Can A Spouse Be Paid As A Family Caregiver? (Tips, Programs, and Benefits)

Joshua Iversen

Caring for a family member, whether they’re a parent, grandparent, child, or spouse, along with the emotional challenges involved, can present financial challenges by keeping you from working full or even part-time.

If you are serving as a family caregiver for your spouse, there are certain government programs that may offer compensation for the services you provide. 

Additionally, there are programs available from a variety of entities that may offer other assistance for family caregivers in the form of access to resources or care services. 

There may also be alternative options to consider for receiving compensation for caring for your spouse. For instance, alternative forms of financial assistance could come from:

  • A relative or friend who wants to contribute to your spouse’s medical care. 

  • Your spouse’s income from Social Security or SSI, if any, may be used for this purpose if feasible. 

  • An employer may offer paid family leave to you to care for your spouse for a certain period of time.

Below we have listed a number of programs that may provide compensation or other assistance to spousal caregivers who help their loved one perform certain activities of daily living.

4 Financial Assistance Programs For Spousal Caregivers

Some of these programs are sponsored by federal or national organizations, while others are sponsored by state governments, a combined federal/state effort, or other organizations. These sources, if applicable, can be combined with any other sources of support to deliver directed care and build personal care programs.

When using these and other resources to build a program of comprehensive assistance for family caregivers, it should be noted that qualification criteria differ from program to program. 

The Medicaid program, for example, is generally mean- or condition-based, while qualifying for Medicare is based on the care recipient’s age. 

Programs that may offer compensation or other assistance to spousal caregivers based on the financial means or the medical condition of the person receiving care include:

1. Medicaid 

Most states allow Medicaid recipients to hire a family member as a paid caregiver through a Medicaid waiver program: Medicaid waiver self-directed long-term services and supports (LTSS) programs.

States offer a variety of consumer-directed caregiving options, including self-directed personal assistant services, which enable participants to choose and pay their health services provider.

These Home & Community-Based Services (HCBS) fall under the waiver program. To determine if a person qualifies for Medicaid, contact your state’s Medicaid office.


2. State Programs

In some states, programs that pay family caregivers stipends to care for a loved one may be available for those who don’t qualify for Medicaid or when certain conditions are involved such as traumatic brain injury.

For instance, in California, in-home supportive services (IHSS), provide resources to help qualifying individuals receive care at home.

New York, Florida. New Jersey and Arizona have similar programs. To see if your state offers this type of program, you can contact your state’s department of social services or human services, or Medicaid office. 

State Health Insurance Assistance Program (SHIP)

SHIP operates on a national basis to provide counseling, resources, and assistance accessible to adults on Medicare, Medicaid, and Medicare supplemental insurance, also known as Medigap.

Centers for Medicare & Medicaid Services

The Centers for Medicare & Medicaid Services (CMS) provides several programs to eligible individuals, with different features from state to state.

The CMS facilitates accessible and affordable options for care with Medicaid, Medicare, and Health Insurance Exchanges.

Programs that may offer assistance to caregivers based on the age of the individual receiving care include:

Program of All-Inclusive Care for the Elderly (PACE)

PACE is a program sponsored by Medicare that covers some of the medical and social service expenses paid by adults who need nursing home care level at home. 

The program’s goal is to enable adults to live in their homes while receiving care rather than staying at a long-term care facility. This program is not available in every state.

Eligibility for PACE in the states where it is offered requires the following:

  • 55 or older

    • Reside in the PACE service area

    • Require a nursing home-level of care

    • The PACE program will enable the person to live safely in the community 

For Medicaid program participants, no monthly premium is charged for the long-term care aspect of PACE.

If a PACE participant has Medicare, there is a monthly premium for the long-term care benefit as well as a premium for Medicare Part D drugs. To learn more, visit Medicare’s PACE page.

Elder Affairs/Aging Department:
Each state has a department focused on helping seniors, offering a variety of services.

Other programs which may offer assistance including compensation to caregivers include:

  • The National Family Caregiver Support Program (NFCSP)
    NFCSP offers grants that states and territories can use as funding to support family and informal caregivers.

    The program offers:

  • Information to caregivers about available services

    • Assistance to caregivers in gaining access to the services

    • Individual counseling, organization of support groups, and caregiver training

    • Respite care

    • Supplemental services, on a limited basis

Can Long-Term Care Insurance Help With Caregiving Expenses?

A long-term care insurance policy could be another source of income for home health care services provided by a spouse caregiver.

Such policies typically cover expenses for care that are not covered by health insurance, care needed for seniors who have Alzheimer’s disease, a disability inhibiting their ability to perform daily personal care, or a chronic medical condition.

If your spouse has a long-term care insurance policy, you can contact the insurance company that wrote the policy to see if they offer in-home care provider compensation.

In addition to government programs, long-term care insurance can be another option for receiving payment as a family caregiver. It typically covers expenses for care that is not covered by health insurance, cares needed for seniors who have Alzheimer’s disease, a disability inhibiting their ability to perform daily personal care, or a chronic medical condition.

Tax deductions also may be available for those providing family caregiving services. One such option is the dependent care credit, which can cover up to 35% of your qualifying expenses. 

Looking to be a Paid Caregiver For Your Spouse?

Caregiving for a spouse can be similar to working a full-time job. 

As a result, if you are caring for a spouse, it can significantly cut into the time you have available to earn money through employment. 

For this reason, it makes sense to look into the various programs offered by the government and other organizations that may provide caregivers with compensation or other resources. The programs listed above can provide just these types of resources for those who meet their eligibility requirements.

Try calling your local Administration on Aging (AOA) to learn what resources are available to you that might help reduce certain caregiving costs. You can also search to find resources in your area that provide information and assistance for older adults and caregivers.