Most family members who want to get paid through Medicaid are not disqualified. A few specific things can affect eligibility, and most depend on your state and program. They include your relationship to the person, your background check, where you live, and whether you work another job.
Some rules are about the person you care for. They must be on Medicaid and need a certain level of care. Other rules are about you, the caregiver.
This family caregiver guide walks you through what disqualifies you from being a caregiver, if a spouse or power of attorney (POA) can be a paid caregiver, and if you can be a caregiver with a felony. At the end, check your own eligibility in 60 seconds.
Most family caregivers are not disqualified. Eligibility comes down to two tests.
Test 1: the person you care for. They must be enrolled in Medicaid. They must also need help with daily activities, or need a nursing-facility level of care.
Test 2: you, the caregiver. Your age, background check, relationship to the person, living arrangement, and job can all matter. Each one depends on your state and program.
Always check your eligibility, even if you think you don’t qualify. Each state has different rules, so you may qualify.
You can’t get paid as a family caregiver yet if your family member isn’t enrolled in Medicaid or doesn’t have a functional need. Your family member needs help with activities of daily living like dressing, mobility, eating, or bathing, or requires a nursing facility level of care. In other words, they can't safely manage at home on their own.
Structured Family Caregiving is a Medicaid program that pays a family member or friend who lives with the person to give daily care.
Some states, like Georgia, require your family member to meet an a nursing facility level of care (NFLOC) to be approved for Home and Community Based Services Medicaid waivers. Medicaid may look at:
If your family member isn't on Medicaid yet, they can apply. If their income or assets are too high, some states let them "spend down" to qualify. Rules and look-back periods vary by state, so check with your state Medicaid agency before spending anything. See if your family member may qualify.
Sometimes a spouse can be paid as a caregiver if your state program allows it. Some Medicaid self-directed programs pay spouses in specific cases. Self-directed means the person getting care, or their representative, chooses and manages their own caregiver (Medicaid.gov). Structured Family Caregiving may exclude spouses in some states. Many states limit which family members can be paid, and spouses are often left out (Health Affairs Scholar, 2025).
A spouse can't be paid as a caregiver through Structured Family Caregiving in Georgia. Georgia considers spouses "legally responsible individuals" who have a legal duty to care for their spouse without Medicaid funding. Georgia's program also generally requires the caregiver to be a relative.
Yes, in Ohio a spouse can be a paid caregiver. Spouses are regularly approved. Your relationship to the person generally isn't a factor in approval. Ohio caregivers also don't need to be related by blood.
"In Ohio, spouses are very common, and they've never raised an issue for any caregiver we've worked with," says Ariel, Sabion at Givers. "The 'certain circumstances' idea sounds scarier than it is in practice."
The Connecticut Medicaid Adult Family Living (AFL) program doesn't pay a spouse because of the "legally responsible relative" rule. Adult Family Living pays a caregiver who lives with the person to give daily care.
It depends on the program in Michigan: the Home Help Program and the Michigan Choice Waiver have different rules for spouses. The Michigan Home Help Program does not pay a spouse for caregiving. Michigan has proposed a change to its MI Choice waiver that may allow paid spouse caregivers. That change is not live yet, so check with your state program for the current rule.
Even if your state doesn’t pay a spouse for caregiving, most Medicaid programs may pay another family member or friend. Work with an eligible family member to coordinate a care plan.
Medicaid requires a background check, and some criminal offenses can disqualify you from paid caregiving. A felony or criminal record doesn’t automatically disqualify you as a caregiver, especially if it is a past nonviolent offense. Many states review older, nonviolent offenses on a case-by-case basis. In most states, violent felonies and sexual offenses generally lead to automatic disqualification even if they happened years ago.
Ohio sorts disqualifying offenses into tiers. Most carry an exclusionary period of five, seven, or ten years. The clock starts when you are fully discharged from prison, probation, and parole. It does not start on your conviction date. Once that period passes, the offense no longer blocks you.
Only the most serious offenses carry a permanent bar. Most of these are violent crimes against people. The list also includes some non-violent felonies, like Medicaid fraud.
"The record people worry about most is a non-violent offense that's already past the exclusionary period," says Ariel Sabillon at Givers.
For example, the Georgia Department of Community Health (DCH) reviews past criminal convictions as part of Georgia’s fingerprint-based background check. In general, violent felonies and sexual offenses disqualify you in Georgia, no matter how old the crime.
Programs look closely at who was harmed. An offense against an older adult or someone in your care, like abuse or fraud, is more likely to disqualify you. Because a caregiver is often entrusted with sensitive information and the well-being of a senior, these types of offenses may disqualify you.
"When a past offense isn't an automatic disqualifier, we ask the caregiver to explain what happened," says Mojeed Olaogun at Givers. "We need to make sure the offense didn't involve an older adult."
A POA can be a paid caregiver, but Medicaid will look at you closely for a conflict of interest. There are real concerns about the same person signing decisions and also being paid. Some state programs have specific rules about whether a POA can be a paid caregiver. They may require a written agreement or care plan. Check your eligibility with your state program. This guide is general information and not legal advice. For your situation, talk to an elder law attorney.
In most cases, you can be a paid caregiver if you live with the person you care for. Living together doesn’t automatically disqualify you from being a paid caregiver. Structured Family Caregiving programs generally require that the caregiver and care recipient live in the same home. Some programs, like an hourly personal care service, don’t require caregivers to live in the same home. Where you live can change which program fits you.
It depends on the program. Some programs, including SFC in many states, expect caregivers to work full-time without an outside job. Caregivers can’t have outside employment under Structured Family Caregiving. If you already work another job, you may fit an hourly program instead. Find out what program works best for you.
In almost all states, the minimum caregiver age requirement is 18 to be a paid caregiver. Connecticut allows caregivers as young as 16 to be a paid caregiver under Connecticut’s self-directed Community First Choice Program and has extra rules. SFC and most self-directed Medicaid programs require the paid caregiver to be 18 or older.
If you are under the minimum caregiver age requirement, an adult household member may enroll instead.
In many cases, you can be a paid caregiver if your family member is on Medicaid and needs the care, and you are an eligible relative without a criminal background. Most caregivers concerned about losing benefits find that the caregiving pay is a much higher amount. Always check your own money situation and eligibility before making a decision.
Some programs, like Structured Family Caregiving, require caregivers to work full-time without working somewhere else. If you already have a job, you can choose caregiving with an hourly program instead.
Yes. Your care recipient needs to be enrolled in Medicaid and need personal care for you to get paid. Some programs require that your care recipient needs a Nursing Facility Level of Care, and others just look at your relative’s ability to complete basic ADLs safely and independently. Each state program has different requirements. If your family member isn’t enrolled in Medicaid, start the application process.
In some cases, a POA can be a paid caregiver. However, Medicaid will most likely review your case for conflicts of interest and may require a written personal care plan or agreement.
Your relationship to the care recipient, age, criminal background, current job, or POA status may disqualify you from being a paid caregiver. However, each case is different, so always check your eligibility. Disqualification is not automatic in most cases.
In almost all states, the minimum caregiver age requirement is 18 to be a paid caregiver. Connecticut allows caregivers as young as 16 under Connecticut's self-directed Community First Choice Program with extra standards for 16 and 17 year olds (Conn. Agencies Regs. § 17b-262-596). Connecticut's Adult Family Living program may still require caregivers to be 18. SFC and most self-directed Medicaid programs require the paid caregiver to be 18 or older.
A criminal record doesn’t automatically disqualify you from being a paid caregiver. You can be a caregiver with a felony based on the crime, victim demographic, and when it happened. In general, violent crimes, elder abuse, fraud against an older person, and sexual assault stop you from being a paid caregiver no matter how old the crime. Medicaid will usually approve caregivers with misdemeanors or past non-violent criminal record on a case-by-case basis. You can be a felon and be a caregiver.
Each state has different rules regarding spouses getting paid for caregiving. Some states may exclude spouses from SFC programs or expect a spouse to be “legally responsible” for their care without Medicaid funding. Some programs do pay spouses for caregiving in specific cases. For example, you can usually get paid to be a caregiver in Ohio.
