How to Get Paid as a Family Caregiver in Indiana

Indiana is one of a small number of states where a spouse can be paid to provide care at home, through a program called Structured Family Caregiving.1

Under SFC, the caregiver lives with the person they support and receives a tax-free daily stipend through a contracted provider agency, available under PathWays for Aging and the Health and Wellness waiver.2 Hourly attendant care (ATTC) is a second route for non-spouse relatives who direct their own attendant.3

This guide lays out every legitimate way to be paid as a family caregiver in Indiana for 2026: who can be hired under each program, how the pay works, and how to choose the route that fits your family.

The Short Version

If you are a spouse caring for your husband or wife, Indiana's Structured Family Caregiving is the route. You live with them, you become a paid caregiver through a contracted SFC provider agency, and you receive a daily stipend. You do not need to be separately employed.

If you are an adult child or non-co-resident relative, the Attendant Care (ATTC) self-directed option is the most flexible route. The care recipient directs your work; a fiscal agent handles payroll.

If your loved one is a veteran, check the VA programs first. The Program of Comprehensive Assistance for Family Caregivers (PCAFC) pays a tax-free stipend, and Veteran-Directed Care allows paid spouses. Both can combine with Indiana Medicaid.

If your family has enough private assets, a written personal services contract can pay a caregiver now while documenting the arrangement for later Medicaid planning.

What Makes Indiana Different: SFC and the PathWays Launch

Indiana has two main Medicaid pathways for paid family caregiving, and the right one depends on whether you live with the person you care for.

Structured Family Caregiving (SFC) is the model for live-in caregivers. The caregiver and the care recipient share a home; the caregiver receives a daily stipend through a contracted SFC provider agency rather than an hourly wage. SFC is notable for allowing a spouse to be the paid caregiver, something most states do not permit under Medicaid.1

Attendant Care (ATTC) is the self-directed hourly model. The care recipient chooses, hires, trains, and manages their own attendant, and a fiscal agent handles payroll. A spouse or parent of a minor child (legally responsible individuals) can no longer initiate new ATTC arrangements as of July 1, 2024; those wanting paid spousal care now use SFC. Non-spouse relatives and friends remain eligible as ATTC attendants.3

Both are available under PathWays for Aging, Indiana's managed long-term services and supports program that launched July 1, 2024, for Hoosiers age 60 and older on Medicaid. PathWays is administered by three MCEs (Anthem, Humana, UnitedHealthcare) and integrates long-term services with acute care management.4

The Indiana Paid Family Caregiver Pathways

1. Structured Family Caregiving (SFC): Live-In Caregiver Stipend

Who pays: Indiana Medicaid, through the assigned Managed Care Entity (Anthem, Humana, or UnitedHealthcare) and a contracted SFC provider agency.

Who can be paid: A live-in caregiver who is at least 18 years old, passes a criminal background check, and is deemed physically and mentally capable of providing care. Importantly, this includes a spouse, an adult child, a sibling, a friend, or a Power of Attorney or Attorney in Fact who lives with the recipient.1

What it is: The SFC model pays a tax-free daily stipend rather than an hourly wage. The stipend runs across three tiers tied to the care recipient's level of care, roughly from more than $77 per day at the lowest tier to a little more than $133 per day at the highest tier. Under Indiana's House Enrolled Act 1120 (2024), the provider agency must pass at least 60 percent of the state SFC payment through to the caregiver. Exact per-tier amounts are set by the Family and Social Services Administration (FSSA) rate schedule and are periodically adjusted; confirm the current figures with the SFC provider agency you choose.2,5

Eligibility, recipient: Enrolled in Indiana Medicaid, qualifies for an HCBS waiver (PathWays for Aging or Health and Wellness), needs a nursing facility level of care, and lives full-time with the caregiver.2

Eligibility, care recipient financial: Income up to approximately $2,982 per month (confirm the current standard with FSSA) and countable assets up to $2,000.4

How you get paid: The SFC provider agency pays the daily stipend directly. Your income is structured as a tax-free payment in most circumstances; confirm the specific tax treatment with a tax preparer.

Best for: A spouse or other live-in family member caring for a Medicaid-eligible Hoosier who needs nursing-level support at home.

2. Attendant Care (ATTC): Self-Directed Hourly Care

Who pays: Indiana Medicaid, through the MCE.

Who can be paid: An adult child, sibling, other relative, friend, or neighbor who is not the care recipient's spouse or a legally responsible individual (LRI). As of July 1, 2024, a spouse or parent of a minor cannot initiate a new ATTC arrangement.3

What it is: ATTC is an hourly self-directed service, paid at roughly more than $34 per hour under the current FSSA rate schedule, with the provider agency required to pass at least 70 percent of the state payment through to the attendant. The care recipient directs their own attendant for help with activities of daily living; a fiscal agent handles payroll and tax withholding.5

Best for: A non-co-resident adult child or other relative who wants to be paid hourly for helping a PathWays-eligible parent or family member.

3. VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

Who can be paid: A designated Primary Family Caregiver of an eligible veteran, including a spouse, adult child, parent, or other family member.6

2026 stipend: The PCAFC stipend is calculated from the federal GS-4, Step 1 annual rate for the veteran's locality, divided by 12, then multiplied by a level factor. Confirm the exact amount with the VA Caregiver Support Coordinator.6

Veteran eligibility: Service-connected disability rating of 70 percent or higher, needs personal care for at least six continuous months, enrolled in VA health care.

Why it stands out: Tax-free stipend, allows paid spouses, can stack with SFC or ATTC.

Best for: Families of eligible veterans where one person provides substantial daily care.

4. VA Veteran-Directed Care (VDC)

Who can be paid: Almost any caregiver the veteran chooses, including a spouse.

How it works: The veteran receives a flexible monthly budget from their VA care team and hires caregivers at a self-set rate within that budget. Ask your VA social worker whether VDC is available at your Indiana VA medical center.

Best for: Indiana veterans who want to pay a spouse or choose their caregiver directly.

5. VA Aid and Attendance Pension

2026 maximums: Single veteran up to $2,424 per month ($29,093/year); veteran with one dependent up to $2,874 per month ($34,488/year). Confirm current figures at the VA pension rate page before applying.7

Eligibility: Wartime veteran or surviving spouse meeting the functional criteria and with combined income and assets under $163,699 (2026 net-worth limit).7

How caregivers get paid: The pension goes to the veteran; caregivers are paid out of it, ideally under a written agreement. Indiana's county Veterans Service Officers help file at no cost through the Indiana Department of Veterans Affairs.

Best for: Wartime veterans or surviving spouses under the income and asset limits.

6. Private Personal Services Contract

Who can be paid: Any family member under a written contract, signed before care begins, at a fair-market rate documented against local agency quotes.

Why the format matters: Indiana enforces a 60-month Medicaid look-back. Informal payments from a parent to an adult child for care are presumed to be gifts and can create a penalty period when Medicaid long-term care is later needed. A properly drafted contract converts the payment into a documented exchange. Confirm the current transfer-penalty divisor with FSSA or an Indiana elder-law attorney.8

Best for: Families with enough assets to private-pay now who want to protect future Medicaid eligibility.

Comparing the Indiana Pathways

How to Choose

1. Is your loved one a veteran? Check VA programs first. PCAFC pays a tax-free stipend, and Veteran-Directed Care allows paid spouses. Both can stack with Indiana Medicaid.
2. Are you a spouse or live-in family member? Structured Family Caregiving is your Medicaid route. Contact the MCE or an SFC provider agency to start.
3. Are you a non-co-resident adult child or relative? Self-directed Attendant Care (ATTC) lets your family member hire you directly. Contact the MCE to enroll in ATTC.
4. Is your loved one age 60 or older on Medicaid? PathWays for Aging is the managed LTSS program that delivers both SFC and ATTC. Start with the MCE assigned to their Indiana Medicaid plan.4
5. Do you have substantial private assets? Work with an Indiana elder-law attorney to draft a personal services contract before payments start.

How to Become a Paid Family Caregiver in Indiana: Step by Step

Both Structured Family Caregiving and Attendant Care run through the same Medicaid front door: the care recipient must qualify for a home- and community-based waiver and a nursing-facility level of care before anyone gets paid. Here is the path from first call to first payment.

Where to Get Help in Indiana

Tax Considerations

• SFC daily stipend is structured as a tax-free payment in most circumstances. Confirm the specific treatment with a tax preparer.8
• ATTC pays W-2 wages through the fiscal agent.
• VA PCAFC is a federal tax-free stipend.
• VA Aid and Attendance is tax-free to the veteran; caregivers pay ordinary income tax on what they receive.

IRS Notice 2014-7: If you live in the same home as the person you care for and are paid through a Medicaid waiver, your wages may be excluded from federal gross income. This applies to many Indiana SFC and ATTC arrangements. Talk to a tax preparer before filing.

Indiana state income tax: Indiana levies a flat income tax of 2.95 percent (2026) plus county income taxes.8

Common Misconceptions

"My spouse can't be paid to care for me in Indiana." Under Structured Family Caregiving, they can. SFC is specifically designed for live-in caregivers and explicitly allows a spouse.

"I can be my spouse's paid ATTC attendant." Not for new arrangements since July 1, 2024. A spouse is a legally responsible individual, and ATTC no longer allows new LRI attendant care arrangements. The route for spousal caregiving is SFC.

"Medicare will pay me to be my parent's caregiver." Medicare does not pay family caregivers. It only covers short-term skilled home health through certified agencies.

"I can informally get paid out of Dad's savings." Not without a written personal services contract. Informal transfers trigger Indiana's 60-month Medicaid look-back.

Related Terms

• Consumer Directed Services (CDS): The national framework for self-directed programs like Indiana's Attendant Care, where the care recipient directs their own attendant.
• HCBS waiver: The federal authority behind the PathWays for Aging and Health and Wellness waivers that fund SFC and ATTC.
• Activities of Daily Living (ADLs): The functional basis for the nursing-facility level of care that Indiana waivers require.
• Nursing Facility Level of Care: The clinical threshold for Indiana HCBS waiver eligibility.

Learn More

Find personalized help getting paid as a family caregiver in Indiana 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.