West Virginia's Aged and Disabled Waiver pays family members, such as adult children, to give in-home care to a parent who needs nursing-home-level care but wants to stay at home., The West Virginia Aged and Disabled Waiver (ADW) offers this family caregiver pay to relatives, including relatives who live with the person, working as personal attendants under either of its two models.

Who West Virginia's Aged and Disabled Waiver Pays as a Family Caregiver

The day-to-day care you may already give your parent for free is what the West Virginia ADW can pay a relative to provide as a personal attendant. The ADW is a Medicaid section 1915(c) waiver that lets a person stay in, or return to, their own home instead of a nursing home., West Virginia's ADW application, approved by the Centers for Medicare & Medicaid Services (CMS) and renewed effective July 1, 2025, says relatives "may be paid for providing Personal Attendant and/or Transportation services," excluding the person's legal guardian and spouse.

Family member Can be paid?
Adult child or other relative Yes, as a relative
Relative who lives with your parent Yes
Spouse No
Court-appointed legal guardian No
Power of attorney, medical power of attorney or health care surrogate Only through an agency, or with a separate program representative

The ADW provider manual says attendants who live in the member's home don't need Electronic Visit Verification or a National Provider Identifier (NPI) to bill for the member they live with.

ADW care has to be for your parent's sole benefit, and for errands and community activities the manual advises special caution when the attendant is a relative or lives with the member. An ADW member also can't be a paid caregiver in another waiver program or in West Virginia Medicaid's Personal Care Services program.

For a spouse, see getting paid to care for a spouse in West Virginia.

Agency or Personal Options: Either Can Pay a Relative

If you'd rather your parent not take on hiring and supervising you, the agency route is there; either way, the ADW's relatives rule covers personal attendant hours under both the Traditional model, run through an ADW provider agency, and Personal Options.

  • With an agency (Traditional): an ADW provider agency employs you, and the ADW manual says your hourly wage is set solely by that agency.
  • With Personal Options: your parent hires, trains and supervises you within a monthly budget based on assessed need; in West Virginia's words, "your staff is hired by you and work directly for you.",

What the relative needs before getting paid, under either model:

  • be at least 18
  • current CPR and First Aid cards
  • cleared state and federal fingerprint-based background checks, which under Personal Options the worker pays for
  • a cleared check against the federal Office of Inspector General (OIG) Medicaid Exclusion List
  • the state's initial competency-based training, finished before the first paid shift, plus any annual training required after that

If you hold your parent's power of attorney (or are their medical power of attorney, health care surrogate or other legal representative), you can be the paid ADW attendant only by working for an ADW provider agency or, if your parent self-directs, when someone else serves as program representative. Under Personal Options, the program representative, who helps your parent with employer duties, can't be paid for that role or be the paid attendant.

How Many Hours Will West Virginia's Aged and Disabled Waiver Pay a Family Caregiver?

Under both models, West Virginia ADW pay covers the hours your parent is assessed to need, not every hour you give, which can be hard to hear if you already provide care most of the day. Under the Traditional model, the highest level, Level D, ranges from 125 to 155 hours a month, and the manual says no member is guaranteed the maximum hours within a level. Community activities can't exceed 20 hours a month.

The manual says informal support isn't mandatory, but for essential errands and community activities, willing and available family or friends should be used before paid attendant time, and the ADW service plan has to address that. Before you cut back at work, ask the case manager how many paid hours the plan will include.

Who sets your wage depends on the model, as described above. We haven't found a published wage for a family attendant on the waiver, so ask the agency or case manager what your pay would be; the BLS estimate above is for the occupation, not the program.

Who Qualifies and How to Start

Your parent has to pass both a medical test and a money test, and West Virginia checks the money first. To join the ADW, your parent must be 18 or older, live in West Virginia, be approved for a nursing home level of care through a nurse's medical assessment, and have needs in at least five areas of daily living, such as eating, bathing and dressing. CMS describes the West Virginia ADW as serving people 65 or older and people 18 to 64 with physical disabilities.

Your parent must be found financially eligible for the ADW before medical eligibility is decided, so these limits decide whether the rest of this guide applies to your family. West Virginia's Medicaid long-term care fact sheet sets the income limit at 300% of the maximum Supplemental Security Income (SSI) payment, which CMS puts at $2,982 a month for 2026, and the asset limit at $2,000 for one person or $3,000 for a couple. If only one spouse needs care, some of the couple's assets are protected for the spouse at home and aren't counted. West Virginia Medicaid can later recover what it paid for home and community-based services, such as the ADW, from the estate of a member 55 or older, and an heir can apply for a hardship waiver., See our West Virginia Medicaid estate recovery guide, income and asset limits guide and spousal impoverishment guide.

1
Step 1

Apply for Medicaid if your parent isn't enrolled

WV PATH is the state's recommended way to apply; the West Virginia Department of Human Services (DoHS) hotline at 1-877-716-1212 also takes applications for some types of Medicaid. Our guide to applying for West Virginia Medicaid walks through it.

2
Step 2

Ask your parent's doctor, physician assistant or nurse to submit the Medical Necessity Evaluation Request (MNER)

form; the form and where to send it are on the state's waiver program site.

3
Step 3

Call the Bureau of Senior Services at 1-866-767-1575

with application questions. Even after ADW approval, services start only when an opening is available.

4
Step 4

Choose a model, name the relative you want hired and tell the case manager,

who develops the service plan with your parent; keep the power of attorney rules above in mind.

If there's a wait. A wait with no emergency priority is hard when your parent needs help now. Applicants found financially and medically eligible but without a funded slot go on the ADW's Managed Enrollment List in order of the date the MNER was completed, so send it early; the state doesn't move anyone up for urgent needs, and families on the list are notified, with instructions, when a slot opens. Take Me Home transition applicants aren't held to the same list rules. For questions about where an application stands, call the Bureau of Senior Services.

Frequently Asked Questions

Is waiver caregiver pay taxable?

It may not be. Under IRS Notice 2014-7, West Virginia ADW payments, as 1915(c) waiver payments, can be excluded from federal income when you give care in a home you share with your parent, but not when you have a separate home of your own., See whether Medicaid waiver payments are taxable.

Who can answer questions about my parent's Medicaid coverage?

Client Services for West Virginia Medicaid takes coverage questions at 1-800-642-8589 or 304-558-2400, the numbers in the state's member handbook.

What if my parent is denied?

West Virginia Medicaid applicants who disagree with an eligibility decision can request a state fair hearing from the West Virginia Board of Review within 90 days of the action's effective date, including by phone at 304-352-0805. The Bureau of Senior Services takes ADW hearing questions. Our West Virginia Medicaid appeals guide explains the steps.

My parent doesn't need nursing-home-level care. Is there another option?

West Virginia Medicaid's Personal Care Services program helps eligible members with daily activities at home, at work or in the community, and has its own medical test. Our West Virginia caregiver programs directory compares the options.

Learn More

CaregiverHow to Get Paid as a Family Caregiver in West VirginiaSee which West Virginia programs pay a family member to give care: Medicaid Personal Care, ADW self-direction (no spouses), and VA caregiver stipends. CaregiverHow to Get Paid to Care for Your Spouse in West VirginiaWest Virginia Medicaid bars a spouse from being the paid caregiver under both the ADW and Personal Care Services. A VA caregiver stipend can pay a spouse. CaregiverCaregiver Programs in West VirginiaKey caregiver programs in West Virginia: Medicaid in-home care, NFCSP respite, VA caregiver benefits, and taxes explained for family caregivers. MedicaidWest Virginia Medicaid HCBS WaiversWest Virginia Medicaid HCBS waivers explained: how the Aged and Disabled Waiver (ADW) covers home care, who qualifies, what it pays, and how to apply. MedicaidHow to Apply for West Virginia MedicaidHow to apply for West Virginia Medicaid via WV PATH online, phone, or in person, plus the documents, the spend-down, spousal rules, timelines, and appeals.

Find personalized help getting paid through the West Virginia Aged and Disabled 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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