Yes. Medi-Cal pays for caregivers in California through the In-Home Supportive Services program, which covers non-medical personal care for people who need help with daily activities and would otherwise require placement in a care facility. You can choose who provides that care, and family members — including spouses, adult children, and parents — can be paid for the work.
What IHSS Pays a Caregiver to Do
IHSS is established under Welfare and Institutions Code section 12300 and covers a defined set of non-medical tasks.1Justia. California Welfare and Institutions Code Article 7 – In-Home Supportive Services Those tasks fall into three broad buckets: personal care such as bathing, dressing, and help with bowel and bladder needs; domestic work including meal preparation, laundry, and housecleaning; and accompaniment to medical appointments. When a doctor authorizes it, IHSS also covers paramedical tasks like injections or catheter care that a caregiver can safely perform at home.
One point of confusion worth clearing up early: Medicare does not pay for this kind of care. Federal regulations specifically exclude custodial (non-skilled) care from Medicare coverage.2eCFR. 42 CFR Part 411 – Exclusions From Medicare and Limitations on Medicare Payment If what you need is ongoing help with daily living rather than short-term medical recovery, IHSS through Medi-Cal is the program to look at.
Who Qualifies for IHSS
Qualification has two parts: financial and functional.
Financially, you generally need to be eligible for Medi-Cal, which requires household income below 138 percent of the federal poverty level. For a single person in 2026, that works out to annual income under $21,597.3California Department of Health Care Services (DHCS). Eligibility Chart As of January 2025, California fully eliminated the Medi-Cal asset limit under Assembly Bill 133, so savings, a second vehicle, or other property no longer disqualify you from coverage in most categories.
Functionally, you must be 65 or older, blind, or disabled, and you must show that without in-home help, you would need the level of care provided in a nursing facility.4Department of Health Care Services. In-Home Supportive Services Plus A licensed healthcare provider documents that need on the Health Care Certification form (SOC 873), describing your specific impairments and how they limit your ability to handle daily tasks.
Paying a Family Member as the Caregiver
IHSS lets you pick your own provider, and that provider can be a relative. Spouses, adult children, and other family members can enroll as paid IHSS providers.4Department of Health Care Services. In-Home Supportive Services Plus Parents of minor children can also serve as paid providers, though choosing a parent as provider affects which IHSS sub-program the child falls under rather than whether the child is eligible for IHSS at all.5Department of Social Services. In-Home Supportive Services Program – IHSS for Children
Before any payment starts, the family member has to complete the provider enrollment process. That means attending a mandatory county orientation and clearing a criminal background check through Livescan fingerprinting.6Department of Social Services. Orientation Process – IHSS Provider Orientation The fingerprinting fee runs roughly $35 to $90 depending on the county and is paid by the provider. Certain serious convictions, including elder abuse and fraud, permanently bar someone from working as a paid IHSS provider.
Once cleared, the family caregiver is paid by the state through the IHSS payroll system. The arrangement becomes a formal employment relationship with timesheets, pay stubs, and labor protections, not an informal family favor.
How to Apply
Start with two forms: the SOC 295 (Application for In-Home Supportive Services) and the SOC 873 (Health Care Certification).7California Department of Social Services. Application for In-Home Supportive Services SOC 295 Submit the SOC 295 to your local county IHSS office in person or by mail. The county will then mail you the SOC 873 to take to your doctor or other licensed provider for completion.
After both forms are on file, a county social worker schedules a home visit. The social worker observes your living environment, assesses how well you handle daily activities on your own, and decides how many hours you qualify for in each service category: personal care, housecleaning, meal preparation, grocery shopping, and so on. The maximum authorization is 283 hours per month, depending on the severity of your needs.
The county then sends a Notice of Action listing your approved hours by category. Read it carefully. It is the official record of what you were granted and tells you how to appeal if you disagree. From application to first payment, the process usually takes 60 to 90 days.
Caregiver Pay Rates and Hours
IHSS wages are set at the county level. The statewide floor is the California minimum wage, $16.90 per hour as of January 1, 2026.8California Department of Industrial Relations. Minimum Wage Many counties pay above that floor. Larger urban counties often set rates between $19 and $23 per hour, while rural counties tend to pay closer to the state minimum. Your county IHSS office can give you the exact local rate.
Hours are driven by the social worker’s assessment. Each authorized task category gets its own hour allotment, and you can generally use up to one quarter of your total monthly hours in any given week. If the recipient’s condition changes, say after a hospitalization or a new diagnosis, you can request a reassessment to adjust the hours.
A primary family caregiver may also qualify for respite hours through CalAIM Community Supports, which provides up to 336 hours of respite per calendar year so the regular caregiver can take a break.9Department of Health Care Services. Personal Care and Homemaker Services and Respite Services
Taxes on Family Caregiver Pay
If you are a family caregiver living in the same home as the person you care for, your IHSS payments may be fully excluded from federal gross income. Under IRS Notice 2014-7, Medicaid waiver payments received by a caregiver who shares a home with the care recipient are treated as difficulty-of-care payments and are tax-free under Section 131 of the Internal Revenue Code.10Internal Revenue Service. Certain Medicaid Waiver Payments May Be Excludable From Income The home has to be genuinely your residence, the place where you sleep, eat, and live your daily life. The exclusion still applies if you moved into the recipient’s home, and more than one caregiver sharing the home can claim it. It does not cover respite care provided in your home when the recipient does not actually live there.
Social Security and Medicare (FICA) withholding follows separate rules. Spouses and parents of IHSS recipients are generally not eligible to have FICA withheld from their paychecks, and this is a federal rule counties cannot override.11California Department of Social Services. When You Are an IHSS Provider for a Family Member or a Close Friend An adult child providing care for a parent, by contrast, is generally subject to FICA.12Internal Revenue Service. Family Employees Because the result depends on both your relationship to the recipient and your living arrangement, it is worth running your situation past a tax professional.
If You Are Denied or Given Too Few Hours
If the county denies your application or authorizes fewer hours than you believe you need, you can request a state hearing. The Notice of Action explains how. You generally have 90 days from the date on the notice to file.13CDSS – CA.gov. Hearing Requests After that, you need to show good cause for a late filing.
For certain Medi-Cal eligibility actions, such as a termination of coverage or an increase in your share of cost, a temporary extension gives you 120 days instead of 90. That extension has been in effect since April 2023 and remains active until further notice. It applies to redetermination-related decisions, not to disputes about IHSS service hours.
At the hearing you can present medical records, testimony from your doctor, and other evidence that the county’s assessment underestimates what you need. If the county cut hours you were already receiving, ask about “aid paid pending” when you file, which can keep your existing hours in place while the appeal moves forward.
Medi-Cal Estate Recovery
One downstream consequence of receiving Medi-Cal benefits that families often miss is estate recovery. Federal and California law allow the state to seek reimbursement from your estate after you die for certain Medi-Cal services received on or after age 55.14Office of the Law Revision Counsel. 42 US Code 1396p – Liens, Adjustments and Recoveries, and Transfers of Assets That includes nursing facility services and home and community-based services tied to IHSS waivers.
California has chosen to limit recovery to what federal law requires rather than expand it to all Medi-Cal services. The state cannot recover from the estate of anyone survived by a spouse or registered domestic partner, by a child under 21, or by a child of any age who is blind or disabled.15California Legislative Information. California Welfare and Institutions Code 14009.5 The Department of Health Care Services must also waive its claim when recovering against a modest homestead would cause undue hardship.
Nothing happens while you are alive and at home. Recovery is a post-death process, and it applies only once the protected family members are no longer living. If you own a home or have other assets you want to pass on, talking with an elder law attorney before or soon after enrolling in Medi-Cal can help your family plan around these rules.