How to Become a Paid Family Caregiver in New Mexico

To become a paid family caregiver in New Mexico, you enroll through one of two Medicaid programs that pay relatives to provide in-home care: the Centennial Care Community Benefit or the Mi Via Waiver. Both are run by the New Mexico Health Care Authority (HCA).¹ The path is the same in shape: your relative gets approved for Medicaid long-term services, then you get enrolled as their paid caregiver through their managed care plan or a Financial Management Agency.

Which Program Fits Your Situation

The Centennial Care Community Benefit serves people who meet a nursing facility level of care but want to stay at home.² It comes in two versions. Agency-Based Community Benefit (ABCB) puts a home health agency between you and the paperwork; the agency hires you, schedules you, and cuts your check. Self-Directed Community Benefit (SDCB) lets the care recipient (or an Employer of Record acting on their behalf) hire you directly, set your schedule, and manage your work, with a Financial Management Agency handling payroll behind the scenes.

The Mi Via Waiver is a separate self-directed program for people with intellectual or developmental disabilities who meet an ICF/IID level of care.³ Mi Via gives the participant an Individual Budgetary Allotment tied to their age and level of care, which they and a consultant translate into a spending plan that can include hiring family members.⁴

If your relative already has a developmental disability diagnosis and needs an ICF/IID level of care, Mi Via is the fit. Otherwise, Community Benefit is the usual route.

Does Your Relative Qualify

Before you can be paid, the person you care for has to qualify for Medicaid long-term services. Two tests apply.

The financial test: a single applicant’s countable resources cannot exceed $2,000.⁵ The 2026 income limit for institutional and home-and-community-based services is $2,982 per month, which is 300 percent of the federal SSI benefit rate of $994.⁶ The home, one vehicle, and certain personal belongings are typically excluded from the resource count.

The medical test: nursing facility level of care for the Community Benefit, or ICF/IID level of care for Mi Via. In practice, that means regular hands-on help with bathing, dressing, eating, transferring, or toileting. Once Medicaid approves the application, the care recipient’s managed care organization sends someone out for a functional needs assessment that decides both eligibility and how many care hours are authorized.

Do You Qualify as the Caregiver

You must be at least 18. You will go through fingerprint-based criminal history screening under New Mexico’s Caregivers Criminal History Screening Program; certain offenses, including assault, human trafficking, identity theft, and animal cruelty, are permanently disqualifying.⁷ Your name will also be checked against the state’s Employee Abuse Registry; anyone on it cannot be employed as a caregiver.⁸

Employment paperwork depends on the model. Under SDCB you fill out an employee packet processed by the Financial Management Agency. Under ABCB the home health agency handles onboarding. Either way, plan on providing proof of identity, a Social Security number, and tax forms.

Training rules vary by managed care organization and by the services you’ll deliver. The HCA’s Community Benefit explainer does not set a universal training mandate, but your plan or agency may require orientation, CPR certification, or a competency evaluation before your first shift.

If You Are a Spouse, Parent, or Legal Guardian

This is where families most often get the rules wrong. New Mexico does pay spouses, parents of minor children, and legal guardians, but the conditions are strict.

Under the Centennial Care Community Benefit, a legally responsible individual can be approved as a paid caregiver after the health plan completes a needs assessment. The managed care organization makes the call.² Under SDCB specifically, a legally responsible individual generally cannot be paid for personal care they would ordinarily be expected to provide; the plan has to approve an exception for services that go beyond those ordinary responsibilities.⁹

Under Mi Via, the bar is higher. Spouses and parents of minors need written approval from the Department of Health, granted only under extraordinary circumstances, and every service the legally responsible individual will provide requires its own request form.¹⁰ Other relatives (adult children, siblings, aunts, uncles) face fewer hurdles under either program, though a relative cannot serve as the participant’s Mi Via consultant.

The Application Process

The work happens in two phases. First, get your relative onto Medicaid and approved for long-term services. Then, enroll yourself as the caregiver.

Phase One: Medicaid and Service Approval

Apply for New Mexico Medicaid online through the YesNM portal, in person at a local Income Support Division office, by mail, by fax, or by phone at 1-800-283-4465.¹¹ Gather proof of identity, New Mexico residency, income statements, asset records, and a physician’s assessment of functional limitations before you start.

Standard Medicaid applications are processed within 45 days. Applications that involve a disability determination can take up to 90 days. Once eligibility is confirmed, the managed care organization schedules the functional needs assessment that sets the authorized hours.

Phase Two: Enrolling You as the Caregiver

For Agency-Based Community Benefit:

Your relative contacts their health plan’s Care Coordinator, who helps identify an approved home health agency.
If you are a legally responsible individual, the Care Coordinator requests MCO approval.
You apply for employment through the agency, completing background checks and any required training.
Once hired, you begin providing services and clock hours through the Electronic Visit Verification (EVV) system.

For Self-Directed Community Benefit:

Your relative (or their Employer of Record) selects you as caregiver. If you are a legally responsible individual, the health plan must approve first.
You, the member, and a Support Broker complete the employee packet and submit it to the Financial Management Agency.⁹
After the FMA processes the packet, you can start work and track hours through EVV.

Submit the employee packet as early as possible. You will not be paid for any hour worked until the FMA has fully processed the packet.⁹

How You Get Paid

Pay depends on the authorized service hours and the program’s rate structure. Under ABCB, the home health agency sets your hourly rate within Medicaid’s reimbursement limits. Under SDCB, the care recipient’s approved budget sets what’s available, and the Employer of Record has some flexibility to set your rate within state limits. Under Mi Via, the Individual Budgetary Allotment caps everything, and the participant’s spending plan assigns dollar amounts to each service, including your wages.⁴

For self-directed caregivers, both you and the Employer of Record sign timesheets and submit them to the FMA. Timesheets must be submitted within 90 days of the date services were provided, or Medicaid’s timely-filing rules will block payment.⁹ Each new plan year also requires a fresh Employee Agreement; miss that and your paycheck stops until it’s on file.

Taxes: The Same-Household Rule

Under IRS Notice 2014-7, Medicaid waiver payments to individual care providers can be excluded from gross income as “difficulty of care” payments under Section 131 of the Internal Revenue Code.¹² One condition drives the outcome: you and the care recipient must live in the same home.

Share a home with your relative and all of your Medicaid waiver payments for their care can be excluded. Multiple caregivers in the same household can each claim the exclusion. Keep a separate residence and travel over to provide care, and the payments are taxable. The IRS looks at where you actually live (where you sleep, eat, and carry out your routine), not just where you provide care.¹²

Payments that qualify for the exclusion will not show up on a W-2 or 1099. If a prior year’s payments were reported as income by mistake, you can file an amended return to claim a refund; a tax preparer familiar with Medicaid waiver payments can walk you through it.

1
New Mexico Health Care Authority. Health Care Authority
2
New Mexico Health Care Authority. New Mexico Medicaid Family Paid Caregivers in the Community Benefit Program
3
Medicaid. Medicaid Section 1115 Demo – Demonstration and Waiver List – New Mexico
4
New Mexico Health Care Authority. Mi Via Service Planning and Budgets
5
New Mexico Health Care Authority. Eligibility Pamphlet 1.1.2026
6
Social Security Administration. SSI Federal Payment Amounts for 2026
7
New Mexico Health Care Authority. Caregivers Criminal History Screening Program
8
New Mexico Health Care Authority. Employee Abuse Registry
9
New Mexico Health Care Authority. Self-Directed Community Benefit
10
Mi Via Self-Directed Waiver Program. Mi Via Service Standards
11
YES.NM.GOV. How to Apply
12
Internal Revenue Service. Certain Medicaid Waiver Payments May Be Excludable From Income