How to Get Paid as a Family Caregiver in West Virginia (2026)

West Virginia pays family members to provide in-home care through two Medicaid programs: the Personal Care Services (PCS) program and the Aged and Disabled Waiver (ADW). The ADW is self-directed, so the person receiving care can recruit, hire, train, and supervise their own caregiver.1

If your loved one is a veteran, the VA pathways are often the strongest option: a tax-free monthly stipend, a program that can pay a spouse, and no Medicaid eligibility required.2

This guide lays out every legitimate way to be paid as a family caregiver in West Virginia for 2026: who can be hired under each program, how the pay works, and how to choose the route that fits your family.

The Short Version

If your loved one qualifies for the West Virginia Aged and Disabled Waiver or the PCS program, ask about self-direction and whether a family member can be the paid caregiver. Call the Bureau for Medical Services (BMS) at 1-888-483-0797 to start.1

If your loved one is a veteran, check the VA programs first. The PCAFC stipend, Veteran-Directed Care, and Aid and Attendance can pay well and do not require Medicaid eligibility.

If your family has private assets, a written personal services contract can pay a caregiver now while documenting the arrangement for later Medicaid planning. West Virginia enforces a 60-month look-back, so the contract format matters.4

The rest of this guide walks through each pathway in detail.

What West Virginia Medicaid Offers for Paid Caregiving

West Virginia's two main in-home Medicaid programs for paid caregiving are the Personal Care Services (PCS) Program and the Aged and Disabled Waiver (ADW).1

The PCS Program is a Medicaid state plan benefit providing assistance with activities of daily living (eating, bathing, transferring, walking, and dressing) for members who need help in at least three ADL areas. Workers come to the home, workplace, or community.1

The Aged and Disabled Waiver is West Virginia's primary 1915(c) HCBS waiver for older adults and adults with physical disabilities who need a nursing-facility level of care but can be served at home. The ADW promotes self-direction, giving participants decision-making authority over who provides their care. Self-direction is the model that lets a family member be the paid caregiver: within the plan and budget, the participant can hire, supervise, and manage the workers who provide the care.1,3

Whether a specific family member (an adult child, sibling, or spouse) can be the paid caregiver depends on the program's rules, and whether a spouse or other legally responsible relative can be paid is a state option that varies. These West Virginia specifics are not clearly published in widely available secondary sources. Call the Bureau for Medical Services at 1-888-483-0797 to confirm current family-member eligibility before assuming anyone qualifies.1,3

The West Virginia Paid Family Caregiver Pathways

1. West Virginia Medicaid Personal Care (PCS) and ADW Self-Direction

Who pays: West Virginia Medicaid.

Who can be paid: Confirm with BMS at 1-888-483-0797. Under the ADW self-directed model, a family member may be hired as the paid caregiver; the specific rules for a spouse, a co-resident relative, or a legal guardian should be verified directly, because whether a legally responsible relative can be paid is a state option.1,3

What it covers: Hands-on help with activities of daily living, delivered in the home, workplace, or community.1

How you get paid: Through the BMS fiscal intermediary's payroll, with taxes withheld.3

Best for: Families already in or applying for West Virginia Medicaid long-term services and supports who want to confirm family-member eligibility.

2. VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

Who can be paid: A designated Primary Family Caregiver of an eligible veteran, which can be a spouse, adult child, parent, or other family member.2

2026 stipend: The PCAFC stipend is calculated from the federal General Schedule GS-4, Step 1 annual rate for the locality where the veteran lives, divided by 12, then multiplied by a level factor (Level 1 is 0.625; the higher Level 2 applies when VA determines the veteran is unable to self-sustain in the community). Because the rate is tied to the veteran's locality, there is no single national dollar figure; confirm your exact stipend with your VA Caregiver Support Coordinator.2

Veteran eligibility: A VA disability rating (individual or combined) of 70 percent or higher, a need for in-person personal care for at least six continuous months, and enrollment in VA health care.2

How to apply: File VA Form 10-10CG online at caregiver.va.gov, or ask a Caregiver Support Coordinator to help.

Why it stands out: The stipend is federal tax-free, it can pay a spouse, and it requires no Medicaid eligibility. The Hershel "Woody" Williams VA Medical Center in Huntington and the Beckley VA Medical Center are the main West Virginia VA facilities.

3. VA Veteran-Directed Care (VDC)

Who can be paid: Almost any caregiver the veteran chooses, including a spouse. VDC has the most permissive family-hire rules of any program in this guide.

How it works: The veteran receives a flexible monthly budget set by their VA care team and uses it to hire and pay caregivers at a rate they set within that budget. A fiscal agent handles payroll. Ask your VA social worker or Caregiver Support Coordinator whether Veteran-Directed Care is available at the West Virginia VA medical center serving your area.

Best for: A West Virginia veteran with daily-living needs who wants to pay a spouse or set their caregiver's schedule and rate directly.

4. VA Aid and Attendance Pension

Who is paid: The veteran or surviving spouse receives the VA Veterans Pension directly, and a family caregiver is typically paid out of it under a private arrangement.

2026 maximums (effective December 1, 2025 through November 30, 2026): a single veteran with Aid and Attendance receives up to $2,424 per month; a veteran with one dependent up to $2,874 per month. Confirm current figures on the VA pension rate page before applying.5

Eligibility: A wartime veteran or a surviving spouse who meets the Aid and Attendance functional criteria, with countable income and assets under the $163,699 net-worth limit.5

How caregivers get paid: The pension goes to the veteran, who then pays the family caregiver, ideally under a written caregiver agreement. The West Virginia Department of Veterans Assistance and county Veterans Service Officers help file at no cost; avoid for-profit pension consultants who charge a fee.

Best for: A wartime veteran or surviving spouse with income and assets under the limit who needs help with daily activities.

5. Private Personal Services Contract

Who can be paid: A family member, including an adult child, sibling, or other relative, under a written contract signed before care begins.

Why the format matters: West Virginia Medicaid applies a 60-month look-back to asset transfers when determining long-term care eligibility. An informal payment can be treated as a gift and create a penalty period. A properly drafted contract at fair-market rates converts those payments into a documented exchange of value. Confirm the current transfer-penalty divisor with BMS or a West Virginia elder-law attorney before relying on it.4

Best for: Families with enough assets to private-pay a caregiver who also want to preserve eligibility for future Medicaid planning. Work with a West Virginia elder-law attorney to draft the contract.

How to Apply for Paid In-Home Care Through West Virginia Medicaid

If the Medicaid route fits your family, here is the order of operations rather than a single phone call.

Comparing the Pathways

How to Choose Your West Virginia Paid Family Caregiver Pathway

Start with the care recipient's situation:

Where to Get Help in West Virginia

Tax Considerations

• WV Medicaid PCS/ADW pays W-2 wages through the fiscal intermediary, with taxes withheld.
• VA PCAFC is a federal tax-free stipend, not reported on a W-2.2
• IRS Notice 2014-7: If you live in the same home as the person you care for and are paid through a Medicaid program, your wages may be excluded from federal gross income. West Virginia levies a graduated state income tax; confirm the state-level treatment with a tax preparer.

Common Misconceptions

"My spouse can't be paid in any state." Whether a spouse can be paid is a state-by-state choice under Medicaid self-direction, and some states do allow it. Whether West Virginia's ADW allows it in your situation should be confirmed with BMS at 1-888-483-0797.3

"Medicare will pay me to be Mom's caregiver." Medicare does not pay family caregivers. It only covers short-term skilled home health through certified agencies. Paid family caregiving in West Virginia comes through Medicaid, the VA, or a private contract.

"I can informally get paid from Dad's savings." Not without a written personal services contract. West Virginia's 60-month look-back treats informal payments as gifts, which can delay your loved one's Medicaid eligibility later.4

Related Terms

• HCBS waiver: The federal authority (Section 1915(c)) behind West Virginia's Aged and Disabled Waiver.
• Activities of Daily Living (ADLs): The functional basis for authorizing personal care under PCS and the ADW.
• Nursing Facility Level of Care: The clinical threshold for the Aged and Disabled Waiver.
• Consumer Directed Services (CDS): The national term for the self-directed model that lets a care recipient hire and direct their own worker.3

Learn More

Find personalized help getting paid as a family caregiver in West Virginia 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.