Does the State of Florida Pay for Caregivers?

Florida does pay family caregivers, primarily through a Medicaid option called Consumer Directed Care Plus (CDC+), which lets an eligible care recipient hire and pay a relative directly for personal care. Two smaller paths exist alongside it: the federal VA Aid and Attendance benefit, which a veteran can use to pay a family caregiver, and the state’s Relative Caregiver Program, which pays non-parent relatives raising a dependent child placed with them by a court. Everything else Florida offers for family caregivers is support, respite, or services delivered by agencies rather than a paycheck.

Consumer Directed Care Plus: The Main Way Family Gets Paid

CDC+ sits inside the Statewide Medicaid Managed Care Long-Term Care program (SMMC LTC), which covers people who need a nursing-home level of care but want to stay at home.¹ Once someone is enrolled in SMMC LTC, they can request the CDC+ option, which by statute allows the participant to “choose the providers of services and to direct the delivery of services.”²

Under CDC+, the care recipient receives a monthly budget based on a functional needs assessment. They become the employer of record. They set the schedule, negotiate an hourly rate within program guidelines, and pay the caregiver for hands-on services like bathing, dressing, and meal preparation. A fiscal intermediary runs payroll and handles tax withholding so the family isn’t managing that paperwork alone.²

Florida explicitly allows spouses, parents, adult children, siblings, and other relatives to be hired as paid caregivers through CDC+.³ The spousal piece matters: many state Medicaid programs bar spouses from being paid, and Florida does not.

One rule to plan around before you apply. If a family member serves as the care recipient’s designated representative — the person who helps manage the budget and coordinate services — that same person cannot also be paid to provide care. The representative role is unpaid by design, so families need to decide who fills which role.³

Traditional SMMC LTC works differently. If a participant doesn’t choose CDC+, services come from agencies contracted with the participant’s health plan, and family generally cannot be paid unless they happen to work for one of those agencies. If your goal is getting paid to care for a relative, CDC+ is the option to request.

Who the Care Recipient Has to Be

Eligibility for SMMC LTC (and therefore CDC+) has three parts: who the applicant is, what they have, and how much care they need.

The applicant must be either an adult age 65 or older who qualifies for Medicaid, or an adult 18 or older who qualifies for Medicaid because of a disability. Being 18 alone doesn’t do it without a qualifying disability.¹

Countable income cannot exceed 300 percent of the federal SSI benefit rate. For 2026, the SSI rate is $994 per month, so the income ceiling works out to $2,982 per month.⁴ Countable assets for an individual are capped at $2,000. When only one spouse is applying, the non-applicant spouse can keep up to $166,660 in assets for 2026 without disqualifying the applicant, and couples are allowed to shift assets between themselves to meet these limits without triggering a penalty period.

The medical piece runs through the Comprehensive Assessment and Review for Long-Term Care Services (CARES). A CARES nurse or assessor from the Department of Elder Affairs evaluates the applicant at no cost, looking at limitations in daily activities like bathing, dressing, eating, and managing medications, to decide whether the person actually needs a nursing-home level of care.⁵

If Income Is Too High: The Miller Trust

Applicants whose monthly income runs above $2,982 aren’t automatically shut out. Florida allows a Qualified Income Trust, commonly called a Miller Trust, to bring countable income under the threshold. The trust has to be irrevocable, and Florida Medicaid must be named as the remainder beneficiary, so any money left in the trust when the recipient dies goes to Medicaid. Each month’s income must be deposited into the trust and spent that same month on approved health-related expenses like insurance premiums, medical supplies, and the recipient’s share of cost for care. Spending trust funds on property taxes, entertainment, gifts, or general household bills can wreck eligibility.

How to Apply

Start with your local Aging and Disability Resource Center (ADRC). Florida’s 11 regional ADRCs are the front door for elder services and will help identify which programs fit and start the screening.⁵ You can also reach the Department of Elder Affairs through the Elder Helpline at 1-800-963-5337.⁶

Next comes the CARES assessment, which decides whether the applicant meets the medical threshold and produces a care plan describing the services needed.⁵ Approved applicants receive a welcome letter with information about the managed care plans available in their region. Choice counselors at 1-877-711-3662 can help with plan selection. After enrolling in a plan, participants have 120 days to switch if it isn’t a good fit, then one annual open enrollment period going forward.⁷

To be paid as a family caregiver, the enrollee has to specifically request the CDC+ option through their managed care plan or the administering agency. It isn’t the default. Once in CDC+, every provider the care recipient hires, including family, must pass a background screening initiated through the state’s Clearinghouse, with rescreening every five years and after any employment gap over 90 days.⁸

Expect a Waitlist

Approval for SMMC LTC doesn’t always mean immediate enrollment. Applicants are assigned a priority score during the CARES assessment based on frailty, living situation, caregiver health, access to medical care, financial barriers, and limitations in daily activities. Higher scores move faster. The top priority, called Imminent Risk, is reserved for people in the community who cannot care for themselves, have no capable caregiver, and are likely to need nursing home or assisted living placement within one to three months. Nursing home residents who have been in a Florida-licensed facility for at least 60 consecutive days are exempt from the waitlist entirely. While you wait, keep your contact information current with the ADRC and report any decline in the care recipient’s condition, because it can bump the priority score up.

VA Aid and Attendance

Veterans and surviving spouses who already receive a VA pension and need help with daily activities like bathing, dressing, or feeding may qualify for Aid and Attendance, an added monthly payment on top of the regular pension.⁹ For 2026, the maximum added benefit reaches approximately $2,424 per month for a single veteran, $2,874 for a married veteran, and $1,558 for a surviving spouse. The VA does not restrict how the money is spent, so the recipient can use it to pay a family member for daily care. This is federal, not a Florida program, but Florida veterans are eligible if the service and medical criteria are met.

Relative Caregiver Program (For Children, Not Adults)

If you’re raising a relative’s child rather than caring for an adult, Florida’s Relative Caregiver Program is a separate track. It serves non-parent relatives raising children who have been adjudicated dependent and placed with the relative by a court. The child must be under 18, and only the child’s income and assets count toward eligibility, with a $2,000 asset limit. The relative caregiver needs an approved home study, must pass background checks, and must cooperate with child support enforcement. Monthly payments help cover the child’s food, clothing, shelter, and school supplies.¹⁰

Programs That Support Caregivers but Don’t Pay Them

Florida runs several programs aimed at family caregivers that are worth knowing about so you don’t waste months chasing the wrong door. None of them pay a family caregiver.

Community Care for the Elderly (CCE) delivers home-based services like personal care, homemaker help, meals, adult day care, respite, and transportation to functionally impaired adults 60 and older through 47 lead agencies. Services come from contracted providers, not family members hired directly.¹¹

Home Care for the Elderly (HCE) supports adults 60 and older who live with an approved caregiver in a family-type home setting as an alternative to nursing home placement. It provides a modest monthly subsidy for care-related costs, not caregiver wages, and financial eligibility is strict: income below the Institutional Care Program standard, ICP asset limits, and either SSI or low-income Medicare Beneficiary status.¹²

RELIEF (Respite for Elders Living in Everyday Families) matches screened volunteers with families caring for frail elders or people with Alzheimer’s, offering free in-home respite including evenings and weekends. No pay, but time off at no cost. Ask through the Elder Helpline at 1-800-963-5337 or your local ADRC.⁶

Are Those Payments Taxable?

Under IRS Notice 2014-7, certain Medicaid waiver payments qualify as “difficulty of care” payments that can be excluded from gross income entirely, but only if the caregiver and the care recipient share the same home. The IRS defines “the provider’s home” as the place where the caregiver lives and carries out the routines of private life, like sharing meals and holidays with family. A spouse who lives with the care recipient can exclude the payments. An adult child who drives over from their own house cannot, because the caregiver has a separate home.¹³

Even when the payments are excludable, caregivers can still choose to count them as earned income for the Earned Income Tax Credit or the Additional Child Tax Credit, because some low-income caregivers come out better with those credits than with the income exclusion. If you take the exclusion, report the nontaxable amount on Schedule 1, line 8, with “Notice 2014-7” as the explanation.¹⁴

If You Are Denied

A service denial from a managed care plan comes with a Notice of Adverse Benefit Determination. The first move is filing an appeal through the plan’s internal process. Complete that before asking for a state-level hearing. Once the plan issues its Notice of Plan Appeal Resolution, if the outcome is still unfavorable, you can request a Medicaid Fair Hearing. Requesting a fair hearing before the plan appeal is finished will likely be rejected.¹⁵

If the denial happened at the eligibility stage rather than the service stage, the CARES assessment results themselves can be challenged. If the care recipient has declined since the initial evaluation, requesting a new assessment with updated medical documentation may produce a different outcome. When the denial turns on financial eligibility — asset calculations, or whether a Miller Trust was properly structured — an elder law attorney is worth consulting before the appeal deadline passes.

1
Elder Affairs Florida. Statewide Medicaid Managed Care Long-Term Care Program
2
The Florida Legislature. Florida Statutes 0409.221 – Consumer-Directed Care Program
3
Agency for Persons with Disabilities. CDC Plus Program Handbook
4
Social Security Administration. SSI Federal Payment Amounts for 2026
5
Office of Program Policy Analysis and Government Accountability. Department of Elder Affairs
6
Elder Affairs Florida. Respite for Elders Living in Everyday Families (RELIEF)
7
Agency for Health Care Administration. Pick a Long-Term Care Plan
8
Agency for Persons with Disabilities. Background Screening Information for CDC+
9
Veterans Affairs. VA Aid and Attendance Benefits and Housebound Allowance
10
Florida Department of Children and Families. Relative Caregiver Funds
11
Elder Affairs Florida. Community Care for the Elderly (CCE) Program
12
Elder Affairs Florida. Home Care for the Elderly HCE Program
13
Internal Revenue Service. Certain Medicaid Waiver Payments May Be Excludable From Income
14
Taxpayer Advocate Service. Certain Medicaid Waiver Payments May Be Excludable From Income
15
Agency for Health Care Administration. Make a Complaint or Ask for a Fair Hearing About Long-Term Care Services