week, earning between $13 and $20 per hour usually translates to a monthly salary of $2,000 to $3,500. 

The rate varies significantly by state. For example, caregivers in Louisiana and Mississippi earn approximately $16 per hour. In higher-paying states like California and Washington, the rate can be over $25 per hour. These differences reflect the local cost of living, funding levels, and the demand for home-based care in each area.

In some situations, such as when care involves more complex needs, including managing medical equipment, caring for someone with dementia, or assisting with physical therapy routines, the family caregiver salary may exceed the typical range. Overtime pay may also be applicable if the caregiver provides support beyond the agreed-upon hours or works on weekends or holidays, as per the program’s policies.

Challenges in getting paid as a family caregiver

Many caregivers run into roadblocks that can delay or even prevent them from receiving compensation. Here are some of the main challenges to help you prepare in advance and make informed decisions.

• Administrative barriers (paperwork, training, documentation): Applications for caregiver pay require detailed documentation of the care recipient’s medical needs, proof of income or Medicaid eligibility, and sometimes legal documents showing the caregiver’s relationship to the individual. In some states, caregivers are required to complete specific training or undergo a background check before being approved for employment. These steps can be time-consuming and confusing for some.
• Limited availability of programs by location: Not every state offers the same level of support. Some states have well-established Medicaid self-direction programs that allow family members to serve as paid caregivers, while others have limited options or stricter eligibility requirements. Likewise, in some areas, waiting lists are long, funding is limited, or programs may exclude certain family members from being paid.
• Financial planning considerations for families: Even when compensation is available, it may not be enough to fully replace a regular income, especially if the caregiver had to reduce work hours or leave a job entirely. Families also need to consider how becoming a paid caregiver might affect other financial areas, such as health insurance coverage, retirement savings, or eligibility for other public benefits.

Building a better future for family caregivers

Caregivers are gaining more recognition for the vital role they play in supporting loved ones at home. However, they sacrifice work hours, savings, and personal time to ensure their family members receive the support they need. As such, the compensation for family caregivers is essential to make it sustainable in the long term. It reduces financial pressure, allows caregivers to focus on providing consistent care, and acknowledges that the work they’re doing is both important and demanding.

Meanwhile, many caregivers don’t realize that financial support may already be available to them. Start by checking with your state’s Medicaid office, Area Agency on Aging, or a local caregiver support organization to find out what options exist in your area. Even a small amount of support can help ease the burden and make caregiving more manageable over time.