caregiver/florida/how-to-get-paid-family-caregiver

{{component: hero}}

By Brevy Care Team

Florida is one of the few states in America where Medicaid will pay a spouse to care for their husband or wife. That single fact makes Florida's family-caregiver landscape unusually permissive, and unusually misunderstood. Most national articles about paid family caregiving lump every state together and get Florida wrong. This guide does not. We walk through every legitimate pathway in Florida for 2026, who can actually be hired under each, what the pay looks like, and how to choose the right program for your family's situation. {{/component}}

{{component: callout, type: key-fact}}

Key Takeaways

• Six Florida pathways pay family caregivers in 2026. SMMC LTC Participant-Directed Option (PDO), three VA programs (PCAFC, Veteran Directed Care, Aid & Attendance), private Personal Care Agreements, and long-term care insurance reimbursement each have different rules, payers, and who can be paid.
• Florida's PDO is one of the most permissive consumer-direction programs in the country. Spouses, adult children, parents of an adult member, siblings, friends, and neighbors can all be hired as paid Direct Service Workers under the SMMC LTC waiver.
• Spouses CAN be paid under PDO, this distinguishes Florida from most other state HCBS waivers and from Texas's Consumer Directed Services (CDS) program (which does NOT allow spouses). Tennessee's pre-2025 Consumer Direction also excluded spouses; Florida has never had that ban.
• VA PCAFC pays a monthly tax-free stipend to the primary family caregiver of an eligible veteran in Florida, with the amount pegged to the GS-4 federal pay scale and adjusted by VA locality. It can be combined with other Medicaid pathways and Aid & Attendance.
• Paying a family member without a written caregiver agreement can trigger Florida's 60-month Medicaid look-back. AHCA sets Florida's annual transfer-penalty divisor based on average private-pay nursing-facility cost. Use a Florida elder-law attorney to draft the contract before services begin. {{/component}}

The 60-second version

If you're an adult child, sibling, niece, nephew, friend, or neighbor of a Medicaid-eligible adult in Florida, the SMMC LTC Participant-Directed Option (PDO) is the most direct path to being paid. Your loved one applies for the Long-Term Care waiver through DCF + DOEA + AHCA, gets enrolled in PDO through their managed care plan, and hires you as their Direct Service Worker through the plan's Fiscal/Employer Agent (GT Independence or PPL).

If you're a spouse, you have an option in Florida that you don't have in most other states. Under 42 CFR §441.301(c)(4)(vi), Florida's approved waiver lets "legally responsible individuals, including spouses" serve as paid PDO workers, provided you meet all worker requirements (age 18+, Level 2 background screening, executed worker agreement) and the work goes beyond the level of care you'd ordinarily provide for free.

If your loved one is a wartime veteran, VA programs (Aid & Attendance, Veteran Directed Care, PCAFC) often pay more than Medicaid-side programs and can stack with them.

If you have enough private assets, a written Personal Care Agreement at fair-market wages can pay you while reducing your loved one's estate for eventual Medicaid planning. Florida's 60-month look-back makes the contract format critical.

The details matter. Below is the full map.

The Florida pathway map

{{component: table}}

Each row is a separate door. Some families combine two or three (e.g., PDO + VA Aid & Attendance), which is generally allowed as long as each program's authorized hours are tracked separately. The pages below walk through each pathway in order.

Pathway 1, Florida SMMC LTC Participant-Directed Option (PDO)

The Participant-Directed Option, or PDO, is the consumer-direction track within Florida's Statewide Medicaid Managed Care Long-Term Care (SMMC LTC) waiver. It lets a Medicaid LTC member act as the employer of record for their own caregivers, choosing who to hire, training them, scheduling their work, and approving their timesheets, for a defined subset of services. PDO is offered by every Florida LTC managed care plan (Humana, Sunshine Health, Aetna Better Health of Florida, Simply Healthcare, and Florida Community Care).

Who can use PDO

To use PDO, the Medicaid recipient must:

• Be enrolled in the SMMC LTC waiver (not just regular Medicaid, see /medicaid/florida/long-term-care-waiver)
• Be community-dwelling, living in their own home, a relative's home, or another non-facility setting; PDO is not used while the member resides in an Assisted Living Facility, Adult Family Care Home, or nursing facility
• Have at least one PDO-eligible service on their Plan of Care (see below)
• Be willing and able to manage the worker, or designate a PDO Representative who is

PDO-eligible services

Under Florida's approved waiver and the AHCA Exhibit II-B contract, the services that can be self-directed under PDO are:

• Adult Companion Care, supervision, social interaction, light meal prep
• Homemaker Services, light housekeeping, laundry, errands
• Personal Care / Attendant Care, bathing, dressing, toileting, transferring, ambulation, eating
• Intermittent and Skilled Nursing, note: skilled nursing tasks under PDO require a licensed nurse worker
• In-Home Respite Care, short-term relief for the primary unpaid caregiver

Other services on the LTC Plan of Care (case management, adult day care, home delivered meals, ALF placement, transportation, durable medical equipment, etc.) are delivered through the agency-provider network, not PDO.

Who can be hired as a PDO worker

This is the section where Florida diverges most sharply from other states. The state's approved waiver explicitly contemplates that legally responsible individuals, including spouses, may serve as PDO Direct Service Workers, provided all worker requirements are met. Specifically, eligible PDO workers in Florida include:

• Spouses (rare among state HCBS waivers, Florida is one of the more permissive)
• Adult children of the member
• Parents of an adult member
• Siblings, nieces, nephews, cousins, and other relatives
• Friends and neighbors

Important restrictions:

• Workers must be at least 18 years old. Minor children of the member cannot be hired.
• A PDO Representative cannot also be the paid worker for the same member. If the member needs help managing their care AND wants a family member as a paid worker, those have to be two different people.
• A paid PDO worker cannot also receive Caregiver Training service hours, which are reserved for unpaid informal caregivers.
• Hiring a spouse can shift Medicaid eligibility math. A spouse's wages count as the couple's income, which in some cases can reduce the at-home spouse's MMMNA share or increase the applicant's patient liability. Run the numbers with a Florida Medicaid planner before electing a spouse-worker.
• All workers must pass a Level 2 background screening under Chapter 435 of the Florida Statutes, fingerprint-based, AHCA + FDLE + FBI, before they can be paid.

The "extraordinary care" rule

Federal HCBS waiver policy (42 CFR §441.301(c)(4)(vi) and CMS sub-regulatory guidance) lets states pay legally responsible relatives, including spouses, but only for services that go beyond the natural level of care a family member would ordinarily provide voluntarily without compensation. This is the federal "extraordinary care" standard.

In practice, Florida implements the standard through the LTC plan's needs assessment and Plan of Care. The case manager documents:

• The member's clinical need (functional limitations, ADL/IADL deficits)
• The total authorized service hours
• Which services and which hours can be self-directed under PDO
• The expected outcomes

The PDO worker logs only authorized PDO services on the EVV record (more on EVV below), and pay flows only against authorized hours. A spouse who is already cooking dinner and watching TV with their husband is not "extraordinary care"; a spouse who is providing 4 hours/day of bathing, transferring, toileting, and medication reminders that would otherwise require a paid agency aide is.

Pay rates

PDO workers are paid hourly out of an authorized care-plan budget set by the LTC plan's case manager. The member or PDO Representative determines the worker's specific hourly rate within the budget. Florida's statewide minimum wage in 2026 is $14.00/hour, scheduled to rise to $15.00/hour on September 30, 2026 (the final step of the 2020 constitutional amendment, after which annual CPI-based adjustments begin in 2027).

Actual PDO rates vary widely:

• Personal care / homemaker / companion: starts at Florida's minimum wage ($14.00/hour in 2026, rising to $15.00 on September 30)
• Skilled nursing tasks: higher rates reflecting LPN/RN licensure requirements
• Respite (short-shift coverage): at or above Florida's minimum wage

Total monthly pay depends on the authorized hours on the Plan of Care. As an illustrative example, a PDO budget for a community-dwelling member with significant ADL deficits might authorize around 30–60 hours/week; at $15/hour that would equal roughly $1,800–$3,600/month gross — actual hours depend entirely on the assessed Plan of Care. After payroll taxes (FICA, FUTA, Florida reemployment tax) handled by the F/EA, the worker's net pay arrives by direct deposit or paper check on the F/EA's pay schedule.

The Fiscal/Employer Agent (F/EA) split by plan

Florida uses a co-employer model. The member is the legal employer of record (for hiring, firing, and supervision); the F/EA is a co-employer for tax purposes only under IRS Section 3504. The F/EA handles payroll, tax withholding, EVV system access, and worker payments. Florida's F/EA assignment differs by LTC plan:

• GT Independence (gtindependence.com), F/EA for Humana Healthy Horizons, Sunshine Health, and Aetna Better Health of Florida
• Public Partnerships LLC (PPL, publicpartnerships.com), F/EA for Simply Healthcare, Florida Community Care (FCC), and historically AmeriHealth Caritas

Confirm the exact F/EA assignment with the member's specific LTC plan, as plan-vendor relationships occasionally shift. The choice of F/EA matters because each runs its own onboarding workflow, its own EVV mobile app, and its own pay calendar, but it does not change worker eligibility rules, which are set by Florida's waiver, not by the F/EA.

EVV (Electronic Visit Verification)

Federal Electronic Visit Verification is required for all PDO personal care and home health services under the 21st Century Cures Act (P.L. 114-255, §12006). Florida-PDO workers clock in and out via the F/EA's mobile app, IVR phone system, or web portal. EVV captures:

• The worker's identity (login)
• The member's identity (case)
• The date
• The start and end times
• The service type
• The location (GPS or designated landline)

EVV is the audit trail that makes the federal program possible. Workers who log time but don't appear at the member's location, or who log services not authorized on the Plan of Care, can have shifts denied and face termination. Florida is enforcing EVV consistently across all five LTC plans and both F/EAs.

How to enroll in PDO

{{component: accordion}}

Step 1: Get enrolled in the SMMC LTC waiver

PDO is only available to LTC waiver members. If your loved one is not yet on the LTC waiver, that's the first step. See /medicaid/florida/how-to-apply for the full waiver application walkthrough. The shortcut: call the Elder Helpline at 1-800-963-5337, ask for the Area Agency on Aging, and request a 701S screening to start the LTC clock.

Step 2: Pick (or stay with) an LTC managed care plan

Once enrolled, the member is assigned an LTC plan or chooses one through AHCA's enrollment broker (1-877-711-3662 / flmedicaidmanagedcare.com). All five Florida LTC plans offer PDO, but the F/EA differs. If the family already knows they want PDO, this is a useful factor in plan choice, workers who are familiar with one F/EA's app may find another's clunky.

Step 3: Request the PDO option from the case manager

Once enrolled, the LTC plan assigns a case manager. Tell them: "We want to use the Participant-Directed Option to hire a family member as the personal care worker." They will:

• Confirm that PDO is appropriate (community setting, eligible services on the Plan of Care)
• Identify the F/EA for your plan
• Initiate the orientation and worker recruitment process
• Make sure the Plan of Care has the right hours authorized

Step 4: Recruit and onboard the worker

The member (or PDO Representative) recruits the family member, friend, or neighbor. The F/EA then:

• Processes the Level 2 background screening (fingerprinting at an AHCA-approved Livescan vendor, usually $40–$80, sometimes covered)
• Collects required tax forms (W-4, I-9, Florida Direct Deposit form)
• Trains the member and worker on EVV (mobile app, web portal, or IVR phone)
• Issues the worker's first time-tracking access

Step 5: Worker starts shifts and gets paid

The worker delivers authorized care, clocks in/out via EVV, and the F/EA pays on the established calendar (typically every 2 weeks via direct deposit). The member or representative reviews and approves shifts before payroll processes. {{/component}}

Common PDO pitfalls

• The "I'll fix the paperwork later" approach. Workers who deliver care before the background screening clears do not get paid for those hours. Only authorized, EVV-logged shifts of pre-cleared workers count.
• Hiring a spouse without running the eligibility math. A spouse who earns $2,500/month from PDO may be raising the couple's income enough to threaten the at-home spouse's MMMNA. Run the numbers first.
• Confusing PDO with the legacy CDC+ program. Florida's earlier Consumer Directed Care Plus (CDC+) program operated alongside the pre-managed-care waivers and has been folded into PDO under SMMC LTC. There is no separate CDC+ enrollment anymore.
• Skipping the case manager. PDO is a benefit, not a default. The member's case manager has to elect PDO on the Plan of Care. Don't expect it to happen automatically just because you ask the F/EA.
• Forgetting that the PDO Representative cannot also be the paid worker. If a daughter is going to manage the case AND get paid, the family needs a second person to be the PDO Representative, a different sibling, an attorney, or a non-paid friend.

Pathway 2, VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

If your loved one is a wartime veteran with a service-connected disability, the VA PCAFC program may pay you a monthly stipend to be the primary family caregiver. PCAFC is a separate federal program from Medicaid, it does not require Medicaid enrollment.

Who qualifies

The veteran must:

• Be enrolled in VA health care
• Have a single or combined service-connected disability rating of 70% or higher (regardless of when the service was)
• Need at least 6 months of continuous in-person personal-care services from another person, due to a service-connected condition causing inability to perform ADLs, the need for supervision/protection due to neurological impairment, or both

The family caregiver must:

• Be at least 18 years old
• Be a spouse, child, parent, step-family member, extended family member, or someone who lives with the veteran full-time (or will after approval)
• Be willing to undergo training and a home visit

What it pays

PCAFC pays a monthly tax-free stipend pegged to the GS-4 federal pay scale, adjusted for VA locality. Tier 2 (moderate caregiving need) and Tier 3 (highest need) carry different rates; current figures are published at caregiver.va.gov. The veteran also receives access to caregiver training, mental health counseling, and respite care (up to 30 days/year of substitute coverage).

How to apply

Submit VA Form 10-10CG at caregiver.va.gov or call the Caregiver Support Line at 1-855-260-3274. Each VA Medical Center has a local Caregiver Support Coordinator, Florida has VA medical centers in Bay Pines, Gainesville, Lake City, Miami, Orlando, Tampa, West Palm Beach, and several outpatient clinics. The application typically processes in 30–60 days.

Stacking with other pathways

PCAFC stipends can stack with VA Aid & Attendance, Florida Medicaid (including PDO if the veteran is Medicaid-eligible), and Personal Care Agreements. A single family caregiver can receive PCAFC and PDO for the same veteran simultaneously, as long as the authorized hours on each program don't overlap.

Pathway 3, VA Veteran Directed Care (VDC)

VDC is a separate VA program that gives eligible veterans a flexible monthly budget — set by the VA's local Geriatrics & Extended Care office based on assessed need — that the veteran can use to hire their own caregivers, including family members and spouses. VDC is administered through Florida's Area Agencies on Aging (the same AAAs that run the LTC 701S) under contract with the VA.

Who qualifies

VDC is available to veterans of any era who are enrolled in VA health care, are clinically eligible for nursing home placement, and want to receive care at home instead. The VA's local Geriatrics & Extended Care office determines eligibility.

How it works

The veteran works with an AAA care advisor to develop a Spending Plan, a budget specifying who will be hired, what tasks, how many hours, and at what hourly rate. Family members, including spouses, can be hired and paid. The AAA acts as the F/EA for VDC payments.

How to apply

Call the VA medical center's social work or geriatrics department and ask about Veteran Directed Care eligibility. Or call 1-877-222-VETS (8387) for general VA benefits guidance.

Pathway 4, VA Aid & Attendance

Aid & Attendance (A&A) is an enhanced VA pension benefit for low-income wartime veterans (and their surviving spouses) who need help with ADLs or are housebound. A&A is paid to the veteran, who can then use the money however they want, including to pay a family member for care. The family member is paid out of the veteran's pocket; A&A is not a direct caregiver wage.

What it pays

A&A benefit amounts are adjusted annually with COLA and differ by recipient category (single veteran, veteran with dependent, surviving spouse). Current figures are published at va.gov/pension.

Who qualifies

The veteran must have served at least 90 days of active duty, with at least one day during a wartime period, and meet income/asset limits. The medical eligibility hinges on the need for help with ADLs, blindness, nursing home placement, or housebound status.

How to apply

File VA Form 21-2680 ("Examination for Housebound Status or Permanent Need for Regular Aid & Attendance") with the veteran's primary VA Form 21P-527EZ pension application. Florida has accredited VSOs, the Florida Department of Veterans' Affairs (1-844-MyFLVet / 1-844-693-5838) provides free filing assistance.

Stacking

Aid & Attendance can stack with PCAFC and Florida Medicaid. The combination is common: an elderly veteran on Medicaid LTC + A&A on top of basic VA pension + PCAFC stipend for the primary family caregiver can produce a meaningful monthly income for the household.

Pathway 5, Personal Care Agreement (private pay)

If your loved one has private assets and is not yet on Medicaid, a Personal Care Agreement (sometimes called a Caregiver Agreement, Family Care Contract, or Personal Services Contract) is a written employment contract between the senior and a family caregiver that lets the senior pay the caregiver at fair market wages.

Why it matters for Medicaid planning

Florida Medicaid's 60-month look-back scrutinizes every transfer of $500 or more in the five years before LTC application. Without a written Personal Care Agreement, money paid to a family caregiver looks like a gift, and gifts trigger transfer penalties (AHCA sets Florida's annual transfer-penalty divisor based on average private-pay nursing-facility cost; even a modest uncompensated transfer can create multiple months of LTC ineligibility). With a written agreement at fair market wages, the same money is legitimate compensation for services rendered, not a gift, no penalty.

What the agreement should include

• Identity of the parties, who is the senior, who is the caregiver
• Description of services, bathing, dressing, meal prep, transportation, medication reminders, supervision, etc.
• Schedule, days, hours, expected weekly total
• Compensation, hourly rate at fair market value (typically $18–$28/hour in Florida for non-skilled care; higher for skilled)
• Term, start date, ongoing or fixed period
• Tax handling, the caregiver is a household employee for IRS purposes; the senior may need to issue W-2s and pay employer taxes
• Termination clauses

Florida-specific cautions

• Pay must be at fair market value. If you draft a contract paying $50/hour for companion care, DCF will recharacterize the excess as a gift and impose a transfer penalty.
• Pay must flow on a regular schedule. Lump-sum "advance" payments for years of future care are particularly aggressive recharacterization triggers.
• Document the work performed. Keep timesheets, mileage logs, and receipts.
• Use a Florida elder-law attorney to draft the agreement. A generic template downloaded from the internet will not survive DCF scrutiny. Most Florida elder-law attorneys draft Personal Care Agreements for $500–$1,500 flat fee.

Pathway 6, Long-term care insurance (LTCi) reimbursement

If your loved one has a long-term care insurance policy, many policies reimburse for in-home care, including, in some cases, care delivered by a family member.

Common policy structures

• Indemnity policies pay a flat daily benefit regardless of who provides the care; family members can usually be paid (subject to documentation requirements).
• Reimbursement policies pay actual covered expenses up to the daily/monthly cap; coverage of family caregivers depends on the policy's definition of "qualified provider." Some policies require the caregiver to be from a licensed home health agency; others allow informal caregivers if proper documentation is kept.

How to use it

1. Pull the policy and read the "covered services" and "qualified provider" sections.
2. Call the carrier to confirm whether family caregivers qualify and what documentation they require (timesheets, plan of care, physician certification, etc.).
3. Set up timesheets that match the carrier's required format.
4. Submit claims on the carrier's schedule (usually monthly).

LTCi can stack with Medicaid PDO, but the math gets complicated, Medicaid expects LTCi proceeds to be applied first, with Medicaid as the payer of last resort. Talk to a Florida elder-law attorney before assuming both will pay.

Combining pathways: the real-world common cases

Most Florida families end up using two or three of these pathways at once. The combinations that show up most often:

• PDO + VA Aid & Attendance. Veteran with Medicaid and a family caregiver. PDO pays the family member's wages; A&A pads the household income.
• PDO + Personal Care Agreement (transitional). Family pays from private funds during the LTC waitlist; PDO takes over once the waiver slot opens.
• PCAFC + PDO. A primary family caregiver receives the PCAFC stipend (federal VA) AND is paid as the PDO worker (state Medicaid) for non-overlapping hours. The PCAFC training and respite benefits are also valuable independent of the cash.
• Personal Care Agreement + LTCi reimbursement. Senior with LTCi pays a family caregiver under a Personal Care Agreement; the LTCi carrier reimburses up to the policy's daily cap.

The general rule: federal programs (VA) and state programs (Medicaid) generally do not double-count the same hours, but they routinely combine for non-overlapping hours. Always document the schedule clearly.

What about the Florida Caregiver Support Program?

The Florida Department of Elder Affairs (DOEA) runs a Florida Caregiver Support Program (sometimes branded as Project R.E.L.I.E.F., Respite for Elders Living in Everyday Families) that provides limited respite care, short-term substitute coverage, for unpaid family caregivers of seniors with Alzheimer's or related dementias. The program does not pay the family caregiver directly. It pays for short-term professional respite that gives the family caregiver a break.

Useful in combination with the paid pathways above, but not itself a paid-caregiver pathway. Call the Elder Helpline at 1-800-963-5337 to find your county's coordinator.

Frequently asked questions

{{component: faq}}

Can I really be paid to care for my spouse in Florida?

Yes, under the SMMC LTC Participant-Directed Option (PDO). Florida is one of the more permissive state HCBS waivers on this point. The waiver explicitly contemplates that legally responsible individuals, including spouses, may serve as paid Direct Service Workers. The catch is that the work must be "extraordinary care", services beyond the level a spouse would naturally provide for free, and the spouse must meet all worker requirements (age 18+, Level 2 background screening, executed worker agreement). Run the income math first; sometimes paying a spouse can shift the couple's Medicaid eligibility picture in unexpected ways.

Can I be paid to care for my parent?

Yes, through PDO, PCAFC (if your parent is a veteran), Personal Care Agreement, or LTCi. PDO is usually the easiest if your parent is on Florida Medicaid LTC.

Can I be paid to care for my adult disabled child?

Yes, but the program is different, your child is likely served through one of Florida's developmental-disability waivers (iBudget), not the SMMC LTC waiver discussed here. Call the Agency for Persons with Disabilities (APD) at 1-866-273-2273.

What's the maximum I can be paid?

It depends on the pathway and the authorized hours. PDO budgets are set by the assessed Plan of Care; as an illustration, 30–60 authorized hours/week at Florida's minimum wage comes to roughly $1,800–$3,600/month gross before payroll taxes. PCAFC pays a tax-free stipend pegged to the GS-4 federal pay scale — see caregiver.va.gov for current Tier 2/3 rates. A Personal Care Agreement can pay any fair-market rate, with no upper cap, as long as it's documented and reasonable.

Do I need to be a licensed CNA or home health aide?

For PDO non-skilled services (personal care, homemaker, companion, respite), no licensure is required. You must be 18+, pass Level 2 background screening, and complete a written worker agreement. For PDO skilled nursing, you must be a licensed LPN or RN. PCAFC has its own training requirement administered by the VA.

How does taxation work?

PDO workers are W-2 employees of the member, with the Fiscal/Employer Agent handling tax withholding (FICA, FUTA, Florida reemployment tax). PCAFC stipends are tax-free under federal law. VDC payments are tax-free if structured as caregiver stipends; check with the AAA. Personal Care Agreement wages are W-2 wages, the senior is the household employer for IRS purposes. LTCi reimbursements are typically tax-free.

Will being paid affect my own benefits?

It can. A few flags to watch:

• Social Security: PDO wages are earned income and may affect SSI eligibility (if you receive SSI). They do not generally affect Social Security retirement or SSDI.
• TANF/SNAP: PDO wages count as earned income and may reduce other means-tested benefits.
• Medicaid for yourself: PDO wages count as earned income for your own Medicaid (if you're on it).
• Housing: PDO wages count as income for HUD-subsidized housing.

This is one reason to model the math before signing on. A worker whose own benefits drop by more than the new wages add isn't gaining anything.

Can I be paid for hours when my loved one is sleeping?

PDO authorized hours are tied to the Plan of Care. "Sleep" hours are typically not authorized unless the plan specifies overnight supervision needs (e.g., wandering, fall risk, severe nocturnal needs). Don't log time you weren't actually providing supervision or care.

What if my LTC plan changes its F/EA?

Plan-vendor relationships occasionally shift. If the F/EA changes mid-year, the new F/EA reissues onboarding (background screening usually transfers; payroll/EVV systems do not). Pay continuity is the LTC plan's responsibility, gaps shouldn't happen but do. Keep documentation.

Can I switch between pathways?

Yes. A family that started on a Personal Care Agreement can transition to PDO once the LTC waiver opens. A family already on PDO can add VA Aid & Attendance if a veteran is in the household. Pathways are layers, not exclusive choices.

What if my loved one is denied PDO?

PDO eligibility denials are usually because the member is in an ALF/AFCH/nursing facility (PDO is for community-dwellers only), the Plan of Care has no PDO-eligible services, or the case manager has not elected PDO. Push back through the case manager first; if that fails, you can request a Fair Hearing through the DCF Office of Appeal Hearings within 90 days of the Notice (see /medicaid/florida/how-to-apply for the appeals walkthrough).

Where do I go to start?

Pick the pathway that fits your situation, then go to its starting point:

• PDO: call the Elder Helpline at 1-800-963-5337 to start the LTC application
• PCAFC: apply at caregiver.va.gov or call 1-855-260-3274
• VDC: ask your local VA medical center's social work department
• Aid & Attendance: call Florida Department of Veterans' Affairs at 1-844-693-5838 for free filing help
• Personal Care Agreement: call a Florida elder-law attorney
• LTCi: pull the policy and call the carrier {{/component}}

Bottom line

Florida is one of the most permissive states in America for paid family caregiving, with a Medicaid waiver that openly allows spouses, parents, and adult children to be hired; a federal VA program that pays primary caregivers a tax-free monthly stipend; and the strongest homestead protection in the country preserving the family home through the process.

The path that fits your family depends on three questions:

1. Is your loved one Medicaid-eligible? If yes, the PDO is your primary lane.
2. Is your loved one a wartime veteran? If yes, layer in PCAFC, VDC, and/or A&A.
3. Do you have private assets to pay from now while preserving them for Medicaid later? If yes, a Personal Care Agreement bridges the gap.

Most families end up combining pathways. The work is in choosing the right combination, and getting the paperwork right so a 60-month look-back, an EVV audit, or a benefits cliff doesn't undo the plan.

When in doubt, start with the call your situation actually requires. Medicaid LTC starts with the Elder Helpline at 1-800-963-5337. VA caregiver programs start at caregiver.va.gov / 1-855-260-3274. Personal Care Agreements start with a Florida elder-law attorney. The right first call saves months.

Find personalized help navigating Florida's family caregiver programs at brevy.com.

Internal references:

• Florida Medicaid Programs Overview
• Florida Long-Term Care Waiver Guide
• Florida Medicaid Eligibility & Income Limits 2026
• How to Apply for Florida Medicaid
• Florida Caregiver Programs Overview
• Florida Estate Recovery
• Glossary: Participant-Directed Option
• Glossary: Electronic Visit Verification
• Glossary: Personal Care Agreement
• Glossary: Qualified Income Trust
• Glossary: VA Aid & Attendance
• Glossary: PCAFC