West Virginia caregiver programs help families keep an aging parent or a disabled adult at home through Medicaid in-home care and federally funded respite. One source of respite comes through the Older Americans Act, outside Medicaid. Two of the state's Medicaid in-home routes are its Personal Care Services program and the Aged and Disabled Waiver, which has a self-directed option called Personal Options.Centers for Medicare & Medicaid Services. (n.d.). West Virginia Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/WV,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
If you are caring for an aging parent, a spouse, or an adult child with a disability, the hardest part is rarely whether help exists. It is knowing what is there and where to start. This guide maps the major programs for 2026: who qualifies, what it offers, 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.
In This Guide
- West Virginia Caregiver Programs at a Glance
- Which West Virginia Caregiver Programs Pay Family Members?
- How Do I Get a Break? Respite Care in West Virginia
- Where to Get Help in West Virginia
- VA Caregiver Benefits in West Virginia
- Will I Owe Taxes on Caregiver Pay in West Virginia?
- Frequently Asked Questions
- Learn More
West Virginia Caregiver Programs at a Glance
| Program | What It Offers | Pay a Family Member? | Cost to You |
|---|---|---|---|
| Personal Care Services and Aged and Disabled Waiver | In-home help with daily activities; the waiver has a self-directed option | ADW: relatives, not a spouse or legal guardian. PCS: not a spouse, parent of a minor or guardian; ask about other relatives | Paid by Medicaid for eligible members |
| NFCSP (Older Americans Act) | Respite, counseling, support groups, caregiver training | N/A | Ask your Area Agency on Aging |
| VA PCAFC | Monthly stipend VA has described as nontaxable; can pay a spouse | Yes | VA benefit |
| VA Aid and Attendance | Single veteran's pension ceiling of $29,093/yr, minus countable income | Pension to veteran | VA benefit |
Which West Virginia Caregiver Programs Pay Family Members?
For a lot of families, this is the real question: can the person already doing the caregiving get paid for it? In West Virginia, the answer runs through the state's Medicaid long-term care programs, and it depends heavily on who that person is.
West Virginia Medicaid funds in-home care through the Personal Care Services (PCS) Program, which assists eligible members with activities of daily living (ADLs) and instrumental activities of daily living (IADLs) in the member's home, place of employment or community. To qualify medically, a member must have three deficits on the most current Pre-Admission Screening (PAS), and that screening must be started by a Personal Care Medical Necessity Evaluation Request signed by a physician, physician assistant, or nurse practitioner. A member with two deficits can also qualify if the screening shows one of several listed conditions, such as a stage 3 or 4 decubitus or being unable to take their own medications.Centers for Medicare & Medicaid Services. (n.d.). West Virginia Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/WV
The Aged and Disabled Waiver (ADW) is the home and community-based waiver West Virginia runs for people 65 or older and adults 18 to 64 with physical disabilities who meet a nursing facility level of care. The state's ADW site adds that the level of care is based on a medical assessment completed by a nurse, that an applicant must have needs in at least five areas of daily living, and that an opening must be available before someone who is accepted can take part.Centers for Medicare & Medicaid Services. (n.d.). West Virginia Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/WV
Who Can Be Paid Under Self-Direction
The Aged and Disabled Waiver has a self-directed option, Personal Options, under which, in the state's words, your staff is hired by you and work directly for you. Self-direction is not a way around the spousal bar: the same ADW page says staff you hire cannot be your spouse or legal guardian. An ADW member also cannot be a paid caregiver in another waiver program or in Personal Care Services.Centers for Medicare & Medicaid Services. (n.d.). West Virginia Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/WV
Other relatives can be paid. West Virginia's CMS-approved ADW application says relatives may be paid for providing personal attendant and transportation services through the ADW, excluding the person's legal guardian and spouse, and that the services must be for the sole benefit of the member. That applies under both the Traditional (agency) model and Personal Options. A relative who lives with the member can be the attendant too: the state's ADW provider manual says personal attendants who live in the member's home do not have to use Electronic Visit Verification (EVV) and do not need a National Provider Identifier (NPI) to bill for the member they live with. A power of attorney, medical power of attorney, or health care surrogate may be paid only by working for an ADW provider agency or, under Personal Options, if the member has a separate program representative, and the program representative can never be the paid attendant.bms.wv.gov. (2025). Application for a §1915(c) HCBS Waiver: WV.0134.R08.00 (Aged and Disabled Waiver), 5-year renewal effective July 1, 2025 — Appendix C-2-d/C-2-e and Appendix C-1/C-3 Personal Attendant; CMS-approved application as posted by WV DoHS Bureau for Medical Services (bms.wv.gov, Waivers page). Retrieved Oct 14, 2026, from https://bms.wv.gov/media/40961/download?inline
Personal Care Services has its own bar. Medicaid prohibits persons legally responsible for a member, which the program manual defines as a spouse or a parent of a minor child, from being paid to provide personal care services, and court-appointed legal guardians and conservators are prohibited too. Where the direct care worker is a relative or lives with the member, the manual cautions that services must be for the sole benefit of the eligible person to avoid disallowances.Centers for Medicare & Medicaid Services. (n.d.). West Virginia Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/WV Adult children are not on the list of people Personal Care Services bars, though its rules do not say outright that they may be paid. A power of attorney, medical power of attorney, or health care surrogate may provide the care only if employed by a personal care agency. Hours are capped: up to 60 hours a month at Service Level 1, and a maximum of 210 hours a month based on assessed need, and a direct care worker may bill no more than 16 hours a day.Centers for Medicare & Medicaid Services. (2023). West Virginia State Plan Amendment 23-0005 — CMS approval letter (June 16, 2023) and approved pages, Supplement 2 to Attachments 3.1-A and 3.1-B, item 26 Personal Care Services (effective 01/01/2023) — medicaid.gov. medicaid.gov. Retrieved Oct 14, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/WV-23-0005.pdf
Before you count on a particular arrangement, ask West Virginia Medicaid Client Services at 1-800-642-8589 or 304-558-2400, the numbers the state's member handbook gives for questions about Medicaid coverage. For current pay and a side-by-side of every paid pathway, including the VA options, see How to Get Paid as a Family Caregiver in West Virginia.Centers for Medicare & Medicaid Services. (n.d.). West Virginia Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/WV
How to Start a West Virginia Medicaid Caregiver Application
Confirm Medicaid eligibility
These programs run through West Virginia Medicaid, so your loved one must have or qualify for Medicaid. The state's member handbook gives Medicaid Client Services, 1-800-642-8589 or 304-558-2400, for questions about Medicaid coverage.Centers for Medicare & Medicaid Services. (n.d.). West Virginia Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/WV
Get the medical screening started
For Personal Care Services, a physician, physician assistant, or nurse practitioner signs the request that starts the Pre-Admission Screening, and the member needs three deficits, or two plus a listed condition. For the Aged and Disabled Waiver, a nurse completes a medical assessment for nursing home level of care, and the applicant must have needs in at least five areas of daily living.Centers for Medicare & Medicaid Services. (n.d.). West Virginia Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/WV
Decide whether to self-direct
Under the waiver's Personal Options, the staff you hire work directly for you, but they cannot be your spouse or legal guardian.Centers for Medicare & Medicaid Services. (n.d.). West Virginia Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/WV
Confirm who can be paid
Under the Aged and Disabled Waiver, relatives other than a spouse or legal guardian may be paid. For Personal Care Services, ask Medicaid Client Services whether the relative you have in mind can be paid; a spouse cannot be paid under either program. Once accepted for the waiver, an opening must be available before services can start.Centers for Medicare & Medicaid Services. (n.d.). West Virginia Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/WV,bms.wv.gov. (2025). Application for a §1915(c) HCBS Waiver: WV.0134.R08.00 (Aged and Disabled Waiver), 5-year renewal effective July 1, 2025 — Appendix C-2-d/C-2-e and Appendix C-1/C-3 Personal Attendant; CMS-approved application as posted by WV DoHS Bureau for Medical Services (bms.wv.gov, Waivers page). Retrieved Oct 14, 2026, from https://bms.wv.gov/media/40961/download?inline,Centers for Medicare & Medicaid Services. (2023). West Virginia State Plan Amendment 23-0005 — CMS approval letter (June 16, 2023) and approved pages, Supplement 2 to Attachments 3.1-A and 3.1-B, item 26 Personal Care Services (effective 01/01/2023) — medicaid.gov. medicaid.gov. Retrieved Oct 14, 2026, from https://www.medicaid.gov/medicaid/spa/downloads/WV-23-0005.pdf
How Do I Get a Break? Respite Care in West Virginia
Every caregiver needs to step away sometimes, and needing a break does not make you any less devoted. One source of respite sits outside Medicaid, under the federal Older Americans Act.
The National Family Caregiver Support Program (NFCSP), funded by Title III-E of the Older Americans Act, is delivered through Area Agencies on Aging. Services include 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. Respite means temporary relief from caregiving, at home or in an adult day care or institutional setting.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
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. Reach your regional Area Agency on Aging through the Eldercare Locator at 1-800-677-1116.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,eldercare.acl.gov https://eldercare.acl.gov/home · Accessed Sep 2, 2026
For the full breakdown of respite options, see Respite Care in West Virginia.
Where to Get Help in West Virginia
When you are ready to make calls, these are the front doors.
VA Caregiver Benefits in West Virginia
If your loved one served, do not skip this section. VA's caregiver benefits are separate from Medicaid, and its PCAFC stipend can pay a spouse, which West Virginia Medicaid's Personal Care Services and the Aged and Disabled Waiver's Personal Options do not.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,Centers for Medicare & Medicaid Services. (n.d.). West Virginia Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/WV
VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)
The Program of Comprehensive Assistance for Family Caregivers (PCAFC) pays a monthly stipend to the Primary Family Caregiver of an eligible veteran. It starts from the federal General Schedule GS-4, Step 1 annual rate for the veteran's locality, divided by 12, then multiplies that figure by a level factor. Under 38 CFR 71.40(c)(4)(i), which factor applies turns on whether the veteran is in the current program or is a legacy participant or legacy applicant: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
- Current program (38 CFR 71.20(a)): the factor is 0.625, or 1.00 if VA determines the veteran is unable to self-sustain in the community.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
- Legacy participant or legacy applicant (38 CFR 71.20(b) or (c)): the factor comes from the sum of the veteran's 2019 clinical ratings, and no self-sustain determination is required. A sum of 21 or higher pays 1.00, a sum of 13 to 20 pays 0.625, and a sum of 1 to 12 pays 0.25.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 veteran who meets both the current-program and the legacy criteria is paid whichever of the two amounts is 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
- A legacy participant under 71.20(b) cannot be paid less than what the caregiver was eligible for the day before October 1, 2020, as long as the veteran stays at the address VA has on record. The legacy provisions run through October 1, 2028.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
If your veteran has been in PCAFC since before October 1, 2020, ask your local VA Caregiver Support Program team which schedule applies before you assume the lower factor. VA has described the stipend as a nontaxable benefit, and a spouse can serve as the caregiver. VA pays it only after the caregiver enrolls in direct deposit through the VA customer engagement portal. Primary Family Caregivers can also receive caregiver education and training and mental health counseling, and may get access to health care benefits through CHAMPVA if they don't already qualify for care under another health care plan, and at least 30 days of respite care per year.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.). 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
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 is 38 CFR 71.20(a), which states seven requirements and requires every one of them. Four of the seven have no counterpart in the four above, and VA assesses them during the application process: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
- Participating in the program is in the veteran's best interest.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 personal care services the family caregiver would provide are not simultaneously and regularly provided by or through another individual or entity.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 veteran receives care at home, or will do so if VA designates a family caregiver.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 veteran receives ongoing care from a primary care team, or will do so if VA designates a family caregiver.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 no-other-provider condition is the one most likely to surprise a family, because a household already receiving regular personal care through another program or entity can fail PCAFC on that ground alone.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
Aid and Attendance (A&A) adds monthly payments to a VA pension: a veteran or survivor who already gets a VA pension may be eligible if they meet at least one of VA's listed requirements, such as needing another person's help with daily activities like bathing, feeding, and dressing. The VA pension itself is for wartime veterans: among its tests, the veteran must have served at least 1 day of active duty during wartime.U.S. Department of Veterans Affairs. (n.d.). Eligibility For Veterans Pension. va.gov. Retrieved Jul 31, 2026, from https://www.va.gov/pension/eligibility/ From December 1, 2025, to November 30, 2026, the net worth limit for Veterans Pension is $163,699.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/
A single veteran's maximum is $29,093 per year; one with a dependent's is $34,488 per year. VA pays the difference between that ceiling and the veteran's income for VA purposes, so someone with income receives less than the maximum, and some non-reimbursable medical expenses can reduce that income. The payments go to the veteran or survivor, not to a caregiver directly.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/
Will I Owe Taxes on Caregiver Pay in West Virginia?
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)
If you are paid under a Medicaid home and community-based services waiver (section 1915(c) of the Social Security Act) to care for someone who lives with you in your home under their plan of care, those payments may be treated as difficulty-of-care payments and excluded from your federal gross income under IRS Notice 2014-7. Your home, for this rule, is where you reside and carry out the routines of your private life, and the exclusion does not apply if you have a separate home where you reside.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 The Aged and Disabled Waiver is a 1915(c) waiver, so ask your preparer whether the exclusion applies to you.bms.wv.gov. (2025). Application for a §1915(c) HCBS Waiver: WV.0134.R08.00 (Aged and Disabled Waiver), 5-year renewal effective July 1, 2025 — Appendix C-2-d/C-2-e and Appendix C-1/C-3 Personal Attendant; CMS-approved application as posted by WV DoHS Bureau for Medical Services (bms.wv.gov, Waivers page). Retrieved Oct 14, 2026, from https://bms.wv.gov/media/40961/download?inline
West Virginia State Income Tax
State income tax treatment of caregiver wages can differ from the federal rule. Confirm how West Virginia taxes Medicaid waiver payments with the West Virginia Tax Division or a tax preparer before you file.
The PCAFC Stipend
VA's 2020 rulemaking describes the monthly personal caregiver 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 West Virginia?
Not through Personal Care Services or the Aged and Disabled Waiver's self-directed Personal Options. Personal Care Services prohibits a spouse from being paid to provide personal care, and staff hired under the Aged and Disabled Waiver's self-directed Personal Options cannot be your spouse or legal guardian. If your spouse is a veteran, VA's PCAFC stipend can pay a spouse who serves as the Primary Family Caregiver, though the veteran must meet several requirements beyond a 70 percent disability rating.Centers for Medicare & Medicaid Services. (n.d.). West Virginia Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/WV,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
What has to happen before West Virginia Medicaid pays for in-home care?
Your loved one needs Medicaid and a medical screening. For Personal Care Services, a physician, physician assistant, or nurse practitioner signs the request that starts the Pre-Admission Screening, and the member needs three deficits, or two plus a listed condition. For the Aged and Disabled Waiver, a nurse's medical assessment must show nursing home level of care, and an opening must be available before an accepted applicant can take part. For pay and the full process, see the West Virginia paid family caregiver guide.Centers for Medicare & Medicaid Services. (n.d.). West Virginia Waiver Factsheet - CMS State Waivers List, Medicaid.gov. medicaid.gov. Retrieved Sep 2, 2026, from https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/Waiver-Descript-Factsheet/WV
Is there respite in West Virginia without Medicaid?
Yes. The National Family Caregiver Support Program, funded under the Older Americans Act, provides respite care through Area Agencies on Aging. For a caregiver of an older adult, the person cared for must be frail, meaning 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. Reach your regional agency through the Eldercare Locator at 1-800-677-1116.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,eldercare.acl.gov https://eldercare.acl.gov/home · Accessed Sep 2, 2026
Which VA programs pay family caregivers in West Virginia?
The PCAFC stipend pays a Primary Family Caregiver, including a spouse, and VA has described it as a nontaxable benefit; a 70 percent VA disability rating is one of several requirements, not the whole test. Aid and Attendance is paid to the veteran or survivor rather than to a caregiver, as an addition to a monthly VA pension; someone who gets that pension, which is for wartime veterans, may be eligible if they meet one of VA's need tests. Call the VA Caregiver Support Line at 1-855-260-3274.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.). 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,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.). Eligibility For Veterans Pension. va.gov. Retrieved Jul 31, 2026, from https://www.va.gov/pension/eligibility/
How do I reach my Area Agency on Aging in West Virginia?
Call or text the Eldercare Locator at 1-800-677-1116 or visit eldercare.acl.gov, and it will connect you to your regional West Virginia Area Agency on Aging. Your agency provides NFCSP caregiver services, including information, counseling, support groups, caregiver training, and respite care.eldercare.acl.gov https://eldercare.acl.gov/home · Accessed Sep 2, 2026,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
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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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