Nevada's Frail Elderly (FE) waiver can pay a relative as a family caregiver, and both it and the Physical Disabilities (PD) waiver can pay a spouse or guardian the person chooses for some services. The Nevada FE waiver serves people 65 and older, and the Nevada PD waiver serves people with a documented physical disability; both Medicaid waivers pay for in-home help such as homemaker, chore and respite.

In This Guide

Who the Nevada FE and PD Waivers Serve

Nevada's FE and PD waivers are both Medicaid home and community-based services (HCBS) waivers run by Nevada Medicaid with the Aging and Disability Services Division for people who would otherwise need a nursing home.,

Frail Elderly (FE) waiver Physical Disabilities (PD) waiver
Who it serves Age 65 or older Any age, with a documented physical disability confirmed by the state's physician consultant
Care need Nursing facility level of care, at risk of nursing home placement Nursing facility level of care, would need a nursing home within 30 days without services, and an ongoing need for waiver services, not State Plan services alone
Money Financially eligible for Medicaid Meets Medicaid financial eligibility
Main services Homemaker, chore, respite, adult companion, adult day care, meals Attendant care, homemaker, chore, respite, home changes, medical equipment, meals

FE services depend on the person's identified needs and available funding, and the PD waiver has a set number of slots a year, with a waitlist when none are open. A waitlisted Nevada PD waiver applicant gets a denial notice marked "no slot available" showing their priority level. Despite the word denial, a Nevada PD waiver "no slot available" notice means the person is waitlisted as presumed eligible, so keep it. For income and asset rules, see Nevada Medicaid income and asset limits.

Which Family Caregivers Can Be Paid Under the Nevada Frail Elderly and PD Waivers

Nevada sorts family caregivers into two groups: legally responsible individuals (LRIs), meaning spouses, legal guardians and parents of minor children, and other relatives, such as an adult child. Nevada's FE waiver can pay those other relatives; Nevada's PD waiver manual does not say. Under both the Nevada FE and PD waivers, an LRI may be paid for activities family caregivers would not ordinarily perform or are not responsible for performing, only if the person receiving care chooses them. If you are a spouse already doing all of this unpaid, that limit is about what the waiver pays for, not a judgment of the care you give.

Your relationship FE waiver PD waiver
Adult child Yes, as a relative who is not a guardian Not stated in Nevada's manual; ask ADSD
Spouse Only for homemaker, respite, chore or companion Only for attendant care, homemaker, respite or chore
Relative living with them Yes, if not a guardian or spouse Not stated for relatives; a live-in spouse is limited
Legal guardian Only as an LRI, same services as a spouse Only as an LRI, same services as a spouse
Power of attorney Not stated; ask ADSD Not stated; ask ADSD

The FE answers come from Nevada's draft FE waiver application. Under FE, a spouse can do chore work only when they do not live with the person and the live-in primary caregiver needs help.

Under FE, ongoing hands-on help with daily activities comes from Nevada's separate Personal Care Services program, which can pay trusted individuals the person chooses but not a spouse or legal guardian., For every way a spouse can be paid, see getting paid to care for a spouse in Nevada.

How Family Caregiver Pay and Hours Work on the Nevada Frail Elderly and PD Waivers

A spouse or guardian paid under the Nevada FE waiver must be an employee of a provider agency. Under the Nevada PD waiver, a paid spouse or guardian can also work for an Intermediary Service Organization (ISO) or enroll through the Financial Management Service (FMS) vendor. In practice, you sign on with one of these before you're paid, and you'll check in and out of each visit with Electronic Visit Verification (EVV).

Under the Nevada PD waiver, the person can also self-direct attendant care, chore, homemaker and respite. With FMS self-direction, the person is the employer, hiring workers and setting wages within program guidelines and limits the FMS sets.

Nevada's PD waiver manual says attendant care is only provided to adults 21 and older once State Plan personal care limits are used up. Nevada's PD waiver manual also says attendant care is not an extension of State Plan care when the person chooses a spouse or guardian as the paid caregiver or self-directs through FMS. Whether the Nevada PD waiver's age-21 limit applies to a paid spouse or guardian or to FMS self-direction isn't stated, so ask your case manager.

Under Nevada's FE and PD waivers, a live-in spouse or guardian is limited to 2 hours a week of homemaker service. Under the Nevada FE waiver, any spouse or guardian is limited to 2 hours a day of adult companion care, only when the live-in primary caregiver needs a break.

How to Start in Nevada

1
Step 1

Contact ADSD

Send ADSD's intake form, the OCL Program Application, to the nearest ADSD office, or apply by phone with a regional office (numbers above).

2
Step 2

Prepare for the home visit

For the Nevada FE waiver, an ADSD intake specialist schedules a face-to-face visit within 45 days of the application to check the nursing facility level of care. For the Nevada PD waiver, ADSD contacts you within 15 working days; you then have 30 calendar days to gather medical records of the disability, and the visit is set once they arrive.

3
Step 3

Apply for Medicaid if needed

The Nevada Division of Social Services decides Medicaid eligibility. See how to apply for Nevada Medicaid.

4
Step 4

Name the family caregiver in the care plan

Tell the case manager who the person wants as their caregiver; for a spouse or guardian, the person or another representative signs a Designated Representative Attestation form.

5
Step 5

Get hired

The caregiver signs on with the employing agency, ISO or FMS vendor.

Frequently Asked Questions

Is Nevada's FE waiver application final?

The Centers for Medicare & Medicaid Services (CMS) lists the Nevada FE waiver as approved from July 1, 2025, to June 30, 2030, but the application Nevada Medicaid posts is still marked Draft NV.016.08.00, so confirm the family-caregiver rules with ADSD.

Learn More

CaregiverHow to Get Paid as a Family Caregiver in NevadaNevada paid family caregiver rules for 2026: adult children via Medicaid personal care; spouses via some waiver services or live-in dementia care; VA options. CaregiverNevada Caregiver ProgramsEvery caregiver program in Nevada: Personal Care Services self-direction, the skilled family caregiver option, respite, NFCSP grants, VA benefits, and taxes. CaregiverNevada Structured Family Caregiving WaiverNevada's Structured Family Caregiving waiver can pay one live-in caregiver, family or spouse, of someone with dementia. Who qualifies, pay and how to apply. CaregiverRespite Care in NevadaNevada pays for respite care through the Medicaid Frail Elderly Waiver, NFCSP grants with no income test, and the VA. See who qualifies and how. MedicaidNevada Medicaid HCBS WaiversNevada Medicaid HCBS waivers pay for in-home care through the Frail Elderly Waiver for adults 65 and older at nursing-home level of care, plus how to apply.

Find personalized help getting paid through Nevada's Frail Elderly or Physical Disabilities waiver 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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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.