If you are caring for an aging parent or spouse and wondering whether you can be paid for it, or simply get a break, the answer depends almost entirely on your state. Every state receives federal grants to support family caregivers, but whether a family member can be paid through Medicaid is a choice each state makes. The catch is that the programs work differently in every state.,

This directory links you to a complete caregiver programs guide for your state: who pays, who can be hired, the respite options, the VA benefits, and how it is all taxed. It also points you to the national guides that explain the concepts behind every state's programs.

Start with your state below, or read the national guides first to understand how the pieces fit together.

Caregiver Programs by State: Start With the National Guides

These explain the concepts that appear in every state's programs:

How Caregiver Programs Differ by State

For most families, three layers stack. The National Family Caregiver Support Program (NFCSP) is the base: federally funded respite, counseling, and caregiver training delivered through your Area Agency on Aging, for caregivers of an adult 60 or older or of someone of any age with Alzheimer's disease and related disorders. For a family caregiver of an older person, respite care and supplemental services there are available only when that person cannot perform at least two daily activities without substantial help, or needs substantial supervision because a cognitive or other mental impairment leads them to behave in a way that poses a serious health or safety hazard. On top of that, if your loved one qualifies for Medicaid, self-direction can add a paycheck. It is a service-delivery model rather than a separate benefit. Federal rules for one Medicaid option, section 1915(j) self-directed personal assistance services, define it as the opportunity for participants or their representatives to exercise choice and control over the budget, planning, and purchase of services, with authority that includes recruiting and hiring workers. Whether a family member, including a spouse, can be that paid caregiver is a state option, so it varies by state. And if your loved one is a veteran, the VA Program of Comprehensive Assistance for Family Caregivers (PCAFC) pays an approved Primary Family Caregiver (a spouse can qualify) a monthly stipend, which VA has described as nontaxable, plus at least 30 days of respite care a year. VA's first screen is that the veteran has a VA disability rating of 70% or higher, was discharged or has a date of medical discharge, needs at least 6 months of continuous, in-person personal care, and is enrolled in VA health care. Meeting those four is necessary but not enough: you and the veteran apply together, and the regulation adds conditions. The one most likely to surprise a family is that the personal care the Family Caregiver would provide must not be simultaneously and regularly provided by or through another individual or entity, so a household already receiving regular personal care through another program or entity can fail PCAFC on that ground alone. Before you count on combining layers, ask VA how any other personal care you already receive affects the application.

Find Your State's Caregiver Programs Guide

Wherever you are in this, whether just starting to research or already deep in daily care, the right program can mean more rest, more financial stability, or both. Each state guide is a complete directory: the programs that pay family caregivers, respite options, the local Area Agency on Aging, VA benefits, and taxes.

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51 states

Not sure where to start? Chat with Brevy's care navigator for a personalized plan based on your state, your loved one's Medicaid eligibility, and veteran status.

Frequently Asked Questions

What caregiver programs are available in every state?

Three kinds of help exist almost everywhere: caregiver counseling, training, and respite through the National Family Caregiver Support Program (an Older Americans Act program, not Medicaid; for a family caregiver of an older person, its respite care requires that person to be frail); a Medicaid home-care program, which may offer a self-directed option that can pay a family caregiver where the state permits it; and access to federal VA caregiver programs for veterans. The specifics vary; see your state's guide above.,

Which states pay family caregivers the most?

It varies by program and the person's care needs, not just the state. VA's PCAFC stipend is not a flat national figure: it is tied to the federal pay rate for the veteran's locality, so the amount depends on where the veteran lives. Medicaid pay depends on each state's home-care wage and whether it pays a daily stipend or an hourly wage. Your state's guide has the current figures.

Do all states let you get paid to care for a spouse?

Not necessarily. Whether a spouse can be the paid caregiver is a state Medicaid option, and a state may permit it or decline to. Colorado's CDASS program allows a spouse to be hired as the paid attendant, though a member of the household can be paid only for extraordinary care determined by the case manager. Alabama's Personal Choices handbook gives advice for when you have hired a relative or friend to be your personal assistant, bars the participant's representative from being hired to provide Personal Choices services, and its sample spending plan pays an employee listed as a spouse. Wisconsin's IRIS self-directed personal care page allows hiring family members but does not address spouses, so confirm with the program before relying on it. Check your state's guide above for the current rule. The VA's PCAFC program can pay a spouse who is an eligible veteran's approved Primary Family Caregiver. See How to Get Paid as a Family Caregiver for the details.

How do I find caregiver help near me?

Start with your local Area Agency on Aging, which provides the National Family Caregiver Support Program's services or contracts with an entity that does, or use your state's guide above for the direct helpline.

Learn More

CaregiverSigns Your Aging Parent Needs Help: What to Watch ForHow to tell when an aging parent needs help: warning signs in daily tasks, personal care, safety, medications, and memory, plus what to do and where to start. CaregiverGetting Started as a Family Caregiver: A First-Steps GuideNew to caregiving? A first-steps guide with a week-one checklist, caregiver tasks, how to share the load, the legal documents you need, and where to find help. CaregiverHow to Find and Hire In-Home Care for an Aging ParentHow to hire in-home care for an older adult: home care agency vs hiring directly, what to screen for, and the household-employer tax rules most families miss. CaregiverLong-Distance Caregiving: A Practical GuideHow to care for an aging parent from a distance: what you can do from afar, the family meeting to have first, staying connected, and finding local help. CaregiverFMLA for Family Caregivers: Your Right to Job-Protected LeaveHow the Family and Medical Leave Act lets you take job-protected leave to care for a parent or spouse: who qualifies, what it covers, and the unpaid catch. CaregiverHow to Get Paid as a Family Caregiver: The 50-State GuideHow to get paid to care for a family member in 2026: Medicaid self-direction, VA caregiver programs, personal care agreements, plus all 50 state guides. CaregiverRespite Care for Family Caregivers: The 50-State GuideWhat respite care is and how to pay for it in 2026: the main types, NFCSP respite with no income test, Medicaid and VA respite, and every state guide. 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.

Find personalized help navigating caregiver programs in your state 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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Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.