Does Medicare Pay Family Caregivers?
Key takeaways:
A family caregiver provides essential services to a loved one with an illness or disability. The responsibilities, which may be temporary or long-term, can include coordinating medical care, assisting with everyday tasks, and providing emotional support.
Original Medicare doesn’t pay for services provided by family caregivers, but some Medicare Advantage plans may. Starting in 2025, original Medicare will cover training for family caregivers and, in some cases, substitute care to give them breaks.
Family caregivers may be able to receive compensation from Medicaid, long-term care insurance, state programs, or veterans programs. Or they may be able to get paid family leave through an employer while caring for their loved one.
Table of contents
Becoming a family caregiver often starts with simply helping out a loved one with grocery shopping, picking up prescription medications, or rides to medical appointments. Then, as time goes on, minor tasks can evolve into coordinating care, providing nursing services, and handling finances, especially when an older family member is involved.
If you’ve been assisting an older loved one you might have wondered: Does Medicare provide any financial support for family caregivers?
While original Medicare (Part A and Part B) doesn’t provide compensation to family caregivers, some Medicare Advantage plans may pay for services like meal deliveries and in-home support. Original Medicare covers caregiver training and support and substitute caregiving (known as respite care) for enrollees who are in hospice or who are participating in a pilot program for people with dementia.
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In this guide, we discuss Medicare coverage for family caregivers in more detail and other programs that pay family caregivers.
Who qualifies as a family caregiver under Medicare?
One in five U.S. adults — about 53 million people — are considered family caregivers because they provide support to a relative or friend with an illness or disability. Many do so without pay according to the National Alliance for Caregiving and AARP’s 2020 report Caregiving in the U.S., an analysis of the nation’s unpaid family caregivers, based on data collected in 2019.
Family caregivers do not receive compensation from original Medicare. Though, some Medicare Advantage plans may include benefits that pay family caregivers.
Original Medicare only pays caregivers provided by Medicare-certified home healthcare agencies who perform skilled nursing and other home health aide services. But there are other programs that pay family caregivers who may not have the same training, credentials, or licensing as professionals. A family caregiver in those instances may be a:
Spouse or partner
Adult child
Sibling, grandchild, or extended family member
Friend or neighbor
Religious or community group member
When does Medicare pay for family caregivers?
Original Medicare doesn’t pay family caregivers. But you may be able to get some assistance if the person you’re caring for is covered by original Medicare.
Nursing-home-level care at home: Read about the Program of All-Inclusive Care for the Elderly, or PACE, which provides healthcare services and in-home support to older people who qualify.
Adult day care services can help relieve caregivers, but they come at a cost. Adult day care, which provides structured, enriching time away from home, can cost from $100 to more than $400 a day.
Caregiver tips to avoid burnout: Learn what caregivers recommend as the best ways to recharge from the stress of taking care of someone.
As mentioned, original Medicare covers the following:
Family caregiver training
Respite care to ensure family caregivers of enrollees who are in hospice have breaks
Respite care for enrollees who have dementia and have joined the Guiding an Improved Dementia Experience pilot program
Medicare Advantage plans must offer coverage that meets or exceeds the benefits of original Medicare. If the person you care for has a Medicare Advantage plan, they may have access to additional family caregiver benefits.
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How much does Medicare pay family caregivers?
As mentioned, original Medicare doesn’t pay family caregivers directly.
What caregiver services does Medicare not cover?
Original Medicare doesn’t cover these caregiver services:
Around-the-clock care at home
Home meal deliveries
Homemaking services such as shopping and cleaning that aren’t related to medical care
Home health services such as bathing, dressing, or toileting when that’s the only type of care needed
For people with a Medicare Advantage plan, some of the services above may be covered.
Other financial resources for family caregivers
Family caregivers may be able to get compensation through the programs, benefits, and arrangements discussed below.
Long-term care insurance
If you are a family caregiver of someone who has long-term care insurance, you may qualify for compensation through their plan. Benefits of long-term care policies vary, and some may not cover all in-home care.
Medicaid programs
Medicaid has four main types of programs that pay family caregivers:
Home- and community-based services, which you can find with this state-by-state list of programs
Community First Choice programs, which are only available in a few states
Structured family caregiving programs, which are designed specifically to support relatives, including spouses, providing care
Paid family leave
The federal Family and Medical Leave Act (FMLA) allows eligible workers to take up to 12 weeks of unpaid family leave in a 12-month period for various reasons, including caring for a loved one. As of August 2024, 12 states and Washington, D.C., expanded FMLA benefits to include paid family leave for certain employees to enable them to take care of family members. (Though, not all of the expanded laws were implemented at that time.)
Your job also may have paid family leave as an employee benefit.
Personal care agreements
A personal care agreement is a legally binding document between a caregiver and the person receiving care. A personal care agreement should provide details about the caregiver’s work arrangement, including:
Duties
Frequency of service
Length of care
Pay
State-funded, non-Medicaid programs
Some states have additional, non-Medicaid programs that compensate family caregivers, particularly those taking care of people with dementia.
Veterans programs
The U.S. Department of Veterans Affairs (VA) has three programs to compensate relatives and friends who are family caregivers, though some do not pay spouses. These programs are:
Veteran-Directed Care program: The Veteran-Directed Care program enables eligible veterans to choose their own caregivers and remain in their residences instead of living in a nursing home. This Veteran-Directed Care locator can help you find a program location near you.
Aid and attendance benefits: Eligible veterans and survivors of veterans receiving a VA pension can use aid and attendance benefits or a housebound allowance (but not both) to pay for assistance with activities of daily living.
Program of Comprehensive Assistance for Family Caregivers: This program provides healthcare services, respite relief, monthly stipends, and other benefits for family caregivers of eligible veterans who have had or aggravated a serious injury or illness and have at least a 70% service-connected disability rating. The stipend amounts are determined by the local pay rates where veterans live.
Some caregiving experts advise veterans who have the option to set compensation to pay family caregivers $20 or more per hour.
Frequently asked questions
Original Medicare won’t pay you to take care of an aging parent at home, but there are other programs that might. Check with your state’s Medicaid and non-Medicaid programs to find out about possible ways to get compensated. If applicable, it’s also a good idea to look into your parent’s VA benefits or long-term care insurance plan, as well as the possibility of getting paid family leave.
If you support your loved one by paying for more than half of their daily expenses and are not receiving reimbursement, you may be able to claim the person as a dependent and deduct certain medical costs on your tax return. To find out the answer for your specific situation, contact a tax professional.
In 2025, original Medicare is expanding a pilot program that covers caregiver training for people who take care of enrollees with dementia without pay. A healthcare professional must approve this training as part of your loved one’s care plan. The pilot program also covers substitute care to give caregivers breaks.
The bottom line
Original Medicare doesn’t pay family caregivers, but it does cover training and, in some cases, substitute care to reduce strain on loved ones who take care of enrollees. Medicare Advantage plans must offer benefits that meet or exceed what’s covered by original Medicare. So enrollees in these plans may have access to additional benefits.
Family caregivers may be able to get compensation through certain Medicaid programs, some non-Medicaid state programs, veterans benefits, long-term care insurance, or private care agreements. Covered workers also may be able to take paid family leave and receive temporary compensation for family caregiving.
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References
AARP and National Alliance for Caregiving. (2020). Caregiving in the U.S. 2020. AARP.
American Council on Aging. (2023). How personal services contracts serve as a planning tool for long-term care Medicaid eligibility.
American Council on Aging. (2025). Medicaid structured family caregiving program: Paying loved ones as caregivers.
Boutilier, S. (2024). Family caregiver compensation: Long term care insurance. RubyWell.
Centers for Medicare & Medicaid Services. (n.d.). Guiding an Improved Dementia Experience (GUIDE) Model.
Centers for Medicare & Medicaid Services. (2025). Home- and community-based services.
Dementia Care Central. (2025). Programs that compensate family members to care for loved ones with Alzheimer’s or dementia.
Dickey, E., et al. (2024). Understanding Medicaid's Community First Choice program. Nolo.
Institute on Aging. (n.d.). Can a family member get paid to be a caregiver in California? Caring for aging loved ones.
Internal Revenue Service. (2025). For caregivers.
Kennedy, J. B. (2025). Five ways family caregivers can get paid. National Council on Aging.
Medicare.gov. (n.d.). Home health services.
Medicare.gov. (n.d.). Nursing home care.
Medicare.gov. (n.d.). Self-directed personal assistant services 1915 (j).
National Conference of State Legislatures. (2024). State family and medical leave laws.
Rodriguez, J. (2023). Does long-term care insurance pay family caregivers? CBS News.
U.S. Department of Health and Human Services. (2025). Medicare & You handbook 2025. Centers for Medicare & Medicaid Services.
U.S. Department of Veteran Affairs. (2022). PCAFC: Eligibility criteria fact sheet.
U.S. Department of Veteran Affairs. (2024). PCAFC: Monthly stipend for primary family caregivers.
U.S. Department of Veteran Affairs. (2024). VA aid and attendance benefits and housebound allowance.
U.S. Department of Veterans Affairs. (2024). VA caregiver support program.
U.S. Department of Veteran Affairs. (2024). VA nursing homes, assisted living, and home health care.
U.S. Department of Veterans Affairs. (2025). Geriatrics and extended care.
U.S. Department of Veterans Affairs. (2025). The Program of Comprehensive Assistance for Family Caregivers.
