If you care for a parent or spouse, Alaska caregiver programs can cover help at home, and Medicaid's Community First Choice can even pay a qualified spouse to provide that personal care. The spouse must be employed by a state-certified provider., Personal Care Services covers similar help, and under its consumer-directed option your loved one chooses and hires their own assistant, though it generally cannot pay a spouse.,

Knowing that help exists is rarely the hard part. Knowing what it is and where to start is. This guide maps every major Alaska caregiver program for 2026, from Medicaid in-home care to free respite grants and VA benefits.

You don't have to figure this out alone, and you don't have to fund all of it from your savings.

In This Guide

Alaska Caregiver Programs at a Glance

Program What It Offers Pay a spouse? Cost to You
Community First Choice (CFC) In-home personal care, emergency response systems, case management and chore services, for people who need institutional-level care Yes, if employed by a state-certified provider Covered by Medicaid
Personal Care Services (PCS) In-home personal care; consumer-directed option lets your loved one hire their own assistant No, except a court-authorized guardian Covered by Medicaid
ALI waiver Respite, adult day, care coordination, meals, transportation and other services; no personal care No, except a court-authorized guardian Covered by Medicaid
NFCSP respite grants Respite at home or in adult day care, caregiver training, support groups N/A Free
VA PCAFC Monthly stipend VA considers a non-taxable benefit; pays spouses Yes Free (VA benefit)
VA Aid and Attendance Pension up to $29,093/yr, paid to the veteran; care from a relative does not block it Pension to veteran Free to apply (VSO help)

Who Pays Family Caregivers in Alaska?

If you are already doing the hands-on work of bathing, dressing, or supervising a loved one, Alaska Medicaid may be able to cover that help at home, and who it can pay depends on the program and on how you are related. In-home care runs through the Alaska Division of Senior and Disabilities Services (SDS), which administers three pathways that pay for in-home care.

  • Community First Choice (CFC) is a 1915(k) Medicaid state plan option that can include personal care services, personal emergency response systems, case management and chore services. To join, a person must meet federal rules for financial and medical needs, including needing care usually provided in an institution; the first step is to contact your local ADRC or DDRC.
  • Personal Care Services (PCS) is a state plan benefit offering help with daily tasks like bathing, dressing and eating, along with shopping, laundry and light housework, in an Agency-Based option and a Consumer-Directed option.
  • The Alaskans Living Independently (ALI) waiver is a 1915(c) home and community-based services waiver for people 65 or older and adults 21 to 64 with physical disabilities who meet a nursing-facility level of care. Its services include respite, adult day, care coordination, environmental modification, meals and transportation.

Under Consumer-Directed PCS, the person receiving care chooses, hires, supervises and can fire their own personal care assistant. Who can be the paid caregiver depends on the program:

  • Community First Choice can pay a spouse. Alaska regulation 7 AAC 127.015 lets a legally responsible individual, including the recipient's spouse, provide CFC personal care if they are qualified and employed by a provider the state certifies. The regulation still caps that work at 40 paid hours in a seven-day period, but SDS says it will not enforce that limit for CFC personal care and will remove it.
  • Personal Care Services generally cannot pay a spouse. Alaska does not pay a PCS assistant who is the recipient's spouse, the parent of a minor recipient, someone with a state-law duty to support the recipient, or the recipient's representative or that representative's designee, unless the person is a court-appointed guardian whom a court authorizes to provide the care. SDS states that legally responsible individuals may not provide State Plan PCS.
  • The ALI waiver may allow some relatives to be paid, but not a spouse. A spouse may not provide any ALI service unless they are a court-appointed guardian whom the court explicitly authorizes to provide waiver services. For a relative who is older than 18 and has no state-law duty to support the participant, the department may allow an SDS-certified provider to employ them for some listed services, such as respite, adult day, meals and transportation, with limitations. ALI does not include personal care.

If you have been caring for your husband or wife without pay, ask SDS about Community First Choice by name. CFC also has a route that does not depend on being a spouse: your loved one may select their representative to provide CFC personal care, and that representative must then name a designee who is at least 18, present in your loved one's community and involved in their day-to-day care, and willing to manage and evaluate the services as they are provided at home. PCS, by contrast, does not pay the recipient's representative or that representative's designee. Apart from that CFC route, none of these programs' rules name adult children specifically, so if you are an adult child, ask SDS at 907-269-3666 whether you can be hired before you count on being paid.,,, If you hold your loved one's power of attorney, SDS allows you to provide PCS or CFC personal care only if an additional person, not affiliated with a provider agency, is named jointly on the POA documentation and you appoint a designee.

Typical pay: about $19.11 an hour (estimate based on home care aide wages in Alaska, BLS, May 2025). That is the median wage for home health and personal care aides, so the program's actual pay may differ.

Eligibility rests on two tests, handled by two offices: a level-of-care assessment by SDS, and Medicaid income and resource limits, determined through an interview and application with the Division of Public Assistance (DPA). Long-term care Medicaid applies a 60-month (five-year) look-back on asset transfers. See the Alaska Medicaid eligibility and income limits guide for the current thresholds.

For the full walkthrough of who can be paid and how the paychecks work, see How to Get Paid as a Family Caregiver in Alaska.

How to Start Medicaid In-Home Care

Starting Medicaid in-home care feels bureaucratic from the outside, but it comes down to four steps.

1
Step 1

Call Senior and Disabilities Services

Reach SDS at 907-269-3666 to ask about assessment and home and community-based services. For CFC, the first step is to contact your local ADRC or DDRC.

2
Step 2

Complete the eligibility determination

SDS assesses whether your loved one meets the level-of-care requirement, while the Division of Public Assistance determines Medicaid income and resource eligibility through an interview and application. Long-term care Medicaid applies a 60-month look-back on asset transfers, so gather five years of financial records before you apply.

3
Step 3

Choose your program

With help from SDS, pick the pathway that fits (CFC, PCS, or the ALI waiver). Under PCS, the Consumer-Directed option lets the person receiving care choose and hire their own personal care assistant.

4
Step 4

Hire your caregiver

Under consumer-direction, the person receiving care hires the assistant. A spouse can be hired for CFC personal care through a state-certified provider, but generally not for State Plan PCS. If you are an adult child or another relative, confirm with SDS whether you can be hired and paid before care starts.,

Respite Care in Alaska, With or Without Medicaid

Caregiving without a break is how burnout starts, and respite exists precisely because no one can be on call around the clock indefinitely. Alaska funds it whether or not your loved one is on Medicaid.

The National Family Caregiver Support Program (NFCSP), funded by Title III-E of the Older Americans Act, flows through Alaska's nine designated Family Caregiver Support Program grantees. Services include information and help accessing services, respite, caregiver support groups, caregiver training, and supplemental services. Because NFCSP is a caregiver-support grant program separate from Medicaid, you qualify based on the caregiving relationship (caring for an adult 60 or older, or a person of any age with Alzheimer's or a related disorder) rather than on your loved one's Medicaid status. Respite and supplemental services carry one more federal condition: the older person you care for must be frail, meaning unable to perform at least two activities of daily living without substantial help, or needing substantial supervision because a cognitive or other mental impairment leads them to behave in a way that poses a serious health or safety hazard to themselves or someone else. Call 907-269-3666 (Alaska Senior and Disabilities Services) to reach a local grantee, or dial 211.,

State Medicaid programs and waivers can also authorize respite within the care plan. For the full respite guide, see Respite Care in Alaska.

Where to Get Help

You do not need to know which program you qualify for before you call. A counselor will identify what is available in your area and help you start an application. These are the front doors, and every call below is free.

Alaska Senior and Disabilities Services (SDS) Administers Alaska Medicaid home and community-based services, including Community First Choice, Personal Care Services, and the ALI waiver, and assesses level of care. Medicaid financial eligibility is handled by the Division of Public Assistance. 907-269-3666 health.alaska.gov/en/senior-and-disabilities-services
Alaska Family Caregiver Support Program (SDS) Connects you to NFCSP respite, caregiver training, and support groups through one of Alaska's Family Caregiver Support Program grantees. 907-269-3666 acl.gov/programs/support-caregivers/national-family-caregiver-support-program
Alaska 2-1-1 The statewide social-services helpline for the broader network of local resources beyond aging and Medicaid programs. 211 alaska211.org
VA Caregiver Support Line For family caregivers of veterans: help, support, and referrals. It is staffed Monday through Friday, 8:00 a.m. to 8:00 p.m. Eastern Time, and it is not a crisis line. In a crisis, call 988 and press 1. 1-855-260-3274 www.caregiver.va.gov

VA Caregiver Benefits in Alaska

If the person you care for is a veteran enrolled in VA health care, a separate set of VA benefits opens up. VA says a veteran and caregiver may take part in more than one in-home care program, so VA benefits and Medicaid can be combined, but not to pay for the same personal care. One PCAFC requirement is that the personal care the Family Caregiver would provide is not simultaneously and regularly provided by or through another individual or entity, and VA will revoke a caregiver's designation if the veteran stops meeting it. Before another program, such as an Alaska Medicaid personal care program, pays for that same personal care, ask your local VA Caregiver Support Program team how the two fit together.

VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

The PCAFC pays a monthly stipend to the Primary Family Caregiver of an eligible veteran. VA says the stipend is considered a non-taxable benefit, and a spouse can be the paid caregiver., VA's first screen has four requirements, all of which must be true: a VA disability rating (individual or combined) of 70 percent or higher, a discharge from the U.S. military or a date of medical discharge, a need for at least six months of continuous, in-person personal care services, and enrollment in VA health care. Meeting those four does not settle it: you and the veteran apply together, and VA decides eligibility through that application. Once approved, the caregiver must enroll in direct deposit through the VA customer engagement portal to receive the monthly stipend.

The stipend is calculated from the federal GS-4, Step 1 annual rate for the veteran's locality, divided by 12, then multiplied by a factor set in 38 CFR 71.40(c)(4)(i). The formula looks technical, but the idea is simple: the factors are the same in every state, and only the monthly rate changes with the federal pay area where the veteran lives. Which factor applies depends on how the veteran qualifies:

  • Current program (38 CFR 71.20(a)): the factor is 0.625, or 1.00 if VA determines the veteran is unable to self-sustain in the community.
  • Legacy participant or legacy applicant (38 CFR 71.20(b) or (c)): the factor comes from the sum of the veteran's 2019 clinical ratings instead, 1.00 for a sum of 21 or higher, 0.625 for 13 to 20, and 0.25 for 1 to 12. No self-sustain determination is required on this route.

A veteran who meets both tests is paid the higher of the two amounts. A legacy participant under 71.20(b) also has a floor: the stipend cannot drop below what the caregiver was eligible to receive on September 30, 2020, for as long as the veteran remains at the address VA has on record. The legacy provisions run until October 1, 2028.

VA Aid and Attendance Pension

Wartime veterans and surviving spouses who meet the functional criteria and have countable assets and income under the net-worth limit ($163,699 in 2026) may receive the Aid and Attendance pension. VA sets these maximums as annual amounts: a single veteran with Aid and Attendance receives up to $29,093 a year; a veteran with one dependent up to $34,488 a year. A monthly payment is the maximum annual rate minus countable income, divided by 12 and rounded down to the whole dollar. The pension goes to the veteran, not to a caregiver, and VA rules say that aid and attendance given by a relative or another member of the household does not prevent VA from granting the allowance.

The State of Alaska Office of Veterans Affairs and the Veteran Service Officers it works with help veterans file VA claims free of charge.

VA Caregiver Support Line: 1-855-260-3274, Monday through Friday, 8:00 a.m. to 8:00 p.m. Eastern Time.

Taxes for Alaska Caregivers

Once you are being paid to provide care, the natural next question is how that income is taxed. The answer depends on which program pays you.

Under IRS Notice 2014-7, payments to an individual caregiver for care under a 1915(c) Medicaid home and community-based services waiver can be excluded from your federal gross income when the care is given in your home and the person you care for lives there with you under their plan of care. Your home, for this rule, is where you live and carry on the routines of your private life. The exclusion does not apply if you have a separate home where you live.

The program matters here. In Alaska, the ALI waiver is a 1915(c) waiver, but Personal Care Services is a state plan benefit and Community First Choice is a 1915(k) option. The IRS does not treat the exclusion as automatic for payments under a Medicaid program that is not a 1915(c) waiver. It says the answer depends on the nature of the payments and the purpose and design of the program. If you are paid through one of those programs, do not assume the exclusion applies. Confirm it with a tax professional before filing.,

Alaska has no state personal income tax, so there is no state income tax on caregiver wages. Confirm how any Medicaid waiver payments are reported with a tax preparer.

For veterans' caregivers, VA says the PCAFC monthly stipend is considered a non-taxable benefit, similar to veteran disability payments.

Not sure which Alaska caregiver program fits your family? Chat with Brevy's care navigator for a personalized comparison based on your loved one's Medicaid enrollment, veteran status, and whether you are a spouse or non-spouse caregiver.

Frequently Asked Questions

Can I get paid to care for my spouse in Alaska?

Yes, through Community First Choice, but generally not through Personal Care Services. Alaska regulation lets a spouse provide CFC personal care if qualified and employed by a state-certified provider, and CFC requires that your spouse need the kind of care usually provided in an institution., State Plan PCS does not pay a spouse, and a spouse cannot provide any service under the ALI waiver, unless a court has appointed the spouse as guardian and authorized them to provide the care., If your spouse is a veteran, VA's PCAFC stipend can also pay a spouse. Call Senior and Disabilities Services at 907-269-3666 to start.

Do I have to qualify for Medicaid to be paid as a caregiver in Alaska?

For Medicaid in-home care, the person receiving care does: your loved one must meet both the SDS level-of-care requirement and Medicaid income and resource limits, which the Division of Public Assistance determines. Once they qualify, a spouse can be hired for CFC personal care through a state-certified provider, but generally not for State Plan PCS., Apart from CFC's route for a representative your loved one selects, adult children are not named in either program's rules, so ask SDS. Long-term care Medicaid applies a 60-month look-back on asset transfers. See the Alaska Medicaid eligibility and income limits guide for current thresholds.

Is there free respite in Alaska without Medicaid?

Yes. The National Family Caregiver Support Program provides respite through Alaska's Family Caregiver Support Program grantees, and it is separate from Medicaid. You qualify based on the caregiving relationship (caring for someone 60 or older, or a person of any age with Alzheimer's or a related disorder), not on Medicaid enrollment, though federal law limits respite to caregivers of an older person who is frail. Call 907-269-3666 (Alaska Senior and Disabilities Services) or dial 211.

Which VA programs pay family caregivers in Alaska?

The PCAFC stipend (for veterans with a 70%+ disability rating who meet VA's other requirements; VA considers it a non-taxable benefit, and a spouse can receive it) pays the caregiver directly. The Aid and Attendance pension (for wartime veterans and surviving spouses under the net-worth limit) is paid to the veteran or surviving spouse rather than the caregiver, and care from a relative or household member does not prevent the award. Call the VA Caregiver Support Line at 1-855-260-3274.,,,,

How do I reach a Family Caregiver Support Program grantee in Alaska?

Call 907-269-3666 (Alaska Senior and Disabilities Services) to reach a local grantee, or dial 211. They handle NFCSP respite, caregiver training, and support groups.

Learn More

Find personalized help navigating Alaska caregiver programs at brevy.com.


The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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