Caregiver finances

Can You Get Paid to Care for a Parent?

In most states yes, through self-directed Medicaid. Your parent becomes the employer and can hire you as their paid caregiver.

Medicaid.gov calls that “employer authority”. It is the phrase worth saying out loud when you call your state programme, because it is the thing you are actually asking for.

Nobody can tell you the hourly rate, and pages that do are guessing. Self-directed budgets are set per participant by each state, based on assessed need. Any national figure you see quoted for this is invented. The only number that will be true for you comes from your parent’s own state programme.

How self-directed Medicaid actually works

Medicaid.gov describes self-directed services as participants having “decision-making authority over certain services” and taking “direct responsibility to manage their services”. In practice that means the person receiving care, not an agency, chooses who provides it.

Two specific authorities matter, and knowing the names of both is most of the battle:

CMS termWhat it gives your parent
Employer authorityThe authority to recruit, hire, train and supervise the people who provide their services. This is what lets them hire you.
Budget authorityDecision-making authority over how the Medicaid funds in their budget are spent.

A programme may offer one, the other, or both. Ask which your parent’s state offers before assuming.

The programme has a different name in every state. Consumer Directed Care, Participant Directed Services, Cash and Counseling, Self-Directed Personal Assistance. Ask for “self-directed services” and let them translate.

What to actually do, in order

  • Check your parent’s Medicaid status first. Self-direction runs through Medicaid, so eligibility is the gate. If they are not enrolled, that application comes before everything else.
  • Call the state Medicaid office and ask about self-directed services by that name, then ask whether the programme includes employer authority.
  • Ask specifically whether an adult child can be the paid caregiver, and separately whether a spouse can. The answers are often different.
  • Ask what the budget and hourly rate would be for your parent, based on their assessment. This is the real number.
  • Call your Area Agency on Aging as well. They know the local programme names, the waiting lists, and the non-Medicaid options, and the call is free.

Things that catch people out

  • Waiting lists for waiver programmes can run months or longer in some states.
  • Being paid makes you an employee, with tax and payroll consequences. Most states use a fiscal intermediary to handle that; ask who it is.
  • Approved hours are usually fewer than the hours you are actually doing. Being paid for some of the work is the realistic outcome, not all of it.

If your parent is a veteran

VA Aid and Attendance is a monthly payment added to an existing VA pension. VA.gov says you may qualify if you receive a VA pension and need another person to help with daily activities such as bathing, feeding and dressing, or are largely bedridden through illness, or are in a nursing home due to loss of mental or physical abilities related to a disability, or have severely limited eyesight.

The payment goes to the veteran or surviving spouse rather than to you, and they may use it to pay a caregiver, including a family member. It cannot be combined with Housebound benefits, which is a separate programme.

Rates change annually and differ for a veteran, a surviving spouse and a married couple, so check the current figures on VA.gov rather than trusting a number on any other site, including this one.

Why Medicare is not the answer

This trips up almost everyone. Medicare.gov states that Medicare does not pay for custodial or personal care that helps with daily living activities such as bathing, dressing or using the bathroom, when this is the only care you need. Family caregiving is exactly that, so Medicare does not fund it at all.

The full picture of what Medicare will and will not cover at home is on our Medicare home health page. If you end up paying privately instead, what home care actually costs is the comparison worth having.

Where Call Mabel fits

Call Mabel does not pay caregivers and is not a caregiver. If you are doing the physical work of caring for a parent, nothing here replaces that or funds it.

What a daily call does is cover the hours you are not there. Mabel calls whatever phone is already in the house, has a real conversation, and tells you if a call goes unanswered or something sounds off. For families where one person is doing most of the caring and carrying the worry on the days between visits, that is the gap it fills.

Plans start at $29.97 a month, no long-term contract. See how the daily call works →

Sources

  • Medicaid.gov, “Self-Directed Services”, read 21 August 2026, for the definition of self-direction and for employer authority and budget authority as CMS defines them.
  • VA.gov, “Aid and Attendance benefits and Housebound allowance”, read 21 August 2026, for the eligibility criteria and the rule that it cannot be combined with Housebound benefits.
  • Medicare.gov, “Home health services”, for the exclusion of custodial and personal care when that is the only care needed.
General information, not financial or legal advice. Medicaid programmes, eligibility rules and payment rates are set state by state and change. Nothing here predicts what your family would receive. Speak to your state Medicaid programme, your Area Agency on Aging, or a benefits counsellor about your own situation.

Published 2026-08-21.