How to Get Paid by the State for Taking Care of a Family Member in New York

Many people are already helping a relative at home without realizing that an eligible caregiver may receive regular pay through a Medicaid-funded Home Care program.

This does not mean New York State sends money directly to anyone who helps a family member. The person who needs care must first qualify for Medicaid Home Care, the proposed caregiver must meet the program and agency requirements, and the caregiver must be hired through a participating licensed Home Care agency.

When both the patient and caregiver qualify, an extended family member or trusted person may serve as the patient’s Personal Care Aide and receive payment for providing approved care at home.

How the Family Caregiver Process Works

The pathway we support is based on PCA Home Care. Personal Care Aides help eligible patients with daily activities that have become difficult because of a long-term illness, physical limitation, disability, or age-related decline.

Approved assistance may include:

• Bathing, dressing, and personal hygiene
• Walking, transferring, and mobility support
• Using the bathroom safely
• Preparing meals and assisting with eating
• Light household tasks related to the patient’s care
• Following the approved daily care plan

The Medicaid assessment determines whether the patient qualifies and how many Home Care hours may be authorized. We cannot guarantee approval or a specific number of hours.

Who Needs to Qualify?

Both the patient and the proposed caregiver must qualify. The process starts by reviewing four basic questions:

1. What is the caregiver’s relationship to the patient?
2. What area of New York does the patient live in?
3. Does the patient currently have Medicaid?
4. Does the patient have a long-term or ongoing condition?

The patient generally needs active Medicaid coverage or must be eligible to apply. They also need assistance with daily activities because of an ongoing health condition or disability. Medicare by itself does not normally provide ongoing PCA Home Care.

A person who does not currently have Medicaid should not assume they are automatically disqualified. Medicaid eligibility can be reviewed during the enrollment process. Learn more about our Home Care application process on our Home Care application process page.

Which Family Members May Be Paid?

The caregiver’s relationship to the patient is one of the first details we screen. Under the PCA family caregiver pathway we support, possible caregivers may include siblings, grandchildren, cousins, nieces, nephews, aunts, uncles, and certain trusted family friends.

The following relationships are not eligible under this PCA pathway:

• A spouse caring for a spouse
• A son or daughter caring for a parent
• An in-law caring for the patient
• A legal guardian caring for the person under their guardianship

If the preferred caregiver does not qualify, another extended relative or a vetted aide may still be considered. We confirm the relationship before requesting detailed patient information or proceeding with the case.

Does the Caregiver Need Certification?

A caregiver hired as a Personal Care Aide must meet employment requirements and complete approved PCA training unless an accepted certification or competency pathway applies. New York’s standard PCA training program includes a minimum of 40 hours of approved instruction.

Previous healthcare experience is not always required. The licensed Home Care agency reviews the caregiver’s work authorization, health documents, training status, background requirements, and ability to perform the patient’s approved care tasks.

What About Developmental Disabilities?

When the person has autism, an intellectual disability, cerebral palsy, or another qualifying developmental disability, the Office for People With Developmental Disabilities, commonly known as OPWDD, may be the more appropriate program.

OPWDD has a separate eligibility review and different caregiver rules. Parents and legal guardians are not eligible caregivers through the OPWDD pathway we support. A sibling, cousin, extended relative, or another qualified worker may be considered depending on the person’s services and approved plan.

We review whether PCA Home Care or OPWDD is the more appropriate direction before sending the case to a vetted, licensed provider.

Who Actually Pays the Caregiver?

The caregiver is not paid directly by New York State. Medicaid funds the approved Home Care services, and the participating licensed Home Care agency employs and pays the caregiver through its normal payroll system.

Payment cannot begin simply because someone has already been helping a relative. The patient must be assessed and approved, the caregiver must complete the agency’s hiring requirements, and the Home Care case must officially start.

How to Find Out Whether You Qualify

Before starting paperwork, confirm the patient’s location, Medicaid status, condition, and relationship to the proposed caregiver. This prevents ineligible cases from losing time on forms they cannot use.

Frequently Asked Questions:

Can I get paid for care I already provided?

Payment generally begins only after the patient is approved, the caregiver is hired, and the licensed Home Care agency authorizes the caregiver to begin working. Past unpaid care does not automatically qualify for retroactive payment.

Can a son or daughter be paid to care for a parent?

Adult sons and daughters are not eligible caregivers under the PCA pathway we support. Another extended relative, trusted person, or vetted aide may qualify.

Does the patient need Medicaid?

Yes. The Home Care pathways discussed here depend on Medicaid eligibility. A patient without active Medicaid may first need an eligibility review and assistance with the application.

Is approval guaranteed?

No. Patient eligibility, authorized hours, caregiver approval, and Start of Care depend on the Medicaid assessment, health plan, licensed agency, and applicable program rules.