Get Paid to Care for Your Spouse in Colorado (2026)

Can you get paid to care for your spouse in Colorado? In many states the answer is a flat no, but Colorado is one of the states where the answer is yes.

Spouses are turned away in a lot of places, because most Medicaid home-care benefits treat a husband or wife as a "legally responsible relative" who is already expected to help for free. Colorado works differently. Through its self-directed Medicaid programs, a spouse can be hired and paid as the caregiver, and if the person you care for is a veteran, the VA pays spouses too.

In This Guide

• Key Takeaways
• Can You Get Paid to Care for Your Spouse in Colorado?
• The Medicaid Self-Directed Route: CDASS and IHSS
• When a Spouse Is Blocked: the Legally Responsible Relative Rule
• The VA Route: PCAFC and Veteran-Directed Care
• Aid and Attendance for a Veteran Spouse
• How to Get Paid to Care for Your Spouse in Colorado: Who to Call
• Frequently Asked Questions
• Learn More

Can You Get Paid to Care for Your Spouse in Colorado?

Yes. This is the answer many families searching for how to get paid to care for your spouse in Colorado are surprised to hear, because the same question in a neighboring state so often ends in a no.

Here is why Colorado is different. When Medicaid pays a family member for personal care, federal rules draw a line between relatives who choose to help and relatives who are already legally expected to help. A husband or wife falls in the second group. In Medicaid's language a spouse is a "legally responsible relative," one of the people who have a duty under state law to care for another person, and that status can block payment under the most basic Medicaid home-care benefit.8

But that block only applies to one kind of benefit. It does not apply to Colorado's self-directed programs, and that is the door spouses walk through here. Colorado runs two self-directed Medicaid options, CDASS and IHSS, and both allow a family member, including a spouse, to be the paid attendant.1,2 So the honest answer for Colorado is not "maybe" and not "call and hope." It is yes, through a specific route, with a specific limit, and the rest of this guide is about getting you onto that route.

The Medicaid Self-Directed Route: CDASS and IHSS

Both Colorado routes rest on the same idea, called self-direction. Instead of an agency assigning a stranger to your home, self-direction lets the person receiving care, or their authorized representative, control the budget and choose, hire, train, and supervise their own attendant, with a financial management company handling payroll and taxes.9 That authority is exactly what lets a spouse become the paid worker.

CDASS (Consumer-Directed Attendant Support Services). This is the fuller self-direction option. The member holds both budget authority and employer authority, meaning the member or their authorized representative selects, hires, trains, schedules, and sets the pay rate for their own attendants within a monthly allocation, and picks a Financial Management Services vendor (Colorado contracts with Palco and Public Partnerships) to run payroll and tax withholding.3 Colorado's own rules confirm a family member, including a spouse, may be hired and paid as the attendant.1

IHSS (In-Home Support Services). This option works much the same way, except an enrolled IHSS agency serves as the attendant's legal employer and handles hiring, payroll, and supervision while the member still directs the care. IHSS also lets an attendant perform certain skilled "health maintenance activities" under professional training and oversight. A spouse can be a paid IHSS attendant, but with one wrinkle worth planning around: the authorized representative who directs or signs off on the attendant's care must be a different person, and cannot be the paid attendant.2 As of July 1, 2025, both CDASS and IHSS are delivered through Colorado's Community First Choice (CFC) Medicaid State Plan benefit, so newly enrolled members reach them directly through CFC.3

Two practical limits shape what a spouse actually earns. First, the hours. Colorado's CDASS rule never uses the word "spouse." It defines a family member as anyone related to the member by blood, marriage, adoption, or common law, which is how a husband or wife is covered, and it says a family member or legal guardian cannot be reimbursed for more than 40 hours of CDASS in a seven-day period running from Sunday through Saturday. Two narrower limits sit inside that one, and both matter for a spouse. A member of the client's household, which is where a husband or wife living in the same home lands, may be paid only to furnish extraordinary care as determined by the case manager, meaning care that exceeds the range of care a family member would ordinarily perform in the household for a person of the same age without a disability or chronic illness. That extraordinary care has to be documented on the service plan. Separately, under Community First Choice, a legally responsible person providing Homemaker services is limited to 10 hours per week rather than 40, though the member can receive additional homemaker hours from a different provider or from another legally responsible person.3 Second, the pay rate: Colorado sets a minimum base wage for HCBS direct care workers, and effective January 1, 2026 that floor is $17.00 per hour statewide, rising to $19.29 per hour in Denver and $18.17 per hour in Edgewater to match those cities' local minimums.10 The member sets the actual rate within the monthly allocation, but it cannot fall below that floor.

When a Spouse Is Blocked: the Legally Responsible Relative Rule

It helps to understand the rule Colorado is stepping around, both so you can explain your situation clearly on the phone and so you know what to avoid.

Under the standard Medicaid state plan personal care benefit, the services must be "provided by an individual who is qualified to provide such services and who is not a member of the individual's family," and for that benefit a family member "means a legally responsible relative." A spouse fits that description, so under the plain personal care benefit a spouse cannot be the paid worker.8 That is the rule that produces a no in many states, and it is why a general question to a caseworker can get a general no even in Colorado.

The way past it is to ask specifically about self-direction. Federal rules give each state the option, under self-directed personal assistance authority, to let participants hire "any individual capable of providing the assigned tasks, including legally liable relatives," and the definition of legally liable relatives expressly includes a spouse.8 Colorado has taken that option through CDASS and IHSS. So the same word, "spouse," that closes the door on the basic benefit is allowed under self-direction. If someone tells you a spouse cannot be paid, the follow-up question is: "What about the self-directed option, CDASS or IHSS?"

The VA Route: PCAFC and Veteran-Directed Care

If the person you care for is a veteran, you have a second, entirely separate path, and the VA is the one system built to pay spouses directly. It applies anywhere in Colorado and does not depend on Medicaid.

The centerpiece is the Program of Comprehensive Assistance for Family Caregivers (PCAFC), which pays an eligible veteran's approved Primary Family Caregiver a tax-free monthly stipend, and a spouse is expressly allowed to be that caregiver. To qualify, the veteran generally needs a VA disability rating of 70 percent or higher, must need at least six months of continuous in-person personal care, and must be enrolled in VA health care.4 The stipend is not a single national figure. It starts from the OPM GS-4, step 1 annual rate for the locality where the veteran lives, divided by 12 to give a monthly base, so the exact amount depends on where in Colorado you live. It is not an hourly wage. 38 CFR 71.40(c)(4)(i) then multiplies that base by a factor, and which factor applies turns on whether the veteran is in the current program or is a legacy participant or legacy applicant under the pre-October 2020 rules. In the current program the factor is 0.625, or 1.00 when the VA finds the veteran unable to self-sustain in the community. On the legacy route it comes from the sum of the veteran's 2019 clinical ratings instead, with no self-sustain determination required: 1.00 at a sum of 21 or higher, 0.625 at 13 to 20, and 0.25 at 1 to 12. A veteran who meets both sets of criteria is paid whichever amount is higher, a legacy participant's stipend cannot fall below what the caregiver was eligible for the day before October 1, 2020 while the veteran remains at the address on record, and the legacy schedule lapses October 1, 2028.4 If your spouse is a legacy participant, do not treat 0.625 as your ceiling; our Colorado guide to getting paid as a family caregiver sets out all five rows and what to ask your Caregiver Support Coordinator.

The second VA route is Veteran-Directed Care (VDC), which works on the same self-direction principle as Medicaid. The veteran receives a monthly budget set by the VA and uses it to hire and supervise their own caregivers, including family and friends, with a financial management service handling payroll. In Colorado, VDC is offered in the Denver metro area through the Denver Regional Council of Governments (DRCOG) Area Agency on Aging in partnership with the Rocky Mountain Regional VA Medical Center, and other Colorado Area Agencies on Aging partner with VA medical centers to offer it in their regions.5 Because VDC is self-directed, there is no rule against paying a spouse from the veteran's budget.

Aid and Attendance for a Veteran Spouse

Aid and Attendance comes up often in the same searches, so it is worth being clear about what it is and is not. It is not a wage paid to you as the spouse. It is an increase to a veteran's or surviving spouse's VA pension for someone who needs another person's help with daily activities such as bathing, dressing, and eating.4

What it does is add household income a couple can put toward care however they choose, including making up for income a spouse gave up to provide that care. The VA publishes these ceilings as annual amounts and pays a twelfth of the award each month. For 2026, a single wartime veteran with no dependents who qualifies for Aid and Attendance can receive up to $29,093 a year, about $2,424 a month, and a surviving spouse can receive up to $18,697 a year, about $1,558 a month.11 Aid and Attendance requires that the veteran or survivor already qualify for a VA pension, which has income and net-worth tests (the 2026 net-worth limit is $163,699), so it reaches lower-income households.11 If your spouse is a veteran, it is worth checking whether PCAFC, Veteran-Directed Care, or Aid and Attendance fits your situation, since they serve different needs and can sometimes work together.

How to Get Paid to Care for Your Spouse in Colorado: Who to Call

Because the paying program is a Medicaid benefit, the path runs through Colorado Medicaid, and it usually takes a few weeks rather than a single call. Here is the order that works.

One caution before you set anything up informally: Colorado Medicaid applies a five-year (60-month) look-back to asset transfers when it determines long-term-care eligibility, and paying a family caregiver informally, without a written agreement, can be treated as an uncompensated transfer that creates a penalty period.13 Getting paid through CDASS or IHSS, with a real employment arrangement and a financial management company, avoids that trap. And on taxes: when you live in the same home as the person you care for and are paid through a Medicaid program, your wages may be excludable from federal gross income as "qualified Medicaid waiver payments" under IRS Notice 2014-7, an exclusion that reaches Medicaid waiver payments but not money paid from your own funds.14 Because spouses so often share a home, this frequently applies. State income-tax treatment varies, so ask a tax preparer familiar with Medicaid caregiver pay before you file.

Learn More

Find personalized help getting paid to care for your spouse in Colorado 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.