You can get paid to care for a family member in Ohio through the state’s Medicaid home-care waiver programs, which let a qualifying loved one hire you directly as their personal care provider. The main routes are the PASSPORT waiver for adults 60 and older, the Ohio Home Care Waiver for people under 60 with disabilities, the Next Generation MyCare program for people who have both Medicare and Medicaid, and Structured Family Caregiving, which pays a live-in family member a daily stipend instead of an hourly wage. Your relative has to meet a medical standard and a financial standard, and you have to pass a background check and complete specific training before payments begin.
The Four Programs That Pay Family Caregivers
PASSPORT is Ohio’s home-care waiver for adults 60 and older who need a nursing-facility level of care and qualify financially for Medicaid institutional care.1Ohio Department of Aging. PASSPORT Eligibility It has a consumer-directed option that lets the care recipient hire their own personal care provider, including a family member or spouse.
The Ohio Home Care Waiver covers people from birth through age 59 who have a physical disability and need a nursing-facility level of care.2Cornell Law School. Ohio Admin Code 5160-46-02 Under its self-directed track, the participant has employer authority: they can hire, manage, and dismiss caregivers (including family) and manage the waiver funds allocated to them.3Ohio Department of Medicaid. Self-Direction Service Descriptions
Next Generation MyCare launched January 1, 2026, replacing the former MyCare Ohio managed-care plan. It coordinates Medicaid and Medicare for people who carry both. To enroll, your relative must have full Medicaid, Medicare Parts A, B, and D, and be 21 or older.4Ohio Department of Medicaid. Next Generation MyCare Program Self-directed personal care is available under this program.
Structured Family Caregiving (SFC) works differently from the hourly waiver programs. A live-in family caregiver receives a flat daily stipend that can add up to roughly $1,800 per month depending on the care recipient’s tier of need. SFC is Medicaid-funded, so the person receiving care must qualify for one of Ohio’s home-care waivers, and the caregiver must actually live in the home.
How Much You Can Earn
Under PASSPORT and the Ohio Home Care Waiver, consumer-directed personal care services reimburse at $3.44 per 15-minute unit as of the January 2024 rate sheet, which works out to about $13.76 per hour.5Ohio Department of Aging. ODA Medicaid Waiver Rates by Service Groups Agency-managed personal care pays $7.24 per 15 minutes on paper, but much of that goes to the agency rather than the worker. Under Structured Family Caregiving, monthly compensation can reach around $1,800 based on assessed need rather than clock time.
Ohio caps paid hours for close family. A spouse can be paid a maximum of 40 hours per week, and a parent caring for a minor child is likewise capped at 40 hours per week. Other relatives caring for someone over 17 face a similar 40-hour weekly cap per relative. The Ohio Department of Medicaid can grant exceptions when the person’s health and safety needs require more.6Ohio Legislative Service Commission. Ohio Admin Code 5160-44-32
Whether Your Loved One Qualifies
Your relative has to clear two tests: medical and financial.
The medical test is called “level of care.” A case manager from the local Area Agency on Aging or another designated agency comes to the home and evaluates whether the person needs the same intensity of care they would get in a nursing facility.7Ohio Department of Medicaid. ODM03697 Level of Care Assessment Form and Instructions Meeting that standard is the gateway to PASSPORT, the Ohio Home Care Waiver, MyCare, and Assisted Living waivers.
The financial test is Medicaid eligibility for institutional care. For 2026, the countable asset limit is $2,000 for a single person and $3,000 for a couple.8Ohio.gov. Medicaid Standards Help Sheet Income is capped at 300 percent of the federal SSI benefit rate — that was $2,829 per month for one person on the 2024 PASSPORT eligibility page, and it adjusts each year with Social Security cost-of-living increases.1Ohio Department of Aging. PASSPORT Eligibility People above the income limit may still qualify depending on their medical needs. Ask the local Area Agency on Aging for the current number before assuming your relative is over.
Not everything counts against the asset limit. The primary home, one vehicle, personal belongings, and certain other categories are typically excluded. The financial rules for long-term care Medicaid are stricter than for standard Medicaid, so someone who already has regular Medicaid may still need a separate review.
Whether You Qualify as the Caregiver
You must be at least 18, authorized to work in the United States, and able to provide a government-issued photo ID and Social Security number for provider enrollment.9Ohio Department of Medicaid. Provider Enrollment
Background Check
A criminal background check is mandatory. Ohio has been moving home-care waiver providers to RAPBACK (Retained Applicant Fingerprint Database), which gives the Department of Medicaid continuous criminal-history monitoring rather than annual rechecks. Under RAPBACK there is no cost to the provider after initial enrollment. Providers who enrolled before the transition may need one final check before being switched over.
Training
Before payments begin, you need current First Aid and CPR certifications from in-person courses taught by a certified instructor. Online-only certifications do not count. You also have to document one of the following within the past 24 months:
- State Tested Nurse Aide (STNA) certification in good standing with the Ohio Department of Health
- Medicare Competency Evaluation Program for Home Health Aides, which requires 75 hours of training plus a skills checklist
- An equivalent training program covering personal care services, basic home safety, and universal precautions
These rules apply to non-agency Personal Care Aides and Home Care Attendants, which are the typical classifications for family caregivers who enroll as individual providers.10Ohio HCBS Provider Network. Non-Agency Provider Enrollment Resources
Extra Rules for Spouses and Parents of Minors
Ohio adds conditions when a spouse wants to be paid, or when a parent wants to be paid to care for a minor child. Across all Medicaid waiver programs, that arrangement is only allowed if no other willing and qualified provider is available and the Department of Medicaid (or its designee) has confirmed the person’s health and safety needs can be met that way.6Ohio Legislative Service Commission. Ohio Admin Code 5160-44-32 When approved, the care must meet “extraordinary care” standards documented on a specific state form, and the caregiver has to cooperate with monthly contacts from a care management agency, including in-person visits at least every 60 days. Spouses and parents of minors cannot provide respite care.
Adult children, siblings, grandparents, aunts, and uncles do not face those extra hurdles. They can serve as paid direct care workers through an agency or through the self-directed track without proving that no one else is available.
How to Apply
Step 1: Call Your Area Agency on Aging
The entry point for PASSPORT and most other long-term care programs is your local Area Agency on Aging. Ohio’s statewide hotline is 1-866-243-5678, which connects to the AAA serving your county.11Ohio Department of Aging. Local Office For the Ohio Home Care Waiver (ages 0–59), you can also reach the Department of Medicaid’s self-direction team at selfdirection@medicaid.ohio.gov.12Department of Medicaid. Self-Direction Resources for Caregivers
Step 2: Complete the In-Home Assessment
After intake, a case manager schedules a home visit to evaluate the care recipient’s health, functional abilities, and living situation. This assessment decides whether the person meets the nursing-facility level of care required for waiver enrollment. The case manager also documents preferred service settings and goals.
Step 3: Enroll as a Provider
If your relative is approved, you complete provider enrollment with the Ohio Department of Medicaid. That includes submitting enrollment paperwork, consenting to the background check, and choosing whether to enroll through a Fiscal Management Service (FMS) for the self-directed track. The FMS handles payroll, tax withholding, and billing on your behalf, which takes most of the administrative work off you.
What Changes After Approval
Ohio requires ongoing documentation to keep payments flowing. Family caregivers providing personal care services have to use Electronic Visit Verification (EVV) to log each visit. The system records six data points: the type of service, who received it, the date, the location, who provided it, and the start and end times.13Ohio Department of Medicaid. Electronic Visit Verification The preferred method is Ohio’s Sandata Mobile Connect smartphone app; a telephone option exists as a backup. Manual entry is only allowed when the app and phone system are genuinely unavailable.
One important carve-out: caregivers who live in the same household as the person receiving care can apply for an exemption from EVV logging. GPS tracking through the app is optional, requires the care recipient’s written consent, and has to be renewed each year. Co-signatures from the care recipient (or their authorized representative) are required on visit documentation.
How Your Pay Is Taxed
If you live with the family member you care for, you may be able to exclude your Medicaid waiver payments from federal gross income entirely. Under IRS Notice 2014-7, payments made through a state Medicaid home and community-based services waiver qualify as “difficulty of care” payments when the caregiver and care recipient share a home, and they are excludable under Section 131 of the Internal Revenue Code.14Internal Revenue Service. Certain Medicaid Waiver Payments May Be Excludable From Income For someone earning $13 to $14 an hour for 40 hours a week, the annual tax savings can run into the thousands.
The exclusion has limits. Respite pay, vacation pay from the state, and care provided when the recipient does not live in the caregiver’s home are generally taxable. Structured Family Caregiving stipends are designed as tax-free compensation because the caregiver has to live with the care recipient, which typically satisfies the Notice 2014-7 test.
On employment taxes, family caregivers paid through a self-directed waiver are typically treated as employees of the care recipient, with an FMS handling payroll. Special IRS rules may exempt certain family relationships (a spouse, a child under 21, or a parent) from FICA withholding depending on the arrangement.15Internal Revenue Service. Family Caregivers and Self-Employment Tax If you reported these payments as taxable income in an earlier year, you can file Form 1040-X to amend the return for any year still within the statute of limitations.
If Your Loved One Is Denied
You have the right to request a state hearing. The Bureau of State Hearings must receive the request within 90 days of the mailing date on the denial notice.16Ohio Department of Developmental Disabilities. Medicaid Appeals There is a shorter deadline hidden inside that window: if the hearing request arrives within 15 days of the notice date, any existing services continue without interruption while the appeal is pending. Miss the 15-day mark and services can be cut or stopped in the meantime.
At the hearing you can represent yourself or bring a guardian, attorney, or anyone else to speak for you. If the hearing officer rules in your favor, corrective payments are backdated to the date of the incorrect action. If you lose, you can pursue an administrative appeal and then judicial review in court.
A Non-Medicaid Alternative for Veterans
Ohio veterans who receive VA healthcare have an option outside the Medicaid system. The Veteran Directed Care (VDC) program, available through some Area Agencies on Aging in Ohio, gives veterans a flexible budget to hire caregivers of their choice, including family and friends. VDC does not require Medicaid eligibility, which matters for veterans whose income or assets are too high for the waiver programs. Call your local AAA or VA medical center to find out whether VDC is offered in your area.