Yes, you can get paid for taking care of a family member in PA. Pennsylvania funds family caregiving mainly through two Medicaid programs, Community HealthChoices and the OBRA Waiver, and through the federal Veteran-Directed Care program. Hourly pay typically runs between $11 and $18, set by the home care agency that employs you and based on the care recipient’s assessed needs and your county.
Programs That Pay Family Members to Provide Care
Three programs do most of the work here. Each one has its own rules about who qualifies and, importantly, which relatives can be hired.
Community HealthChoices
Community HealthChoices (CHC) is Pennsylvania’s Medicaid managed care program for long-term services and supports. It covers adults 21 and older who are enrolled in both Medicare and Medicaid, or who qualify for Medicaid-funded long-term care because of a physical disability.1Commonwealth of Pennsylvania. Apply for Community HealthChoices Participants can receive personal care at home and, in most cases, choose a family member as their paid aide. Spouses cannot be hired under CHC. The program runs through managed care organizations (MCOs) that coordinate services and payment.
OBRA Waiver
The OBRA Waiver serves Pennsylvanians 18 to 59 with a severe developmental physical disability who need an institutional level of care. People who turn 60 while enrolled keep their services, but new applicants 60 and older are routed to other programs.2Commonwealth of Pennsylvania. OBRA Waiver As with CHC, a family member other than a spouse can be hired as a paid personal care aide.
Veteran-Directed Care
Veteran-Directed Care is a federal program run by the Department of Veterans Affairs together with local Area Agencies on Aging and other aging and disability network partners.3Administration for Community Living (ACL). Veteran-Directed Care Program Eligible veterans get a flexible budget and hire their own caregivers, including family members and spouses.4U.S. Department of Veterans Affairs. Veteran-Directed Care – Geriatrics and Extended Care This is the only program covered here that allows a spouse to be paid for caregiving.
What You’ll Earn and How Hours Are Set
Family caregivers paid through Pennsylvania’s Medicaid programs generally earn between $11 and $18 per hour. The exact rate depends on your county, the MCO handling the case, and the recipient’s assessed level of care. Higher-acuity care and urban areas tend toward the top of that range. Rates are set by the home care agency that employs you, not negotiated between you and your relative.
The weekly hours come from the care recipient’s individualized service plan, built from their functional assessment. A person needing substantial daily help generates more paid hours than someone who needs assistance a few times a week. Federal overtime rules apply, so hours over 40 in a week are paid at one and a half times the regular rate.
Whether Your Family Member Qualifies
The person you’d be caring for has to clear two gates: Medicaid’s financial rules and a functional assessment showing they need long-term care.
Income and Assets
For 2026, a single applicant’s monthly income cannot exceed $2,982, which is 300 percent of the federal SSI benefit rate.5Centers for Medicare & Medicaid Services (CMS). 2026 SSI and Spousal Impoverishment Standards Countable assets for a single applicant are capped at $8,000, combining the federal $2,000 resource standard with a $6,000 Pennsylvania allowance. The primary home (within equity limits), one vehicle, and personal belongings don’t count.
Married couples get extra protection. When one spouse applies and the other stays in the community, the community spouse can keep between $32,532 and $162,660 in countable resources for 2026, plus a minimum monthly income allowance of $2,643.75.5Centers for Medicare & Medicaid Services (CMS). 2026 SSI and Spousal Impoverishment Standards
Functional Need
A Functional Eligibility Determination confirms the medical need. An assessor evaluates how independently the person handles daily activities like bathing, dressing, eating, toilet use, walking, and transferring between positions, looking at performance over a three-day period.6Commonwealth of Pennsylvania. PA Functional Eligibility Determination Form The point is to confirm the person requires a nursing-facility level of care but wants to stay home.
What You Need to Qualify as the Caregiver
You have to be at least 18 and authorized to work in the United States. The real hurdle for most applicants is the criminal background check. Pennsylvania requires home care agencies to run a criminal history report on every direct care worker applicant. If you’ve lived in Pennsylvania for at least two years, you’ll need a State Police criminal history record; shorter-term residents face additional checks.7Pennsylvania Code and Bulletin. 28 Pa. Code 611.52 – Criminal Background Checks The report must be current when you apply or obtained within the preceding year. Convictions involving violence or abuse will disqualify you.
Once cleared, you become an employee of a home care agency that contracts with the recipient’s MCO. The agency handles payroll, tax withholding, and employment law compliance. Your daily duties follow the recipient’s individualized care plan: bathing assistance, meal preparation, help with dressing, mobility support, medication reminders. You don’t freelance beyond the plan.
How to Apply
The application starts with the care recipient. For Community HealthChoices, call the Pennsylvania Independent Enrollment Broker at 1-877-550-4227 or apply online at compass.state.pa.us.8Pennsylvania Government. Application Guide for Long-Term Services and Supports For the OBRA Waiver, contact your county’s Area Agency on Aging or the Department of Human Services.
After the functional assessment and a Medicaid eligibility determination, the recipient picks an MCO available in their region. A service coordinator then builds the care plan, and the recipient chooses a home care agency contracting with that MCO. The agency hires you as a direct care worker once background checks and onboarding clear.
Veterans should contact their local VA medical center or Area Agency on Aging. Veteran-Directed Care follows VA eligibility rules, not state Medicaid rules.
Logging Shifts With Electronic Visit Verification
If your pay comes through a Medicaid-funded program, you’ll use an Electronic Visit Verification (EVV) system to document every shift. This is a federal mandate under the 21st Century Cures Act. Pennsylvania uses an open-system model, so your agency chooses the software.9Commonwealth of Pennsylvania. Electronic Visit Verification (EVV) GPS tracking is not required. Some agencies use phone apps, some use landline call-in, some use a small device in the home. Your agency trains you on its system. Missed or botched log entries delay pay, so get the habit right from day one.
Taxes on Caregiver Pay
Caregiver wages are generally taxable, but there’s a big exception for family members who live with the person they care for. Under IRS Notice 2014-7, Medicaid waiver payments are treated as difficulty-of-care payments that can be excluded from gross income when the caregiver and care recipient share a home.10Internal Revenue Service. Certain Medicaid Waiver Payments May Be Excludable From Income The IRS defines “the provider’s home” as the place where you actually live and carry out daily personal routines, including sharing meals and holidays with family. If you keep a separate residence where you spend weekends and holidays, the exclusion doesn’t apply.
The practical effect is significant. An adult child who moves in with a parent and provides full-time care through CHC can potentially exclude all of those Medicaid waiver payments from taxable income. An adult child who drives over daily and goes home at night cannot. More than one caregiver living in the home can each claim the exclusion.10Internal Revenue Service. Certain Medicaid Waiver Payments May Be Excludable From Income
If you don’t qualify for the exclusion, your home care agency withholds income and payroll taxes like any other employer. If you’re paid directly by a relative under a private arrangement instead, the family member becomes a household employer and must withhold and pay Social Security and Medicare taxes once cash wages reach $3,000 in 2026.11Internal Revenue Service. Publication 926 (2026), Household Employer’s Tax Guide
Personal Care Agreements When Programs Don’t Fit
Families who don’t qualify for government programs, or who want to supplement state-funded hours, can use a Personal Care Agreement. It’s a written contract between the care recipient and the family caregiver that lays out specific duties, weekly hours, and pay rate. It looks simple, but it does more than organize the arrangement.
Pennsylvania’s Medicaid program reviews any asset transfers made within 60 months before someone applies for long-term care benefits. If the county assistance office finds that assets were given away without receiving fair market value in return, a penalty period starts during which Medicaid won’t pay for long-term care. The penalty length equals the uncompensated transfer value divided by the average daily cost of private nursing facility care.12Commonwealth of Pennsylvania. Medicaid and Payment of Long-Term Services – Section: Transfer of Assets
A properly drafted Personal Care Agreement keeps those caregiver payments from being read as gifts during the look-back review. It documents that the care recipient paid fair market value for actual services. Without one, regular payments from a parent to an adult child look exactly like the kind of transfer that triggers a penalty. Sign the agreement before care starts, use a reasonable local-market hourly rate, and keep records of hours worked and services provided. An elder law attorney is worth the cost if Medicaid eligibility is anywhere on the horizon.
Handle the tax side correctly, too. The care recipient (or a representative) becomes a household employer responsible for payroll tax withholding once payments reach the $3,000 annual threshold for 2026, filing Schedule H with their tax return, and issuing a W-2 to the caregiver.11Internal Revenue Service. Publication 926 (2026), Household Employer’s Tax Guide Skipping those steps creates IRS problems and weakens the agreement if Medicaid later reviews the payments.