Vermont caregiver programs include paid in-home care through Choices for Care, the state Medicaid long-term-care program, plus respite help and VA caregiver benefits. In Choices for Care, participants may hire their own caregivers, and a spouse can be paid, but only for personal care with daily activities (ADLs).Centers for Medicare & Medicaid Services. (2022). CMS approval of Vermont Global Commitment to Health Section 1115(a) demonstration amendment, with Special Terms and Conditions (approval period July 1, 2022 through December 31, 2027). medicaid.gov. Retrieved Aug 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-appvl-01022025.pdf,Centers for Medicare & Medicaid Services. (2024). CMS approval of Vermont's Caregiver Reimbursement Protocol (March 22, 2024), enclosing the Global Commitment to Health waiver/expenditure authorities, STCs and approved Attachment P - medicaid.gov. medicaid.gov. Retrieved Oct 14, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-apprvl-03222024.pdf
If you are caring for an aging parent, a partner, or an adult child with a disability in Vermont, the hard part is rarely whether help exists. It is knowing what is there and where to start. This guide maps the major Vermont caregiver programs for 2026: who qualifies, what each one pays or covers, and the first call to make.
You do not have to figure this out alone, and you do not have to fund all of it from your own savings.
Vermont Caregiver Programs at a Glance
| Program | What It Offers | Pay a Family Member? | Cost to You |
|---|---|---|---|
| Choices for Care | Long-term services at home or in another setting; can be self-directed | Spouse: ADL personal care only; adult child: ask DAIL | Paid by Medicaid; a monthly patient share may apply |
| NFCSP (Older Americans Act) | Respite, counseling, support groups, caregiver training | No caregiver wage among the services listed | Ask your Area Agency on Aging |
| Dementia Respite Grants | Help paying for in-home care, respite, homemaker and adult day services | No caregiver wage among the uses listed | Ask your Area Agency on Aging |
| VA PCAFC | Monthly stipend for the approved Primary Family Caregiver of an eligible veteran, which VA called a nontaxable benefit in its 2020 proposed rule | Yes: spouse, son, daughter or other family member, if VA approves them | VA benefit |
| VA Aid and Attendance (A&A) | For a veteran who qualifies for a VA pension and meets an A&A need condition, raises the ceiling to $29,093/yr (no dependents) | No: paid to the veteran, not the caregiver | Vermont Veteran Service Officers help you apply |
Which Vermont Programs Pay Family Caregivers?
For a family already giving care, the real question is whether the person doing the caregiving can get paid for it. In Vermont, the answer runs mostly through one program, and it depends on who you are to the person you care for.
Vermont's Choices for Care is a Medicaid long-term-care program administered by the Department of Disabilities, Aging and Independent Living (DAIL). It provides long-term services and supports to Vermonters who need a nursing home level of care, but age 18 is only the floor: a person must be at least 65, at least 18 with a physical disability, or eligible under Medicaid for Children and Adults rules. For services other than nursing facility care, DAIL also requires a functional physical limitation caused by a physical condition, such as a stroke, dementia or a traumatic brain injury, or associated with aging. A person whose need for services is due to a developmental disability, autism or mental illness is not eligible. Participants choose where to receive services: in their own home, in their family's home, in an Adult Family Care home, in Enhanced Residential Care, or in a nursing facility.Centers for Medicare & Medicaid Services. (2022). CMS approval of Vermont Global Commitment to Health Section 1115(a) demonstration amendment, with Special Terms and Conditions (approval period July 1, 2022 through December 31, 2027). medicaid.gov. Retrieved Aug 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-appvl-01022025.pdf
Each participant has three ways to run their care: self-direct it, have a qualified designated representative direct it on their behalf, or choose traditional agency-based services. Through the consumer- or surrogate-directed option, participants may hire their own caregivers, but DAIL's rules limit which relatives Choices for Care can pay, and for what:Centers for Medicare & Medicaid Services. (2022). CMS approval of Vermont Global Commitment to Health Section 1115(a) demonstration amendment, with Special Terms and Conditions (approval period July 1, 2022 through December 31, 2027). medicaid.gov. Retrieved Aug 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-appvl-01022025.pdf,Centers for Medicare & Medicaid Services. (2024). CMS approval of Vermont's Caregiver Reimbursement Protocol (March 22, 2024), enclosing the Global Commitment to Health waiver/expenditure authorities, STCs and approved Attachment P - medicaid.gov. medicaid.gov. Retrieved Oct 14, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-apprvl-03222024.pdf
- A spouse or civil union partner can be paid for personal care with activities of daily living (ADLs) only. DAIL bars spouse pay for instrumental activities of daily living (IADLs) such as housekeeping and shopping, and for respite or companion care; a COVID-era expansion into those categories ended after November 11, 2023.Centers for Medicare & Medicaid Services. (2024). CMS approval of Vermont's Caregiver Reimbursement Protocol (March 22, 2024), enclosing the Global Commitment to Health waiver/expenditure authorities, STCs and approved Attachment P - medicaid.gov. medicaid.gov. Retrieved Oct 14, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-apprvl-03222024.pdf,Centers for Medicare & Medicaid Services. (2022). CMS approval of Vermont Global Commitment to Health Section 1115(a) demonstration amendment, with Special Terms and Conditions (approval period July 1, 2022 through December 31, 2027). medicaid.gov. Retrieved Aug 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-appvl-01022025.pdf
- A paid spouse has conditions to meet. Under DAIL's guidelines for paying spouses, the spouse must meet the same minimum requirements as any other personal care provider and cannot be the participant's surrogate employer or legal guardian, and a plan for the spouse's own relief must be in place. Adult day, respite or companion services can meet that relief plan, and the decision to pay a spouse rests with the participant.Centers for Medicare & Medicaid Services. (2022). CMS approval of Vermont Global Commitment to Health Section 1115(a) demonstration amendment, with Special Terms and Conditions (approval period July 1, 2022 through December 31, 2027). medicaid.gov. Retrieved Aug 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-appvl-01022025.pdf,Centers for Medicare & Medicaid Services. (2024). CMS approval of Vermont's Caregiver Reimbursement Protocol (March 22, 2024), enclosing the Global Commitment to Health waiver/expenditure authorities, STCs and approved Attachment P - medicaid.gov. medicaid.gov. Retrieved Oct 14, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-apprvl-03222024.pdf
- A legal guardian appointed by probate court may not be paid to provide personal care unless DAIL grants an individual variance. A surrogate employer may not be paid to provide personal care to the participant they act for.Centers for Medicare & Medicaid Services. (2024). CMS approval of Vermont's Caregiver Reimbursement Protocol (March 22, 2024), enclosing the Global Commitment to Health waiver/expenditure authorities, STCs and approved Attachment P - medicaid.gov. medicaid.gov. Retrieved Oct 14, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-apprvl-03222024.pdf
- An adult child is not named in DAIL's limits, which restrict spouses, legal guardians and surrogate employers. No cited Vermont source bars an adult child, but none names one as payable either, so confirm with DAIL before counting on pay.Centers for Medicare & Medicaid Services. (2024). CMS approval of Vermont's Caregiver Reimbursement Protocol (March 22, 2024), enclosing the Global Commitment to Health waiver/expenditure authorities, STCs and approved Attachment P - medicaid.gov. medicaid.gov. Retrieved Oct 14, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-apprvl-03222024.pdf
- Adult Family Care (a 24-hour shared-living option) pays a home provider who is 21 or older, owns or rents the home, and lives there under the same roof as the participant, in a home contracted with an Authorized Agency. The participant's parent, stepparent, adoptive parent, domestic partner, spouse, legal guardian or representative payee may not be the paid home provider.Centers for Medicare & Medicaid Services. (2024). CMS approval of Vermont's Caregiver Reimbursement Protocol (March 22, 2024), enclosing the Global Commitment to Health waiver/expenditure authorities, STCs and approved Attachment P - medicaid.gov. medicaid.gov. Retrieved Oct 14, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-apprvl-03222024.pdf
Paid personal care is limited to the maximum hours on the DAIL-approved service plan, and IADLs other than meal preparation and medication management are limited to 4.5 hours per week.Centers for Medicare & Medicaid Services. (2024). CMS approval of Vermont's Caregiver Reimbursement Protocol (March 22, 2024), enclosing the Global Commitment to Health waiver/expenditure authorities, STCs and approved Attachment P - medicaid.gov. medicaid.gov. Retrieved Oct 14, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-apprvl-03222024.pdf
As a benchmark for what this work pays, the Bureau of Labor Statistics estimates the median wage for home health and personal care aides in Vermont at $20.00 an hour (May 2025). That figure reflects what aides earn across employers, so Choices for Care pay may differ.data.bls.gov. (2025). BLS OEWS Profiles, May 2025, 31-1120 Home Health and Personal Care Aides (national estimates). Retrieved Oct 14, 2026, from https://data.bls.gov/oesprofile/?year=2025&major_group=310000&occupation=311120&measure=01&areas=INDUSTRY,STATE,MSA
Because Choices for Care is Medicaid, your loved one has to meet both a clinical and a financial eligibility test for long-term care Medicaid in Vermont. DAIL decides the clinical test and DVHA the financial one. The applicant must also be a Vermont resident and meet the age rule above. In 2026, countable resources must be at or below $2,000 for an individual or $3,000 for a couple, and a person without a spouse who owns and lives in their home and chooses care there gets an extra $3,000 disregard. Once someone is eligible, the state also works out a monthly patient share: how much of their income goes toward the cost of care. The full rules are in Vermont Long-Term Care Medicaid.Centers for Medicare & Medicaid Services. (2026). CMS CMCS Informational Bulletin — Updated 2026 SSI and Spousal Impoverishment Standards (April 27, 2026), with the 2026 SSI and Spousal Impoverishment Standards chart. medicaid.gov. Retrieved Jul 30, 2026, from https://www.medicaid.gov/federal-policy-guidance/downloads/cib04272026.pdf,dvha.vermont.gov. (n.d.). Vermont Department of Vermont Health Access — Long-Term Care (how to apply; 202LTC; LTC Customer Support Unit contacts; DVHA/DAIL/Designated Agency/DMH eligibility split; eligibility criteria; covered settings; annual review). Retrieved Jul 10, 2026, from https://dvha.vermont.gov/members/long-term-care,Centers for Medicare & Medicaid Services. (2022). CMS approval of Vermont Global Commitment to Health Section 1115(a) demonstration amendment, with Special Terms and Conditions (approval period July 1, 2022 through December 31, 2027). medicaid.gov. Retrieved Aug 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-appvl-01022025.pdf
You may read that spouse pay is waiting on a federal caregiver reimbursement protocol. CMS has approved that protocol, and it sets the rules for payment to legally responsible individuals in Vermont's Developmental Disability Services and Brain Injury programs, not Choices for Care. For help applying, call the Vermont Senior Helpline at 1-800-642-5119.Centers for Medicare & Medicaid Services. (2022). CMS approval of Vermont Global Commitment to Health Section 1115(a) demonstration amendment, with Special Terms and Conditions (approval period July 1, 2022 through December 31, 2027). medicaid.gov. Retrieved Aug 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-appvl-01022025.pdf,Centers for Medicare & Medicaid Services. (2024). CMS approval of Vermont's Caregiver Reimbursement Protocol (March 22, 2024), enclosing the Global Commitment to Health waiver/expenditure authorities, STCs and approved Attachment P - medicaid.gov. medicaid.gov. Retrieved Oct 14, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-apprvl-03222024.pdf
For the full side-by-side of who can be paid, the VA options, and a private caregiver agreement, see How to Get Paid as a Family Caregiver in Vermont.
How to Start a Choices for Care Application
Call the Vermont Senior Helpline
Dial 1-800-642-5119 and say you want to apply for Choices for Care. Your local Area Agency on Aging or Home Health Agency can also help you apply.Centers for Medicare & Medicaid Services. (2022). CMS approval of Vermont Global Commitment to Health Section 1115(a) demonstration amendment, with Special Terms and Conditions (approval period July 1, 2022 through December 31, 2027). medicaid.gov. Retrieved Aug 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-appvl-01022025.pdf,dvha.vermont.gov. (n.d.). Long-Term Care - Department of Vermont Health Access. Retrieved Sep 3, 2026, from https://dvha.vermont.gov/members/long-term-care
File form 202LTC
Complete the Application for Long-Term Care Medicaid (form 202LTC). Print it from DVHA, or call 1-802-476-0100 (toll-free 1-833-840-0061) to have one mailed, then mail it to the Green Mountain Care Application and Document Processing Center, 280 State Drive, Waterbury, VT 05671-1500.dvha.vermont.gov. (n.d.). Vermont Department of Vermont Health Access — Long-Term Care (how to apply; 202LTC; LTC Customer Support Unit contacts; DVHA/DAIL/Designated Agency/DMH eligibility split; eligibility criteria; covered settings; annual review). Retrieved Jul 10, 2026, from https://dvha.vermont.gov/members/long-term-care
Complete the eligibility review
DAIL determines clinical eligibility, meaning whether your loved one needs a nursing home level of care, and DVHA determines financial eligibility for long-term care Medicaid.Centers for Medicare & Medicaid Services. (2022). CMS approval of Vermont Global Commitment to Health Section 1115(a) demonstration amendment, with Special Terms and Conditions (approval period July 1, 2022 through December 31, 2027). medicaid.gov. Retrieved Aug 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-appvl-01022025.pdf,dvha.vermont.gov. (n.d.). Vermont Department of Vermont Health Access — Long-Term Care (how to apply; 202LTC; LTC Customer Support Unit contacts; DVHA/DAIL/Designated Agency/DMH eligibility split; eligibility criteria; covered settings; annual review). Retrieved Jul 10, 2026, from https://dvha.vermont.gov/members/long-term-care
Choose who directs the care
The participant can self-direct, name a qualified designated representative to direct services, or choose agency-based services.Centers for Medicare & Medicaid Services. (2022). CMS approval of Vermont Global Commitment to Health Section 1115(a) demonstration amendment, with Special Terms and Conditions (approval period July 1, 2022 through December 31, 2027). medicaid.gov. Retrieved Aug 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-appvl-01022025.pdf
Where Can You Find Respite Help in Vermont?
Every caregiver needs to step away sometimes, and needing a break does not make you any less devoted. Respite help in Vermont comes through more than one door, and one of them does not require Medicaid at all.
The National Family Caregiver Support Program (NFCSP), funded by Title III-E of the Older Americans Act, is managed in Vermont by the state's five Area Agencies on Aging. ACL lists five types of NFCSP services: information about available services, help getting access to them, individual counseling, support groups and caregiver training, respite care, and supplemental services on a limited basis.U.S. Government Publishing Office. (2024). 42 U.S.C. §3030s-1 — Program authorized (Older Americans Act, Title III Part E; U.S. Code 2024 ed., govinfo.gov). govinfo.gov. Retrieved Oct 12, 2026, from https://www.govinfo.gov/link/uscode/42/3030s-1?link-type=html,Centers for Medicare & Medicaid Services. (2022). CMS approval of Vermont Global Commitment to Health Section 1115(a) demonstration amendment, with Special Terms and Conditions (approval period July 1, 2022 through December 31, 2027). medicaid.gov. Retrieved Aug 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-appvl-01022025.pdf,dvha.vermont.gov. (n.d.). Long-Term Care - Department of Vermont Health Access. Retrieved Sep 3, 2026, from https://dvha.vermont.gov/members/long-term-care
Respite and supplemental services carry a condition the other services do not. For a caregiver of an older adult, the person you care for must be 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 because their behavior poses a serious health or safety hazard. Contact your local Area Agency on Aging at 1-800-642-5119, or dial 211.U.S. Government Publishing Office. (2024). 42 U.S.C. §3030s-1 — Program authorized (Older Americans Act, Title III Part E; U.S. Code 2024 ed., govinfo.gov). govinfo.gov. Retrieved Oct 12, 2026, from https://www.govinfo.gov/link/uscode/42/3030s-1?link-type=html,asd.vermont.gov. (n.d.). State Health Insurance Program. Retrieved Oct 2, 2026, from https://asd.vermont.gov/services/ship,dvha.vermont.gov. (n.d.). Long-Term Care - Department of Vermont Health Access. Retrieved Sep 3, 2026, from https://dvha.vermont.gov/members/long-term-care
If the person you care for is living with dementia, DAIL also supports family caregivers through Dementia Respite Grants, managed by the same five Area Agencies on Aging. The grants can pay for in-home care, respite care, homemaker services and adult day services, and each Area Agency on Aging location has a Director of Caregiving. For support any hour, the Alzheimer's Association 24/7 Helpline at 1-800-272-3900 is free and confidential. More is in Dementia Care in Vermont.dvha.vermont.gov. (n.d.). Long-Term Care - Department of Vermont Health Access. Retrieved Sep 3, 2026, from https://dvha.vermont.gov/members/long-term-care
Choices for Care also includes respite services, and adult day, respite or companion services can meet the relief plan a paid spouse must have in place.Centers for Medicare & Medicaid Services. (2024). CMS approval of Vermont's Caregiver Reimbursement Protocol (March 22, 2024), enclosing the Global Commitment to Health waiver/expenditure authorities, STCs and approved Attachment P - medicaid.gov. medicaid.gov. Retrieved Oct 14, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-apprvl-03222024.pdf For the full breakdown, see Respite Care in Vermont.
Where to Start With Vermont Caregiver Programs
When you are ready to make calls, these are the front doors.
Can the VA Pay You to Care for a Veteran in Vermont?
If your loved one served, do not skip this section. Veterans' benefits sit alongside Medicaid, and the VA's PCAFC caregiver stipend can pay an approved Primary Family Caregiver of an eligible veteran. The caregiver must be at least 18 and either a spouse, son, daughter, parent, stepfamily member or extended family member, or someone who lives full time (or is willing to live full time) with the veteran.U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp
VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)
For a family caregiver, PCAFC means a monthly payment for care you are already giving. VA pays it to the Primary Family Caregiver of an eligible veteran: the federal General Schedule GS-4, Step 1 annual rate for the veteran's locality, divided by 12, then multiplied by a factor set in 38 CFR 71.40(c)(4)(i). In plain terms, the caregiver receives a quarter, five-eighths or all of that monthly GS-4 amount. VA pays the stipend only after the caregiver enrolls in direct deposit through the VA customer engagement portal.U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp,U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
| Veteran's status | Factor |
|---|---|
| Current program (meets 38 CFR 71.20(a)) | 0.625 |
| Current program, and VA finds the veteran unable to self-sustain in the community | 1.00 |
| Legacy participant or applicant, 2019 clinical ratings sum to 21 or higher | 1.00 |
| Legacy participant or applicant, ratings sum to 13 to 20 | 0.625 |
| Legacy participant or applicant, ratings sum to 1 to 12 | 0.25 |
A veteran who meets both the current-program and the legacy criteria is paid whichever amount is higher, and the legacy schedule lapses October 1, 2028. The protections for households in the program before October 1, 2020 are explained in the VA caregiver stipend guide.U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp
Veteran eligibility: VA publishes four conditions, and they are the first screen rather than the decision. The veteran must meet all four:U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
- A VA disability rating, individual or combined, of 70 percent or higher.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
- Discharge from the U.S. military, or a date of medical discharge.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
- A need for at least six months of continuous, in-person personal care services.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
- Enrollment in VA health care.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
Meeting those four is necessary, not sufficient. The binding test, 38 CFR 71.20(a), also requires that participating is in the veteran's best interest, that no other person or entity simultaneously and regularly provides the same personal care, that the veteran receives care at home, and that the veteran receives ongoing care from a primary care team (or will, once VA designates a family caregiver). VA assesses these during the application.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
VA Aid and Attendance (A&A) Pension
The Aid and Attendance (A&A) pension is a higher VA pension ceiling. A veteran or survivor who gets a VA pension may be eligible if they meet at least one of VA's listed conditions, such as needing another person's help with daily activities like bathing, feeding, and dressing.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf The VA pension itself is for wartime veterans who meet age-or-disability requirements and income and net-worth limits. The net-worth limit is $163,699 from December 1, 2025 to November 30, 2026.U.S. Department of Veterans Affairs. (n.d.). Current Pension Rates For Veterans. va.gov. Retrieved Sep 29, 2026, from https://www.va.gov/pension/veterans-pension-rates/ The VA sets these as annual maximums and pays the difference between that maximum and the claimant's income for VA purposes, so someone with income receives less: the ceiling is $29,093 a year for a veteran with no dependents and $34,488 for a veteran with one dependent. The pension is paid to the veteran, not to the caregiver. For the full rules, see Aid and Attendance in Vermont.U.S. Department of Veterans Affairs. (n.d.). Current Pension Rates For Veterans. va.gov. Retrieved Sep 3, 2026, from https://www.va.gov/pension/veterans-pension-rates/
The Vermont Office of Veterans Affairs' certified Veteran Service Officers complete pension applications with veterans so the VA has what it needs to process them; call 802-828-1082.U.S. Department of Veterans Affairs. (n.d.). Get Help From A VA Accredited Representative Or VSO. va.gov. Retrieved Jul 31, 2026, from https://www.va.gov/get-help-from-accredited-representative/
Will You Owe Taxes on Caregiver Pay in Vermont?
Getting paid to care for someone you love raises a practical worry: will a tax bill eat into it? Here is the short version, though a tax preparer familiar with caregiver pay is worth a call before you file.
IRS Notice 2014-7 (Federal Exclusion)
Under an IRS rule, Notice 2014-7, payments to a caregiver under a section 1915(c) Medicaid Home and Community-Based Services waiver are excludable from federal gross income when the care is given in the caregiver's own home and the person cared for lives there. The exclusion does not apply if you keep a separate home where you live.Internal Revenue Service. (n.d.). Certain Medicaid waiver payments may be excludable from income. irs.gov. Retrieved Aug 1, 2026, from https://www.irs.gov/individuals/certain-medicaid-waiver-payments-may-be-excludable-from-income
Choices for Care is not a 1915(c) waiver. It runs under Vermont's Global Commitment to Health section 1115 demonstration, and for payments under a state Medicaid program other than a Home and Community-Based Services waiver, the IRS says the treatment will depend on the nature of the payments and the purpose and design of the program. Ask a tax preparer, and the Vermont Department of Taxes for the state return, how your pay is treated before you file.Centers for Medicare & Medicaid Services. (n.d.). Vermont Global Commitment to Health. medicaid.gov. Retrieved Aug 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/83391,U.S. Government Publishing Office. (2024). 26 U.S.C. §131, Certain foster care payments (govinfo.gov, United States Code 2024 Edition). govinfo.gov. Retrieved Oct 13, 2026, from https://www.govinfo.gov/content/pkg/USCODE-2024-title26/html/USCODE-2024-title26-subtitleA-chap1-subchapB-partIII-sec131.htm
Is the PCAFC Stipend Taxable?
In the preamble to its March 2020 proposed PCAFC rule, VA described the monthly stipend as a nontaxable benefit.U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
Frequently Asked Questions
Can I get paid to care for my spouse in Vermont?
Yes, for personal care with activities of daily living (ADLs) only. Under Choices for Care, a spouse or civil union partner cannot be paid for IADLs such as housekeeping and shopping, or for respite or companion care, and cannot also be the participant's surrogate employer or legal guardian. A plan for the spouse's own relief must be in place. If your spouse is a veteran who meets VA's PCAFC eligibility requirements (a 70 percent or higher disability rating is one of several), the stipend can pay you once VA approves you as the Primary Family Caregiver.Centers for Medicare & Medicaid Services. (2024). CMS approval of Vermont's Caregiver Reimbursement Protocol (March 22, 2024), enclosing the Global Commitment to Health waiver/expenditure authorities, STCs and approved Attachment P - medicaid.gov. medicaid.gov. Retrieved Oct 14, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-apprvl-03222024.pdf,Centers for Medicare & Medicaid Services. (2022). CMS approval of Vermont Global Commitment to Health Section 1115(a) demonstration amendment, with Special Terms and Conditions (approval period July 1, 2022 through December 31, 2027). medicaid.gov. Retrieved Aug 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-appvl-01022025.pdf,U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp,U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
Can I get paid to care for my parent in Vermont?
Possibly. Choices for Care participants may hire their own caregivers through the consumer- or surrogate-directed option, and DAIL's published limits name spouses, legal guardians and surrogate employers, not adult children. Confirm with DAIL through the Vermont Senior Helpline at 1-800-642-5119 before you count on pay. If your parent is a veteran who meets VA's PCAFC eligibility requirements (a 70 percent or higher disability rating is one of several), the stipend can pay a son or daughter whom VA approves as the Primary Family Caregiver.Centers for Medicare & Medicaid Services. (2024). CMS approval of Vermont's Caregiver Reimbursement Protocol (March 22, 2024), enclosing the Global Commitment to Health waiver/expenditure authorities, STCs and approved Attachment P - medicaid.gov. medicaid.gov. Retrieved Oct 14, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-apprvl-03222024.pdf,Centers for Medicare & Medicaid Services. (2022). CMS approval of Vermont Global Commitment to Health Section 1115(a) demonstration amendment, with Special Terms and Conditions (approval period July 1, 2022 through December 31, 2027). medicaid.gov. Retrieved Aug 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-appvl-01022025.pdf,U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp,U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf
Is there respite in Vermont without Medicaid?
Yes. The National Family Caregiver Support Program funds respite care through Vermont's five Area Agencies on Aging. For a caregiver of an older adult, respite requires that the person cared for be frail: unable to do at least two daily activities without substantial help, or needing substantial supervision because a cognitive or other mental impairment makes their behavior a serious health or safety hazard. Contact your local Area Agency on Aging at 1-800-642-5119, or dial 211.U.S. Government Publishing Office. (2024). 42 U.S.C. §3030s-1 — Program authorized (Older Americans Act, Title III Part E; U.S. Code 2024 ed., govinfo.gov). govinfo.gov. Retrieved Oct 12, 2026, from https://www.govinfo.gov/link/uscode/42/3030s-1?link-type=html,Centers for Medicare & Medicaid Services. (2022). CMS approval of Vermont Global Commitment to Health Section 1115(a) demonstration amendment, with Special Terms and Conditions (approval period July 1, 2022 through December 31, 2027). medicaid.gov. Retrieved Aug 3, 2026, from https://www.medicaid.gov/medicaid/section-1115-demonstrations/downloads/vt-global-commitment-to-health-appvl-01022025.pdf,asd.vermont.gov. (n.d.). State Health Insurance Program. Retrieved Oct 2, 2026, from https://asd.vermont.gov/services/ship,dvha.vermont.gov. (n.d.). Long-Term Care - Department of Vermont Health Access. Retrieved Sep 3, 2026, from https://dvha.vermont.gov/members/long-term-care
Which VA programs pay family caregivers in Vermont?
The PCAFC stipend, which VA called a nontaxable benefit in its 2020 proposed rule, can pay a spouse or another family member. A 70 percent or higher VA disability rating is necessary but not enough on its own; the veteran must meet VA's other requirements too. The Aid and Attendance pension, which a veteran or survivor who gets a VA pension (a benefit for wartime veterans) may be eligible for if they meet one of VA's need conditions, such as needing help with daily activities, is paid to the veteran, not to the caregiver. Call the VA Caregiver Support Line at 1-855-260-3274.U.S. Department of Veterans Affairs. (n.d.). Program of Comprehensive Assistance for Family Caregivers (PCAFC) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Jun 24, 2026, from https://www.caregiver.va.gov/support/PCAFC-Stipend.asp,U.S. Government Publishing Office. (2018). Program of Comprehensive Assistance for Family Caregivers Improvements and Amendments Under the VA MISSION Act of 2018 — Proposed Rule, 85 FR 13356 (March 6, 2020) (govinfo.gov / Federal Register). govinfo.gov. Retrieved Sep 2, 2026, from https://www.govinfo.gov/content/pkg/FR-2020-03-06/pdf/2020-04464.pdf,U.S. Department of Veterans Affairs. (n.d.). Current Pension Rates For Veterans. va.gov. Retrieved Sep 3, 2026, from https://www.va.gov/pension/veterans-pension-rates/,U.S. Department of Veterans Affairs. (n.d.). VA's National Caregiver Support Line (CSL) - VA Caregiver Support Program. caregiver.va.gov. Retrieved Aug 1, 2026, from https://www.caregiver.va.gov/help_landing.asp
How do I reach my Area Agency on Aging in Vermont?
Contact your local Area Agency on Aging at 1-800-642-5119, or dial 211. Vermont's five Area Agencies on Aging deliver NFCSP services, including respite care, counseling, support groups, and caregiver training.U.S. Government Publishing Office. (2024). 42 U.S.C. §3030s-1 — Program authorized (Older Americans Act, Title III Part E; U.S. Code 2024 ed., govinfo.gov). govinfo.gov. Retrieved Oct 12, 2026, from https://www.govinfo.gov/link/uscode/42/3030s-1?link-type=html,asd.vermont.gov. (n.d.). State Health Insurance Program. Retrieved Oct 2, 2026, from https://asd.vermont.gov/services/ship,dvha.vermont.gov. (n.d.). Long-Term Care - Department of Vermont Health Access. Retrieved Sep 3, 2026, from https://dvha.vermont.gov/members/long-term-care
What if Vermont Medicaid cuts or denies Choices for Care services?
For a DVHA decision about benefits or services, first ask DVHA to review it with an internal appeal within 60 calendar days of the decision. If you still disagree, you can ask for a fair hearing before the Human Services Board within 120 days of the appeal decision letter. DVHA's appeals page does not describe the route for a denial of eligibility itself, so call the Green Mountain Care Customer Support Center at 1-800-250-8427 for appeals and fair hearings. Vermont Legal Aid (1-800-889-2047) and the Office of Health Care Advocate (1-800-917-7787) help for free.U.S. Government Publishing Office. (n.d.). 42 CFR 431.221 — Request for a hearing (federal Medicaid fair-hearing right). ecfr.gov. Retrieved Sep 3, 2026, from https://www.ecfr.gov/current/title-42/section-431.221
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