Yes, you can get paid to care for a family member in Pennsylvania. Three programs make it possible: Community HealthChoices, the OBRA Waiver, and Veteran-Directed Care. Pay generally runs between $11 and $18 an hour, and the family member receiving care has to qualify first, not you. Spouses can only be paid under the veterans’ program.
Which Pennsylvania Programs Pay Family Caregivers
Your options depend on the care recipient’s age, disability, and veteran status. Each program has its own rules about who counts as an eligible paid caregiver.
Community HealthChoices
Community HealthChoices (CHC) is Pennsylvania’s Medicaid managed care program for long-term services and supports. It covers adults 21 and older who are enrolled in both Medicare and Medicaid, or who qualify for Medicaid-funded long-term care because of a physical disability.1Commonwealth of Pennsylvania. Apply for Community HealthChoices Participants can usually choose a family member as their paid personal care aide. Spouses cannot be hired under CHC. The program runs through managed care organizations (MCOs) that coordinate services and pay the home care agency that employs you.
OBRA Waiver
The OBRA Waiver serves Pennsylvanians ages 18 to 59 who have a severe developmental physical disability and need an institutional level of care. People who turn 60 while enrolled can continue receiving services, but new applicants 60 and older are directed to other programs.2Commonwealth of Pennsylvania. OBRA Waiver Like CHC, OBRA lets participants hire a family member other than a spouse as a paid aide.
Veteran-Directed Care
Veteran-Directed Care is a federal program run by the Department of Veterans Affairs together with local Area Agencies on Aging and other aging and disability network agencies.3Administration for Community Living (ACL). Veteran-Directed Care Program Eligible veterans receive a flexible budget and hire their own caregivers, including family members and spouses.4U.S. Department of Veterans Affairs. Veteran-Directed Care – Geriatrics and Extended Care This is the only Pennsylvania option that pays a spouse.
Who Can Be Paid as a Family Caregiver
You must be at least 18 and authorized to work in the United States. For most people, the real gate is the criminal background check. Pennsylvania requires home care agencies to run a criminal history report on every applicant for a direct care worker position. If you’ve lived in Pennsylvania for at least two years, you’ll need a State Police criminal history record. Residents of less than two years face additional checks.5Pennsylvania Code and Bulletin. 28 Pa. Code 611.52 – Criminal Background Checks The report must be current or obtained within the preceding year. Convictions involving violence or abuse will disqualify you.
Once you clear the check, you become an employee of a home care agency that contracts with the care recipient’s MCO. The agency handles payroll, tax withholding, and employment paperwork. Your duties come from the care recipient’s individualized care plan and typically include bathing, meal preparation, dressing, mobility support, and medication reminders. You don’t get to add tasks outside the plan.
What the Care Recipient Has to Qualify For
Two separate tests apply: money and medical need.
Financial Eligibility
For 2026, a single applicant’s monthly income cannot exceed $2,982, which is 300 percent of the federal Supplemental Security Income benefit rate.6Centers for Medicare & Medicaid Services (CMS). 2026 SSI and Spousal Impoverishment Standards Countable assets for a single applicant are capped at $8,000, combining the federal $2,000 resource standard with a Pennsylvania $6,000 allowance. The primary home (within equity limits), one vehicle, and personal belongings don’t count.
Married couples get additional protections. When one spouse applies and the other stays in the community, the community spouse can keep between $32,532 and $162,660 in countable resources and a minimum monthly income allowance of $2,643.75 for 2026.6Centers for Medicare & Medicaid Services (CMS). 2026 SSI and Spousal Impoverishment Standards
Functional Eligibility
The care recipient also has to pass a Functional Eligibility Determination. An assessor evaluates the person’s ability to independently handle daily activities like bathing, dressing, eating, using the toilet, walking, and transferring between positions.7Commonwealth of Pennsylvania. PA Functional Eligibility Determination Form The assessment looks at a three-day window and how much help the person actually needs. The point is to confirm they qualify for a nursing-facility level of care even though they intend to stay home.
How Much You Can Earn and How Many Hours You Get
Pay for family caregivers under Pennsylvania’s Medicaid programs generally runs $11 to $18 an hour. The exact rate depends on the county, the MCO handling the case, and the care recipient’s assessed acuity. Higher-acuity care and urban areas tend toward the top of that range. Rates are set by the home care agency that employs you, not by you or the family member.
Your weekly hours come from the individualized service plan, not from how much help you personally think is needed. Someone assessed as needing substantial daily help generates more paid hours than someone who needs occasional support. Overtime at one and a half times your regular rate kicks in past 40 hours in a week, consistent with federal wage rules.
How to Apply
The application starts with the care recipient. For Community HealthChoices, contact the Pennsylvania Independent Enrollment Broker at 1-877-550-4227 or apply through COMPASS at compass.state.pa.us.8Pennsylvania Government. Application Guide for Long-Term Services and Supports For the OBRA Waiver, start with the county Area Agency on Aging or the Department of Human Services.
After the application, the care recipient goes through the functional assessment. If they clear both the medical and financial tests, they pick an MCO available in their region. That MCO assigns a service coordinator who builds the care plan and connects the participant with a home care agency. The agency then hires the family member as a direct care worker once background checks and onboarding are done.
For Veteran-Directed Care, the veteran contacts their local VA medical center or Area Agency on Aging. Enrollment follows VA rules and is separate from Medicaid.
Tracking Your Hours With Electronic Visit Verification
Every shift you work under a Medicaid-funded program has to be logged in an Electronic Visit Verification (EVV) system. This is a federal requirement under the 21st Century Cures Act, and Pennsylvania uses an open-system model so your agency can choose its own EVV software.9Commonwealth of Pennsylvania. Electronic Visit Verification (EVV) Some systems use a phone app, some a landline call-in, others a small device in the care recipient’s home. GPS is not required. Your agency trains you on its system. Missed or sloppy logs delay pay and create compliance issues, so treat this as part of the job from day one.
Taxes on Caregiver Pay
Caregiver pay is generally taxable, with a significant exception for caregivers who live with the person they care for. Under IRS Notice 2014-7, Medicaid waiver payments are treated as difficulty-of-care payments that can be excluded from gross income when the caregiver and care recipient share a home.10Internal Revenue Service. Certain Medicaid Waiver Payments May Be Excludable From Income The IRS defines the provider’s home as where you actually live and carry out daily personal routines, including things like meals and holidays. Keeping a separate residence you return to on weekends and holidays disqualifies you.
The difference is real money. An adult child who moves in with a parent and provides full-time care under CHC can potentially exclude all Medicaid waiver payments from taxable income. An adult child who drives to the parent’s house each day and goes home at night cannot. More than one caregiver in the same home can claim the exclusion, and it applies to the full waiver payment.10Internal Revenue Service. Certain Medicaid Waiver Payments May Be Excludable From Income
If the exclusion doesn’t apply to you, your home care agency withholds income and payroll taxes like any other employer. If you’re paid directly by a family member under a private arrangement instead, that family member is a household employer and must withhold and pay Social Security and Medicare taxes once they pay you $3,000 or more in cash wages during 2026.11Internal Revenue Service. Publication 926 (2026), Household Employer’s Tax Guide
Personal Care Agreements When Programs Don’t Fit
Families who don’t qualify for a state program, or who want to supplement approved hours, can use a Personal Care Agreement. It’s a written contract between the care recipient and the family caregiver setting out duties, weekly hours, and the pay rate. The document matters for more than organization.
Pennsylvania’s Medicaid program reviews asset transfers made within 60 months before an application for long-term care. If the county assistance office finds that assets were given away without fair market value in return, a penalty period starts during which Medicaid will not pay for long-term care services. The penalty length is the uncompensated value divided by the average daily cost of private nursing facility care.12Commonwealth of Pennsylvania. Medicaid and Payment of Long-Term Services – Section: Transfer of Assets
A properly drafted Personal Care Agreement keeps caregiver payments from being treated as gifts during that look-back. It shows the care recipient paid fair market value for real services. Without one, regular payments from a parent to an adult child look like the sort of transfer that triggers a penalty. Sign it before care begins, set a reasonable hourly rate for the local market, and keep records of hours worked and services provided. If Medicaid is anywhere on the horizon, having an elder law attorney draft or review the agreement is worth the cost.
Handle the tax side too. Once payments reach the $3,000 annual threshold for 2026, the care recipient (or their representative) is a household employer, has to withhold payroll taxes, files Schedule H, and issues you a W-2.11Internal Revenue Service. Publication 926 (2026), Household Employer’s Tax Guide Skipping those steps creates IRS problems and undermines the agreement if Medicaid later scrutinizes the payments.