If you're caring for a parent or spouse, some New Hampshire caregiver programs can pay you, and each one sets its own rules on who can be the paid worker. In short: the Medicaid Choices for Independence waiver lets your loved one hire their own workers, but its adopted rule bars paying a spouse. VA's caregiver stipend can go to a spouse. The state's Alzheimer's respite pays respite providers, not you.

You do not have to figure this out alone, and you do not have to fund all of it from your savings.

In This Guide

New Hampshire Caregiver Programs at a Glance

Program What It Offers Pay a spouse? Cost to You
NH Medicaid CFI waiver (PDMS option) Participant selects workers; an FMS provider runs payroll No (adopted rule bars a spouse) Medicaid-covered service
NH Medicaid PCA services (He-W 552) A personal care attendant for a wheelchair-mobile adult who is their own guardian and directs their own care No (attendant cannot be a family member) Medicaid-covered service
State Alzheimer's respite (He-E 503) Respite for an unpaid primary caregiver of someone with ADRD; budget up to $2,000 a year N/A (pays respite providers, not the caregiver) State-funded
NFCSP caregiver support Information, counseling, training; respite only for a frail older adult N/A Federal grant program
VA PCAFC Monthly stipend to the Primary Family Caregiver, which VA called nontaxable in its 2020 proposed rule Yes VA benefit
VA Veteran-Directed Care Flexible budget; the veteran can hire family as aides Ask the VA social worker Copay may apply
VA Aid and Attendance Pension with A&A; 2026 maximum $29,093/yr for a veteran with no dependents Paid to veteran VA benefit

Programs That Pay Family Caregivers

If money is the worry keeping you up at night, start here. When one person steps back from work to provide care, the lost income is often the heaviest part of the whole situation, so here is what each New Hampshire program allows, and what it does not.

Medicaid Choices for Independence (CFI) Waiver and PDMS

New Hampshire's Medicaid home- and community-based pathway for older adults is the Choices for Independence (CFI) waiver. It covers personal care, respite, adult day services, homemaker and other supports for people 65 or older, and for adults 18 to 64 with physical or other disabilities, who meet a nursing facility level of care. Two NH DHHS bureaus decide eligibility: the Bureau of Family Assistance (BFA) determines financial eligibility, and the Bureau of Adult & Aging Services (BAAS) runs the medical assessment. To apply, contact your regional Aging & Disability Resource Center at 1-866-634-9412, or apply online through NH EASY.

The money test has two parts. The 2026 income cap for CFI is $2,982 a month for a single applicant, but income above it is not an automatic bar: a medically needy route lets someone over the cap qualify when their net income is at or below the protected income level. The resource limit for long-term care applicants is $2,500, and for CFI applicants 18 or older a disregard covers resources between that base and $7,500. The details are in New Hampshire Medicaid Long-Term Care.

CFI's Participant Directed and Managed Services (PDMS) option lets the participant direct any CFI service except residential care facility services, and select service providers. A Financial Management Services (FMS) provider hires the workers the participant chooses, processes payroll, and withholds federal, state and local taxes. The participant's budget is based on the needs the case manager identifies in the comprehensive care plan, and it sets how often and how long each service is provided.

Here is who can be the paid worker, as the adopted CFI rule, He-E 801, states it:

  • Spouse: the rule says a spouse cannot be paid. It bars CFI coverage of any service "provided by a legally responsible relative" (He-E 801.12(a)) and defines that relative as "the participant's spouse" (He-E 801.02(ac)).
  • Guardian, power-of-attorney agent or representative: not for personal care. Personal care services are not covered when provided by the participant's personal care services representative, agent under a power of attorney, or legal guardian (He-E 801.24(c)(3)).
  • Adult child: the rule does not name adult children, and none of its exclusions reaches an adult child as such. An adult child who is also the parent's guardian, power-of-attorney agent or representative falls under the personal care bar above.
  • A relative who lives with your loved one: the rule does not exclude anyone for living in the home, but CFI does not cover a service that "addresses needs being met by another paid or unpaid service."

If you are the spouse, that is hard to hear when you are already giving the care every day. The VA stipend below can pay a spouse if your loved one is a veteran, and the support and respite programs further down can still lighten the load.

Before you plan around a paycheck, ask the Aging & Disability Resource Center at 1-866-634-9412 how these rules apply to your family. If you are an adult child, a useful question is: "Can I be hired as my parent's PDMS worker if I am not their guardian, power-of-attorney agent or representative?"

Typical pay: about $18.64 an hour (estimate based on home care aide wages in New Hampshire, BLS, May 2025). That figure reflects what aides earn across the labor market, so actual program pay may differ.

While a CFI application is pending, look at NFCSP support below: its eligibility is defined by your caregiving relationship. For the full guide to who can be paid and how, see: How to Get Paid as a Family Caregiver in New Hampshire.

Medicaid Personal Care Attendant (PCA) Services

New Hampshire Medicaid also pays for personal care attendant services under a separate rule, He-W 552, but the benefit is narrow. A Medicaid recipient qualifies only when they meet all of these:

  • Is at least 18 and is their own legal guardian
  • Is chronically wheelchair-mobile
  • Is approved for an independent living program by the PCA provider
  • Can take part fully in daily activities such as eating, bathing and dressing
  • Can direct their own attendant (help choosing and directing the attendant is allowed)
  • Lives outside an institution but needs at least 2 hours a day of medically oriented PCA services
  • Has a documented need for the services

The attendant must be employed by or under contract with an enrolled New Hampshire Medicaid provider and must not be a member of the recipient's family. The rule defines family as anyone related within the second degree of kinship, including a spouse, parent, step-parent, sister or brother, or a grandparent, aunt or uncle living in the same household. Its list of examples does not name a son or daughter, so the rule does not clearly say whether an adult child can be the attendant. A physician documents the hours needed, and the provider's registered nurse sets the plan of care.

Programs That Help but Do Not Pay You

New Hampshire's state-funded Alzheimer's respite (He-E 503) does not pay the family caregiver for their own care. It pays respite providers so the unpaid primary caregiver can take a break; see Respite Care Programs below. None of NFCSP's five service types is a cash wage to the family caregiver either.

If your loved one would pay you privately instead, see our guide to personal care agreements. For families of veterans, the VA programs further down are a separate route.

Respite Care Programs

Caring without a break is not sustainable, and respite is help many New Hampshire caregivers can reach.

The National Family Caregiver Support Program (NFCSP), funded by Title III-E of the Older Americans Act and administered by the Administration for Community Living (ACL), is provided by area agencies on aging or the organizations they contract with. It funds five kinds of help:

  • Information about services
  • Help gaining access to them
  • Counseling, support groups and caregiver training
  • Respite care
  • Limited supplemental services

Federal eligibility is defined by your caregiving relationship: it serves adult family and other informal caregivers of an adult age 60 or older, and caregivers of a person of any age with Alzheimer's disease or a related disorder.

One condition is easy to miss. Respite and supplemental services are available only when the person you care for is an older adult who is "frail": unable to perform at least two activities of daily living without substantial human assistance, or, because of a cognitive or other mental impairment, needing substantial supervision due to behavior that poses a serious health or safety hazard. Information, access help, counseling and training carry no such condition.

New Hampshire's CFI waiver also covers respite for its participants. The adopted rule limits CFI respite to 30 24-hour days of care per state fiscal year.

State-Funded Alzheimer's Respite

If you care for someone with Alzheimer's disease or a related disorder (ADRD), New Hampshire runs a separate, state-funded respite service under He-E 503 and RSA 161-F. To qualify, you must be the primary caregiver, providing unpaid care 24 hours a day, 7 days a week, and the person you care for must not already get respite paid through a Medicaid waiver, the VA or any other program. You and the contract agency set a respite budget that cannot exceed $2,000 per primary caregiver a year, and services depend on available funds and staff.

You choose the respite provider: a nursing facility, residential care facility, home health agency, adult day program, or an individual employed through a contracted financial management services agency. The rule does not say whether another relative can be that paid respite worker. For the full respite guide, see: Respite Care in New Hampshire. For other help when a parent has dementia, see Dementia Care in New Hampshire.

Where to Get Caregiver Counseling and Training in New Hampshire

New Hampshire delivers NFCSP as its Family Caregiver Support Program, through the Bureau of Adult & Aging Care Services and the Aging & Disability Resource Centers located throughout the state. Beyond counseling, support groups, training and respite for eligible full-time family caregivers, it can help assess your caregiving needs and connect you with local providers. For some caregivers it also offers limited extra services that may include chore services, assistive equipment, home modifications and transportation. It serves caregivers over 18 caring for someone with Alzheimer's or a related dementia, caregivers of adults over 60, parents of adult children with disabilities, and grandparents and other relatives over 55 raising minor relatives.

Call 1-866-634-9412, the toll-free line for New Hampshire's Aging & Disability Resource Centers. NH DHHS says to call that number for personalized help narrowing down resources to your specific needs. You can also start online at the NH DHHS Adult and Aging Care page. To apply for Medicaid long-term care, NH DHHS directs you to your regional center or to NH EASY online.

VA Caregiver Benefits in New Hampshire

If the person you care for served in the military, slow down here, because VA runs caregiver support programs that are separate from Medicaid. The caregiver stipend below requires the veteran to be enrolled in VA health care, but enrollment alone does not qualify anyone.

VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

For a veteran's spouse, this is the program on this page that clearly can pay you. The PCAFC pays a monthly stipend to the Primary Family Caregiver of an eligible veteran, a spouse can be that caregiver, and VA has described the stipend as a nontaxable benefit.

The amount starts from the federal GS-4, Step 1 annual rate for the veteran's locality, divided by 12, multiplied by a factor of 0.625, or 1.00 if VA determines the veteran is unable to self-sustain in the community. Legacy participants and legacy applicants follow a separate schedule based on the veteran's 2019 clinical ratings, which lapses on October 1, 2028. For the full factor rules, see the VA caregiver stipend (PCAFC) guide.

VA's first screen has four requirements for the veteran, and all four must be true: a VA disability rating (individual or combined) of 70% or higher; discharge from the U.S. military or a date of medical discharge; a need for at least 6 months of continuous, in-person personal care services; and enrollment in VA health care.

Meeting those four is necessary but not the whole test. You and the veteran apply together, and the regulation, 38 CFR 71.20(a), adds conditions VA assesses during that process: participating must be in the veteran's best interest, the veteran must receive care at home and ongoing care from a primary care team (or will do so if VA designates a Family Caregiver), and the personal care services you would provide must "not be simultaneously and regularly provided by or through another individual or entity." That last one can rule out a household already getting regular personal care through another program.

Approval alone does not start the money. VA states: "You must be enrolled in direct deposit using the VA customer engagement portal to get your monthly stipend."

VA Veteran-Directed Care (VDC)

Veteran-Directed Care gives a veteran a flexible budget for home and community services, managed by the veteran or the family caregiver. The veteran can hire their own personal care aides, which VA says "might include their own family member or neighbor." All enrolled veterans are eligible if they meet the clinical need and the program is available, but VA says it "is only available in certain locations," and a copay may apply. Ask your VA social worker whether it is offered near you and whether the relative you have in mind can be hired.

VA Aid and Attendance Pension

Aid and Attendance adds monthly payments to a VA pension, which requires wartime service among other conditions; a pensioner may be eligible by meeting one of VA's listed needs., A claimant's net worth, which counts the claimant's and dependents' assets and income for VA purposes, must be under VA's limit.

Figure Amount
Maximum Annual Pension Rate, veteran with no dependents $29,093 a year
Maximum Annual Pension Rate, veteran with one dependent $34,488 a year
Net-worth limit $163,699

The VA publishes these rates as Maximum Annual Pension Rates (MAPRs), a ceiling, not a flat payment: VA pays the difference between a claimant's countable income and the applicable MAPR, so a veteran or survivor with income receives less than the maximum. These are annual figures; pension is paid monthly. Income for VA purposes is not gross income: VA says non-reimbursable medical expenses may reduce it, though only the amount above a threshold VA prints as $872 for a veteran with no spouse or child may be deducted.

The VA Caregiver Support Line at 1-855-260-3274 offers information on support services, counseling and education, and can connect you to your local VA Caregiver Support Program team. It is staffed Monday through Friday, 8:00 a.m. to 8:00 p.m. Eastern Time. It is not a crisis line: if you or the veteran are in crisis or having thoughts of suicide, call the Veterans Crisis Line at 988 and press 1.

Taxes for New Hampshire Caregivers

If you start getting paid for care, the tax question usually comes next, and the answer depends on where you live and which program pays you.

IRS Notice 2014-7

Under IRS Notice 2014-7, the IRS treats qualified Medicaid waiver payments as difficulty-of-care payments excludable from the caregiver's federal gross income. The payments are excludable only when the care recipient's home is also your home and you do not have a separate home. If you work in the care recipient's home but have a separate home where you reside, you may not exclude the payments. Talk to a tax preparer familiar with the rule before filing.

New Hampshire State Income Tax

New Hampshire's Interest and Dividends Tax was repealed: the New Hampshire Department of Revenue Administration says that for tax periods beginning on or after January 1, 2025, taxpayers are no longer required to pay it. The repeal is not retroactive: taxable periods beginning on or before December 31, 2024 remain subject to audit and collection. That repeal did not leave the state with no income-type tax. The Department still administers the Business Profits Tax, and state law defines a taxable business organization to include a proprietorship organized for gain or profit and carrying on business activity in New Hampshire. For taxable periods beginning on or after January 1, 2025, the Department says a business organization with more than $109,000 in gross business income must file a Business Profits Tax return, a threshold it adjusts every two years. If you are paid as a self-employed or contract caregiver, ask a tax preparer whether that tax reaches your income. New Hampshire also still has a local property tax. The VA PCAFC stipend is different: VA has stated that it is a nontaxable benefit.

Your next step Not sure which New Hampshire caregiver program fits your family? If your loved one is a veteran, start with the VA Caregiver Support Line at 1-855-260-3274. Otherwise, call New Hampshire's Aging & Disability Resource Center at 1-866-634-9412 about the Medicaid CFI waiver. Or chat with Brevy's care navigator for a comparison built around 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 New Hampshire?

Not through Medicaid's CFI waiver, under its adopted rule: He-E 801.12(a) bars coverage of any service provided by a "legally responsible relative," which He-E 801.02(ac) defines as the participant's spouse. Medicaid's PCA services also bar a spouse as the attendant., If your loved one is a veteran, a spouse can be the Primary Family Caregiver who receives the PCAFC stipend. For the full picture, see How to Get Paid to Care for Your Spouse in New Hampshire.

Can I get paid to care for my parent in New Hampshire?

Possibly, through CFI's PDMS option. He-E 801 does not name adult children and none of its exclusions reaches an adult child as such. It does bar paying the parent's legal guardian, power-of-attorney agent or personal care services representative for personal care, so an adult child who holds one of those roles cannot be paid for that care. Ask the Aging & Disability Resource Center at 1-866-634-9412 before you count on the income.

What if my loved one is not a veteran and not on Medicaid?

Start with NFCSP. Eligibility is based on your caregiving relationship (caring for an adult age 60 or older, or a person of any age with Alzheimer's disease or a related disorder). Information, counseling and training carry no frailty condition; respite is available only when the person you care for is an older adult who is frail under the federal definition. Area agencies on aging, or the organizations they contract with, provide the services. In New Hampshire, the program is coordinated through the Aging & Disability Resource Centers; call 1-866-634-9412.

Which VA programs pay family caregivers in New Hampshire?

The PCAFC stipend is paid to the Primary Family Caregiver, who can be a spouse. The veteran needs a VA disability rating of 70% or higher, among other requirements, and VA called the stipend a nontaxable benefit when it proposed the current rules in 2020. Veteran-Directed Care gives the veteran a budget to hire their own aides, which VA says "might include their own family member or neighbor," though it is only available in certain locations. Aid and Attendance is different: it adds monthly payments to a VA pension. Call the VA Caregiver Support Line at 1-855-260-3274, Monday through Friday.

Where to Get Help with New Hampshire Caregiver Programs

NH Aging and Disability Resource Centers (ADRC) The toll-free line for New Hampshire's Aging & Disability Resource Centers. To apply for Medicaid long-term care, contact your regional center or apply online through NH EASY. 1-866-634-9412 www.dhhs.nh.gov/programs-services/adult-aging-care/servicelink
NH DHHS Adult and Aging Care Information on the Choices for Independence waiver and its participant-directed (PDMS) option. 1-866-634-9412 www.dhhs.nh.gov/programs-services/adult-aging-care
VA Caregiver Support Line Monday through Friday, 8:00 a.m. to 8:00 p.m. ET. Information on caregiver support services, and a connection to your local VA Caregiver Support Program team. Not a crisis line: call 988 and press 1. 1-855-260-3274 www.caregiver.va.gov

Learn More

CaregiverCaregiver Programs: The 50-State GuideA directory of caregiver programs in all 50 states: paid family caregiver pathways, respite, NFCSP grants, and VA benefits. Find your state's complete guide. CaregiverMedicaid Self-Direction and Consumer-Directed ServicesHow Medicaid self-direction lets a family member be your paid caregiver: employer authority, budget authority, the 1915(j) spouse rule, and how to get started. CaregiverThe National Family Caregiver Support Program (NFCSP): A Complete GuideWhat the National Family Caregiver Support Program funds, who is eligible, and how to reach respite and caregiver support through your Area Agency on Aging. CaregiverHow to Get Paid as a Family Caregiver in New HampshireGet paid to care for a loved one in New Hampshire through the Medicaid CFI waiver's self-directed option, VA PCAFC, or a personal services contract. CaregiverRespite Care in New HampshireGet a real break: NH Medicaid covers up to 30 days of respite a fiscal year, full-time unpaid dementia caregivers may get up to $2,000 a year, plus VA help. CaregiverHow to Get Paid to Care for Your Spouse in New HampshireThe VA can pay a spouse caring for a qualifying veteran in New Hampshire, but NH's Medicaid CFI waiver rule bars paying a spouse. Here is what to do instead. CaregiverDementia Care in New Hampshire: A Family Caregiver's GuideA 2026 guide to dementia caregiving in New Hampshire: the Alzheimer's Association helpline, Medicaid respite, getting paid to care, and VA benefits for vets. CaregiverSenior Transportation in New HampshireSenior transportation in New Hampshire: aging-network rides through your Area Agency on Aging, ADA paratransit, Medicaid medical rides, and how to choose. CaregiverCaregiver Burnout: Signs, Stages, and How to Get SupportHow to recognize caregiver burnout, why it happens, and what actually helps, from respite care to evidence-based programs like REACH II and Powerful Tools. VA BenefitsVA Benefits for Seniors in New HampshireVA Aid and Attendance in New Hampshire for 2026: who qualifies, up to $2,874 a month for a veteran with a spouse, how to apply, and where to get help in NH. MedicaidMedicaid Planning StrategiesSee which assets you keep, how the 5-year look-back works, and the legal moves that qualify you for Medicaid long-term care without losing the house.

Find personalized help navigating New Hampshire 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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