Virginia Family Caregiver Pay is real: Virginia Medicaid can pay a daughter, son or other relative to be the caregiver a parent would otherwise get from an agency. This Virginia family caregiver pay guide names the program, says who may be paid — including whether a spouse can — explains how the pay is set and delivered, and lays out the enrollment steps in order.
One rule first. The parent must qualify for Virginia Medicaid home care: the same medical and financial tests as a nursing home. The caregiver’s own income does not matter. Figures and program names come from the state agency; where Virginia has not published one we say so.
In This Virginia Family Caregiver Pay Guide:
Virginia Family Caregiver Pay at a Glance (2026)
| Program | Commonwealth Coordinated Care Plus (CCC Plus) Waiver — Consumer-Directed (CD) personal care, respite and companion services, run by the Virginia Department of Medical Assistance Services (DMAS) and delivered through Cardinal Care managed care health plans. |
| Can a spouse be paid? | An adult child, sibling, grandchild, in-law, other relative, or a friend or neighbor may be hired and paid as the consumer-directed attendant, provided the person is at least 18 and clears the required screening. |
| Parent must qualify for | Virginia Medicaid home care (nursing-home level of care) |
| How pay is set | Pay is hourly, not a stipend, and the rate is set by DMAS rather than negotiated with the family. |
| Where to start | The process starts at your local Department of Social Services, which takes the LTSS Screening request and the Medicaid application. |
The Virginia Program Behind Virginia Family Caregiver Pay
This is consumer-directed hourly employment, not a daily live-in stipend and not an agency hiring your relative. The Medicaid member, or a designated Employer of Record acting for them, hires, trains, schedules, supervises and may dismiss the attendant, while DMAS pays through a Fiscal/Employer Agent that issues the paychecks and handles tax withholding.
A Services Facilitator, assigned through the member’s Cardinal Care health plan, visits the home, helps build the person-centered plan and coaches the family on employer duties. Attendant shifts are logged through electronic visit verification.
The full eligibility picture for the parent is in our guide to Virginia Medicaid home care.
Who Can Be Paid Under Virginia Family Caregiver Pay
An adult child, sibling, grandchild, in-law, other relative, or a friend or neighbor may be hired and paid as the consumer-directed attendant, provided the person is at least 18 and clears the required screening.
Since July 1, 2025, Virginia also permits a Legally Responsible Individual — a spouse, or the parent or legal guardian of a minor — to be paid, but only for care documented as “extraordinary,” meaning beyond what that person is already legally obligated to provide. A paid attendant may not simultaneously serve as the Employer of Record.
Every program also requires the caregiver to pass a background check and, in most states, a short training, and to keep timesheets that match the approved care plan.
How the Virginia Family Caregiver Pay Is Set and Delivered
Pay is hourly, not a stipend, and the rate is set by DMAS rather than negotiated with the family. DMAS publishes consumer-directed personal care, respite and companion rates on its fee schedule, with a separate higher rate region for Northern Virginia and a standard rate for the rest of the Commonwealth.
The number of authorized hours comes from the assessment and the approved person-centered plan of care, and the attendant is paid only for verified shifts submitted through electronic visit verification. Overtime and Legally Responsible Individual hour limits also apply.
Pay arrives through a payroll agent as W-2 wages in most consumer-directed programs, or as a stipend through the provider agency in structured models. It does not reduce the parent’s Medicaid benefits.
How to Enroll in Virginia Family Caregiver Pay
First, request an LTSS Screening through the local Department of Social Services; a Community-Based Screening Team — a social worker paired with a health department nurse — visits and completes the Uniform Assessment Instrument to establish level of care. Next, complete the Medicaid application, including the long-term services Appendix D, and enroll in the CCC Plus Waiver through a Cardinal Care plan.
❤️ Get Free Medicare Guides
Free · No spam · Unsubscribe anytime
Then choose the consumer-directed model and meet the Services Facilitator. Finally, the relative enrolls with Consumer Direct Care Network Virginia, the Fiscal/Employer Agent, which runs the criminal background check before payroll begins.
Where: The process starts at your local Department of Social Services, which takes the LTSS Screening request and the Medicaid application. — start here.
The Veteran Route to Virginia Family Caregiver Pay
Yes. If your parent or spouse is a veteran, Veteran Directed Care lets the veteran manage a VA-approved budget and hire family members for personal care, and it is offered in Virginia through Aging and Disability Network agencies partnering with VA medical centers; no service-connected rating is required.
Separately, the Program of Comprehensive Assistance for Family Caregivers pays a monthly stipend directly to an approved family caregiver of an eligible service-connected veteran, and every VA medical center has a Caregiver Support Coordinator who can screen you.
Taxes on Virginia Family Caregiver Pay
Medicaid waiver payments to a caregiver who lives with the person cared for can be excluded from federal income under IRS Notice 2014-7; payments to a caregiver who lives elsewhere are ordinary wages. Ask the fiscal agent how it reports, and keep the care plan with your tax records.
The Other Route: a Personal Care Agreement
When a parent does not yet qualify for Medicaid but has some savings, the family can put a written personal care agreement in place: the parent pays the caregiver a fair market rate for defined services, with timesheets. Done properly it is not a gift, so it does not trigger the Medicaid look-back later, and it lets the parent’s own money pay for care in the family before Virginia family caregiver pay becomes available.
Done informally, with cash and no contract, Medicaid treats the payments as transfers. An elder law attorney can draft one in an hour.
Protecting Yourself as the Paid Caregiver
Caregiving that pays is still caregiving. Ask the case manager about respite hours, which most programs include; use them. Keep every timesheet and the care plan for three years; audits happen. If you are paid as an employee, the fiscal agent handles withholding and you may be eligible for unemployment if the arrangement ends.
Talk about the money with siblings early: Virginia family caregiver pay paid to one child is a common source of family conflict, and the care plan is the neutral document that shows the work was real.
When the Parent’s Needs Change
If the parent enters a nursing home, Virginia family caregiver pay ends with the last day at home; the same Medicaid case usually converts to nursing home coverage without a new financial application. If the parent’s needs grow, ask for a reassessment and a revised care plan rather than working unpaid hours. If the parent dies, the final timesheet is paid and the case closes; the caregiver owes nothing back.
Where to Get Help Free
Two free doors exist in every state: the Virginia SHIP counselor for the Medicare side and the state’s Aging and Disability Resource Center for the Medicaid side. Neither sells anything. For a Virginia family caregiver pay question involving a house, a spouse at home or a recent gift, a local elder law attorney or legal aid office is the next call.
Official Sources
- Commonwealth Coordinated Care Plus (CCC Plus) Waiver — Consumer-Directed (CD) personal care, respite and companion services, run by the Virginia Department of Medical Assistance Services (DMAS) and delivered through Cardinal Care managed care health plans.: https://www.dmas.virginia.gov/for-members/benefits-and-services/waivers/consumer-directed-services/
- The process starts at your local Department of Social Services, which takes the LTSS Screening request and the Medicaid application.: https://www.dmas.virginia.gov/for-members/benefits-and-services/waivers/ccc-plus-waiver/
- Medicaid.gov spousal impoverishment standards: medicaid.gov
- Medicare.gov Medicare Savings Programs: medicare.gov
This Virginia family caregiver pay guide was checked against the state Medicaid agency, CMS and the statute cited above in September 2026. Figures reset on their own calendars (most on January 1); if a number here disagrees with a notice you received, the notice wins — and please tell us. This page is general information, not legal, financial or medical advice.