Getting paid as a family caregiver, and tax help
Some family caregivers can be paid, and some care costs bring tax help. This guide explains the main programs and where to check the rules.
Last reviewed October 27, 2026
General information only. This guide is not medical, legal or financial advice. Talk with a physician, and with an elder-law or financial professional where money or legal papers are involved, about your own situation.
Medicaid self-directed care
Many state Medicaid programs offer self-directed services, which let the person receiving care hire their own caregiver. In some states, that can include a family member. Rules and pay rates vary by state.
Caregivers of veterans
The VA's Program of Comprehensive Assistance for Family Caregivers can provide a monthly stipend, training and support to an eligible primary family caregiver. The veteran must meet the VA's requirements, including a disability rating of 70% or higher.
Tax help
IRS Publication 502 explains which medical expenses can be deducted, including some long-term care. You can deduct only the part of medical expenses that is more than 7.5% of adjusted gross income. If you pay someone to care for a qualifying person so you can work, the credit for child and dependent care expenses may apply.
Before you start
Paid caregiving can affect benefits, taxes and family relationships. Many families write down the agreed duties and pay, and get advice before they start.
- Check the program's rules on who can be paid
- Keep records of hours and payments
- Ask how pay may affect other benefits or taxes
Frequently asked questions
It depends on the state and the program. Some Medicaid programs let the person receiving care choose who provides it, including some family members; the rules on who can be paid vary.
The VA lists several requirements, including a VA disability rating of 70% or higher and a need for at least 6 months of continuous, in-person personal care. The VA decides eligibility.
Some care costs may count as medical expenses, and some people can claim a credit for care that lets them work. The IRS explains the rules; a tax professional can apply them to your situation.
Sources
SeniorLeaf is not affiliated with or endorsed by the organizations listed here.