Get Paid Caring for a Family Member in Pennsylvania

Yes, Pennsylvania Will Pay You — But Only Through Specific Programs

You quit your job or cut your hours to take care of your parent after a hospital discharge. Months in, someone mentions that Pennsylvania has programs that actually pay family members to provide care. It sounds too good to be true, and the details matter more than the headline.

Pennsylvania does allow family caregivers to receive payment for providing personal care services — but only through authorized Medicaid programs with specific enrollment requirements. You can't simply submit receipts or request reimbursement for caregiving you've already been doing informally.

Services My Way (Self-Directed Care)

The primary pathway is Services My Way, a self-directed care option within Pennsylvania's Community HealthChoices (CHC) Medicaid managed care program. Here's how it works:

Your parent must be enrolled in Community HealthChoices and have an approved Person-Centered Service Plan that includes personal care hours. Under Services My Way, instead of receiving care from a home care agency, your parent directs their own care — including hiring a family member as their paid caregiver.

The mechanics:

1. Your parent (or you, as their POA) requests the Services My Way option through their CHC managed care organization (AmeriHealth Caritas, PA Health & Wellness, or UPMC Community HealthChoices)
2. The MCO authorizes a specific number of personal care hours per week based on the service plan
3. A Financial Management Service (FMS) provider — such as Tempus Unlimited or PPL — handles payroll, tax withholding, and employment paperwork
4. You are hired as your parent's employee through the FMS
5. The FMS pays you directly from the Medicaid-authorized budget at the approved hourly rate

The hourly rate varies by region but typically falls between $13 and $15 per hour in Pennsylvania. The hours are capped by the service plan — you won't get paid for round-the-clock care unless the plan authorizes it, which is rare.

Who can be hired: Spouses generally cannot be paid caregivers under CHC (federal Medicaid rules prohibit it in most cases). Adult children, siblings, grandchildren, and other family members typically qualify, subject to the MCO's policies and a background check.

The Tax Exclusion You Need to Know About

Here's the piece most families miss: IRS Notice 2014-7 may allow qualifying Medicaid waiver payments for in-home care to be excluded from the caregiver's federal gross income when the caregiver lives in the same home as the care recipient.

If the payment arrangement qualifies, the amount may be excluded from federal gross income. Do not assume that means it will never appear on a W-2 or that no reporting step is needed; follow the IRS instructions for the forms you receive or ask a tax professional.

The requirements:

• The payment must be a qualifying Medicaid home and community-based waiver payment under Notice 2014-7; confirm that the specific CHC arrangement qualifies
• The caregiver must live in the same home as the care recipient
• The payments must be for care provided in the home

This exclusion can be significant. If you're earning $15/hour for 30 hours per week and the payments qualify, roughly $23,400 per year could potentially be excluded from federal gross income — which changes the math on whether providing family care is financially sustainable.

Pennsylvania state income tax treatment is a separate question; check current Pennsylvania guidance or a tax professional rather than assuming the federal exclusion applies.

The Enrollment Path

The prerequisite to all of this is your parent's enrollment in Community HealthChoices, which requires:

• Financial eligibility: income at or below $2,982/month, assets at or below $8,000 (Tier 1) or $2,400 (Tier 2)
• Clinical eligibility: Nursing Facility Clinically Eligible (NFCE) status, determined through a functional assessment by the Area Agency on Aging
• Referral through the Pennsylvania Independent Enrollment Broker (1-877-550-4227)

If your parent isn't Medicaid-eligible, these paid caregiver programs aren't available. The state-funded OPTIONS program offers limited caregiver support (respite, training, supplemental services) but does not pay family members directly as caregivers.

What This Means After a Hospital Discharge

If your parent is coming home from a Pennsylvania hospital and you're planning to provide ongoing care yourself, start the CHC enrollment process immediately — before discharge if possible. The PA IEB conducts an in-person home visit within seven business days of referral, and the AAA conducts the functional eligibility determination within ten business days of that home visit. Financial approval can take longer.

In the interim, you'll be providing unpaid care. Keep detailed records of the hours and types of assistance you provide. Once CHC enrollment and Services My Way are approved, ask the MCO or FMS when authorized hours and payment begin; do not assume pre-approval hours will be paid retroactively.

The Pennsylvania Hospital Discharge Guide includes the CHC enrollment timeline mapped against the hospital discharge process, plus a caregiver documentation log you can use to track hours from day one — so when the paperwork catches up, you're ready to start receiving payment immediately.

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