Medicaid Programs and My Experience in Pennsylvania
Can I Get Paid to Care for My Disabled Child?
Once the dust has settled and we’ve adjusted to the new full-time job of caring for our disabled or medically fragile child, how to get paid to care for your child is one of the most common questions parents ask. Usually, this is after they’ve already left a job or cut back hours to meet their child’s needs.
Can I get paid to care for my own child?
The answer is complicated, but in short: sometimes, yes.
All 50 states offer Medicaid-funded programs that allow family members to be paid caregivers… but many states don’t include parents or legal guardians and depending on your state your child may not even qualify for Medicaid.
What States Pay Parents to Be Caregivers for Their Child?
This is where things get a little complicated and where a lot of online information gets outdated quickly.
Instead of a simple yes/no list, it’s more accurate to say:
Every state has programs that can pay family caregivers, but only some make it realistic for parents to be paid to care for their own child.
States where this is more commonly accessible include:
Even within these states, eligibility varies. Some programs:
- allow parents only in specific circumstances
- require a certain level of medical need
- or limit the number of paid hours
My Experience Getting Approved Through Abby Care to Care for My Own Child in Pennsylvania
I’m not an expert on state laws and I may not be able to help you determine eligibility to get paid to care for your child, but I wanted to share my experience in Pennsylvania going through the process of becoming a Home Health Aide for my ten year old son with spina bifida.
I’ll cover this farther down, but it’s worth noting here that while medical needs are what qualify your child for Medicaid (which is what will cover getting a Home Health Aide, whether yourself or hired help), it’s the need for assistance with tasks of daily living that will qualify your child for a home health aide. I had originally put in a request including hours for enemas, catheterization, and physical therapy – and I was denied. Those are skilled nursing tasks. In Pennsylvania, you can also be a skilled nurse for your child, but the certification is more labor intensive and you cannot overlap hours as a nurse and an HHA.
How to Become a Paid Caregiver for Your Child (Step-by-Step)
This is what you need to work through to be a paid caregiver in any state – though, you’ll see that depending on where you live you may not be able to proceed beyond the first step.
In general, the process looks something like this:
- Apply for Medicaid or a qualifying waiver program
This is often the longest step and may involve waitlists. In Pennsylvania, Medicaid is not income based. If you are denied, make sure you start again with a disability waiver. If you don’t know how to do this, ask your social worker, physical therapist, or your insurance case worker. - Confirm your state allows parent caregivers
Make sure you clarify the age of your child – that seems to be the difference between states. In many states, you cannot be the legal guardian for the person you’re caring for. In Pennsylvania, you can be a parent caregiver (and a child caregiver, when you’re all grown up and roles reverse!) - Work with an agency or fiscal intermediary
You may have competitive options in your state… or just one. We went with Abby Care in Pennsylvania to get paid as caregivers for our child and overall it has been a smooth process. - Complete caregiver requirements
This may include:- background checks
- training (Abby Care was 72 hours, including two days in-person)
- onboarding paperwork
- Get a care plan and approved hours
You will work with your primary care physician and therapists to determine what hours count for you as a caregiver. From that, you’ll develop a care plan through your home health aide organization.
What the Process to Become a Home Health Aide Actually Looked Like for Me
This is not a simple phone call or online form and now you’re paid for all your work as a caregiver. It’s a laborious process with many forks in the road where you may be denied. Thankfully, we’d sorted Medicaid out when our son was still a baby.
Because a home health aide is assisting with tasks of daily living, you cannot apply until your child reaches an age where assistance is no longer developmentally appropriate. Everyone feeds their eight month old. Spoon feeding an eight year old, however, qualifies as necessary assistance.
Once I discovered Abby Care, the process was fairly straight forward and they had staff to help me through any hurdles.
What Does a Paid Caregiver Do for a Child at Home?
Before going further, it helps to understand what you’re actually being paid to do.
A paid caregiver (often called a home health aide) supports daily care needs that go beyond typical parenting. This can include:
- mobility support (transfers, wheelchair assistance)
- feeding support
- bathing and personal care
- monitoring safety and medical needs
For many families, this looks a lot like what they’re already doing, just formally recognized and documented.
There are also many things you can’t do as a paid caregiver for your child. While you’re on the clock, you can supervise medical routines, but you cannot assist in any tasks that require a nurse. That means you cannot:
- Administer medications
- Assist with enemas, catheterizations, feeding tubes, or other medical routines
- Drive your child
I lay out medications and fill the enema bag before I clock in. I can supervise, but I cannot intervene.
What I Wish I Knew Before Becoming a Home Health Aide for My Child
While I had help, and the steps were fairly clear, there were a lot of questions I simply didn’t know to ask. In hindsight, I wish I’d known:
- What counts toward caregiving hours. I put on big things like toileting and bathing, but I didn’t know I could count all of the little things like nail care, tooth brushing, meal prep (I’m actually not sure why that counts, but it does), and all of those times you’re running around grabbing things or rearranging so that your child can get where they need to go.
- You can work weekends. This is not a replacement for the job you had to leave, this is compensation for the real work you do. That takes place every day of the week.
- You cannot add more hours to your care plan, later. I suppose this goes with the first two. Had I known I could count so many tasks and that weekends could be included, I would have submitted more hours and I would be making more money.
- How time consuming the process is. It took me hours to develop a routine to submit to insurance. There is a lot of communication between doctors and therapists as you get things signed and submitted. Every step ends up having multiple follow-up steps. This is a silly detail, but the video training can’t be sped up. It’s a closed system and there’s no such thing as listening at 1.5 speed, even though you already know all of the content being presented.
- The hours and locations are set – like a regular job. I work 7:15-8:15 every morning and 5:30-7:30 every night. I have to clock in at home on an app that tracks my location. This is a much bigger hassle than I originally thought, but still worth it. If you’re traveling, it is also possible to change your work location or hours through your supervisor.
- In-person check-ins are on a mandated schedule. You will need to plan your vacations around when your supervisor has to come for a check-in.
All of the above made me a little nervous as I was figuring things out, but it’s also worth noting that the care coordinators, at least through Abby Care, are amazingly kind, helpful, and flexible. That goes a long way.
What Happens After You’re Approved as a Paid Caregiver?
Getting approved is a huge milestone, but it’s not the end of the process.
Once you’re set up, you’ll typically:
- log hours worked
- follow a care plan
- complete periodic reassessments
- communicate with a case manager or agency
Pay structures vary:
- Hourly wages are most common.
- Some states may have a daily stipend
- Depending on how many hours you’re approved for, you may be eligible for PTO.
How Much Do Parents Get Paid as Caregivers for Their Child?
Pay varies widely by state and program, but most fall within:
- $10–$20 per hour in most states. Abby Care, in Pennsylvania, is $14 an hour. All programs seem to be close to minimum wage. Just remember it’s mostly money for tasks you’re already doing – though it does add a few tasks to your day with clocking in and out and communicating with supervisors.
The number of approved hours matters just as much as the rate.
Some families receive:
- part-time support
- while others qualify for near full-time care
This income can help, but it doesn’t replace a full salary.
The Part No One Tells You About Getting Paid as Your Child’s Caregiver
Getting paid as your child’s caregiver may be a great option, but it’s rarely straightforward or simple.
There are:
- waitlists
- paperwork
- unclear rules
- and a lot of “it depends”
If you’re interested and you’re not sure where to start, I suggest a conversation with your social worker, insurance provided case worker, or physical therapist. These experts generally know what is available in your state and what you might qualify for.
Frequently Asked Questions About Getting Paid to Care for Your Child
Can I get paid to take care of my disabled child full time?
Sometimes, but it depends on your state and your child’s level of need.
Most programs don’t automatically approve full-time hours. Instead, your child will be assessed, and you’ll be given a set number of caregiving hours based on what they qualify for. Some families receive only a few hours a week, while others qualify for much more extensive support.
Does Medicaid pay parents to be caregivers?
Yes, Medicaid can pay parents to be caregivers, but not in every situation or every state.
Some states limit or restrict payments to parents of minor children unless there are exceptional medical needs or a shortage of available caregivers. In many states, it’s easier for an aunt or friend to get paid as caregiver than a parent.
What states allow parents to be paid caregivers?
All states have programs that pay family caregivers, but not all allow parents of minor children to be paid. Many are designed for children to care for their parents.
Eligibility depends on the program and your child’s needs. The best way to find out is to check your state’s Medicaid waiver options. The article above covers my experience as a home health aide in Pennsylvania.
How do I apply to get paid to care for my child?
In most cases, you’ll need to:
- apply for Medicaid (if you’re not already enrolled)
- apply for a waiver or qualifying program
- confirm that parent caregivers are allowed
- find a home health aide program
- work with doctors and therapists to submit a care plan to insurance
- complete any required training or onboarding
Many families work with an agency to guide them through the process, while others may apply directly through their state. I found it less overwhelming to work with an organization that was able to guide me – Abby Care in Pennsylvania.
Do I need to be certified to be my child’s caregiver?
Generally. (I know – every answer varies so much by situation!)
Some programs require basic training or certification (similar to a home health aide), while others provide training after you’re approved. Requirements vary by state and program, but most are manageable and designed for family caregivers.
How much do parents get paid to be caregivers?
Pay varies widely depending on where you live, but it’s never far from minimum wage. I make $14 an hour as a home health aide for my child through Abby Care in Pennsylvania.
The number of hours you’re approved for often matters more than the hourly rate. Some families receive limited support, while others qualify for more consistent pay. If you’re able to qualify for 30 hours a week, minimum wage goes a long way when you’re not adding much to your schedule.
Can both parents get paid as caregivers?
In most cases, no. Only one caregiver is paid at a time.
There may be situations where hours can be split, or one parent may serve as a skilled nurse – but even those hours usually can’t happen simultaneously.
Will getting paid as a caregiver affect SSI or other benefits?
It can.
Caregiver income may be counted differently depending on the program and your situation. Because this can impact benefits like SSI or Medicaid eligibility, it’s important to ask a caseworker or benefits specialist before getting started.
In Pennsylvania, SSI should not be income based if you have a medical waiver.
Is being a home health aide for my own child considered taxable income?
Yes. Again, this may vary by program and state, but in Pennsylvania you are typically working through a company that is paying you hourly as a home health aide. In fact, you can even use your certification to work as a home health aide for other families.
Is it worth it to become a paid caregiver for your child?
For many families, yes; but, it’s not a simple solution.
The process can be slow and frustrating, and the pay doesn’t replace a full income. For families already providing significant care, it can offer meaningful financial support and recognition for the work they’re already doing every day.
Can I get paid to care for my child in Pennsylvania?
Yes. Pennsylvania does allow some parents to be paid caregivers for their child, but it depends on the program and your child’s needs.
This typically happens through Medicaid waiver programs, such as those that include consumer-directed care options. In some cases, parents can be approved to provide care if their child has significant medical or support needs and no other caregiver is available.
It’s worth it to reach out to Abby Care or another similar company to see if this could be a good fit for you.
**As a home health aide through Abby Care, I have a referral link. If you use my link and end up becoming a home health aide with Abby Care, I will receive a referral bonus when you receive your first paycheck.**