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Pennsylvania caregiver guide
Last updated: 15 September 2026
Pennsylvania can pay some family members for approved care at home, but there is no automatic paycheck for helping an older relative. The main wage-paying path is usually Medicaid long-term services through Community HealthChoices (CHC).
Bottom Line
If an older adult needs hands-on help with daily activities, call the Independent Enrollment Broker at 1-877-550-4227. If CHC is approved, many adult children, siblings, grandchildren, friends, and neighbors may be paid workers. The current waiver excludes the participant’s spouse, legal guardian, representative payee, and power-of-attorney holder.
If Medicaid is not the right route, your local Area Agency on Aging can screen for OPTIONS, Caregiver Support, respite, and other help. See Pennsylvania senior benefits for wider state help.
Start Here
- If Medicaid home care may fit: call the IEB at 1-877-550-4227 or use Pennsylvania’s long-term care application.
- If you are unsure what program fits: call PA Link at 1-800-753-8827 or contact your local Area Agency on Aging.
- If CHC is already active: ask the service coordinator about participant-directed personal assistance and whether your chosen family member can be enrolled as the worker.
For a plain-English overview before you call, see our paid caregiver basics.
Quick Reference
| Situation | Best first route | What to expect |
|---|---|---|
| Older adult may qualify for Medicaid long-term care | IEB / CHC | Clinical assessment, Medicaid financial review, then service planning if approved |
| Family needs relief but CHC is not in place | Local AAA | Screening for Caregiver Support, OPTIONS, respite, meals, and local services |
| Older adult already has CHC | CHC service coordinator | Ask whether participant-directed care fits and whether the chosen worker is allowed |
| Care is being reduced or denied | Read notice now | Appeal and service-continuation deadlines can be short |
What Has Changed
- Pennsylvania’s current CHC waiver is effective 1 July 2026. It continues to allow many relatives and friends to provide covered participant-directed services while excluding the participant’s spouse, legal guardian, representative payee, and power-of-attorney holder. See the current CHC waiver.
- Current 2026 CHC grievance notices use a 15-day window for certain requests to keep existing reduced, changed, or denied services continuing while review is pending. This corrects older continuation wording. The exact notice still controls.
- The Caregiver Support Program’s reimbursement rules were rechecked. The state continues to publish up to $600 per month for approved ongoing costs and up to $5,000 lifetime for approved home modifications or assistive devices, adjusted by the household reimbursement percentage.
Urgent Help
If an older adult is in immediate danger, call 911. To report suspected abuse, neglect, exploitation, or abandonment of an older adult, call Pennsylvania’s elder abuse helpline at 1-800-490-8505, 24 hours a day.
If a notice says existing CHC services will be reduced, changed, or denied, do not set it aside. Read the deadline section immediately. Current CHC notices can require action within 15 days to keep affected services continuing during review.
How Paid Family Caregiving Works in Pennsylvania
The key distinction is between wages for approved care and caregiving expense support. CHC can create an employment arrangement when the older adult qualifies and care is authorized. The Caregiver Support Program reimburses approved costs; it is not an hourly wage program.
CHC includes participant-directed options that give the participant or an allowed representative more control over who provides care. A fiscal employer agent handles approved timesheets, taxes, and payroll. Pennsylvania’s consumer-directed services page explains the model.
Payment is never automatic. The older adult must qualify, the care must be authorized, and the worker must meet program rules. Our home care agency comparison explains the difference between participant-directed and agency care.
Which Relatives Can Be Paid?
The current CHC waiver permits family members to provide certain covered services, including personal assistance, participant-directed community supports, and respite, but it lists four important exclusions. A participant’s spouse, legal guardian, representative payee, or power-of-attorney holder cannot be paid for those services.
| Person | Usually allowed? | Important point |
|---|---|---|
| Spouse | No | The current waiver excludes the participant’s spouse. |
| Adult child | Often yes | The child cannot also be an excluded legal or financial representative. |
| Sibling or grandchild | Often yes | Worker qualifications and the approved service plan still apply. |
| Friend or neighbor | Often yes | The worker does not have to be related. |
| Power of attorney | No | The current waiver excludes the participant’s power-of-attorney holder. |
| Representative payee | No | The current waiver excludes the participant’s representative payee. |
| Legal guardian | No | The current waiver excludes the participant’s legal guardian. |
| Live-in relative | Often yes | Only authorized participant-specific tasks and hours can be paid. |
Do not change a power of attorney, guardianship, or representative-payee arrangement only to qualify for wages. If the chosen caregiver has an excluded role, ask whether another trusted person can be the worker.
Community HealthChoices: The Main Paid-Caregiver Route
What CHC helps with
Community HealthChoices is Pennsylvania’s managed Medicaid system for long-term services and supports. An approved home-care plan can include personal assistance and other supports. The CHC application page explains enrollment.
Who may qualify
The older adult must meet clinical need criteria and Medicaid financial rules. The IEB arranges the needs assessment; the County Assistance Office reviews finances. Do not rely on old internet income figures. The responsible agencies decide eligibility.
How the worker gets paid
In a participant-directed model, approved hours and tasks are recorded through the program’s timekeeping process. The fiscal employer agent handles payroll. The waiver allows participant employer authority over staff wages and benefits subject to state limits, so there is not one guaranteed Pennsylvania family-caregiver wage. Ask the CHC plan or fiscal agent for the current allowed range before making a household budget around expected pay.
Plans and contact details can change. Use the state’s CHC contact list to reach the member’s plan or the IEB.
Hours can require extra review
The 2026 waiver says plans with more than 40 hours per week of certain family-provided services from one worker require CHC plan review. For participant-directed community supports, live-in workers also cannot bill general household chores unless the task is solely for the participant.
Other Pennsylvania Caregiver Programs
These options can be valuable, but they do not all create a family-caregiver paycheck. Use the table to choose the right question to ask.
| Program | What it can do | Key limit |
|---|---|---|
| CHC participant-directed care | Can pay an allowed family member or other worker for authorized services | Older adult must qualify; excluded roles cannot be paid |
| Caregiver Support Program | Reimburses approved caregiving costs and offers care management, training, and respite | Not a wage; reimbursement percentage depends on income |
| OPTIONS | Can arrange personal care, meals, adult day services, and other supports | Not the same as CHC family payroll; local availability can vary |
| LIFE | Coordinates medical and long-term care for eligible adults age 55+ | Must meet eligibility and live in a LIFE service area |
Pennsylvania Caregiver Support Program
The Caregiver Support Program runs through local Area Agencies on Aging. For the common older-adult category, the caregiver must be at least 18 and primarily responsible for a person age 60 or older with functional deficits, or a person of any age with Alzheimer’s disease or a related disorder. They do not have to be related or live together.
There is no financial test just to enter the program, but reimbursement uses the care receiver’s gross household income and household size. The state pays 100% of approved reimbursement at or below 200% of the federal poverty level, then steps the percentage down through 380%. Above 380%, financial reimbursement is unavailable, though some non-reimbursable help may remain.
The Department of Aging publishes maximum reimbursement of $600 per month for approved ongoing costs and $5,000 lifetime for approved home modifications or assistive devices. These are caps before the household percentage is applied, not guaranteed payments. See the CSP program page.
A major eligibility limit matters: the state says the caregiver or care receiver is not eligible for the Caregiver Support Program if either is enrolled in Medicaid long-term services through CHC or LIFE.
OPTIONS
The OPTIONS program helps Pennsylvania residents age 60 or older who have unmet needs affecting daily functioning. It can include personal care, in-home meals, adult day services, care management, and locally available supplemental services. There is no income requirement to participate, but a sliding co-payment can apply based on income.
OPTIONS can help while Medicaid eligibility is being sorted out. It is not a guaranteed family-wage program. Ask the local AAA how services are delivered and whether capacity is limited.
LIFE
The LIFE program is Pennsylvania’s Program of All-Inclusive Care for the Elderly. It combines medical and long-term care services. A person generally must be at least 55, meet nursing-facility or special-rehabilitation level-of-care requirements, meet financial rules or privately pay, live in a LIFE service area, and be safely served in the community.
LIFE is a broad care model, not a promise that a relative will be put on payroll. Compare its full package of care with CHC.
How to Start Without Wasting Time
- Write down the care needs. List help needed with bathing, dressing, toileting, transfers, walking, meals, medication setup, supervision, and safety. Note how often help is needed and what happens without it.
- Call the IEB. Use 1-877-550-4227 when Medicaid long-term services may fit. The IEB can arrange the needs assessment and help move the Medicaid application to the County Assistance Office.
- Say you want family-directed care. If CHC is approved, tell the service coordinator you want to discuss participant-directed services and name the person you hope to hire.
- Check the worker’s role. Before doing onboarding paperwork, confirm that the person is not the participant’s spouse, legal guardian, representative payee, or power-of-attorney holder.
- Ask the AAA about backups. If Medicaid is not in place or approval is slow, use Pennsylvania’s local AAA directory to ask about OPTIONS, Caregiver Support, respite, meals, and other local services. Our Pennsylvania AAA guide explains what to expect.
If the family is trying to cover care costs from several sources, our guide to paying for home care can help you compare Medicaid, private pay, insurance, and other routes.
Documents and Information to Gather
- Photo ID and Social Security information for the older adult.
- Proof of Pennsylvania residence.
- Medicare and Medicaid cards, if available.
- Financial records requested by the County Assistance Office.
- Medication list, diagnoses, recent records, and doctor contact information.
- A written list of daily tasks the person cannot safely do alone.
- Name and contact details for the person who may become the worker.
- Copies of any power of attorney, guardianship, or representative-payee documents.
- Receipts if seeking Caregiver Support reimbursement.
Keep copies of everything you submit and write down the date, office, and name of the person you spoke with. Pennsylvania’s benefits portal guide can help if you are using COMPASS or other state systems.
Reality Checks
- Approval comes first. Informal care already being provided does not automatically become paid care.
- Hours are not guaranteed. The service plan is based on assessed need. A family’s preferred schedule can be different from the approved schedule.
- No single wage applies statewide. Rates are controlled by the program, plan, service, and applicable limits.
- Local aging programs vary. OPTIONS and other AAA services can depend on county resources and provider capacity.
- Reimbursement is not wages. Caregiver Support can be valuable, but it reimburses approved costs under program rules.
- Legal roles matter. A trusted child who handles finances as power of attorney or representative payee may be barred from being the paid CHC worker.
Common Mistakes to Avoid
- Assuming Medicare creates wages. Medicare alone does not create the main Pennsylvania family-pay route.
- Waiting to name the worker. Check relationship and representative-role rules before onboarding.
- Calling reimbursement a paycheck. Caregiver Support is not ordinary hourly wages.
- Using old appeal deadlines. Current 2026 CHC notices use a 15-day continuation window in the situations described on the notice.
- Changing legal roles for pay. Get advice before changing a power of attorney or guardianship.
- Paying privately without records. Use a written agreement and track hours and payments.
Denied, Delayed, or Services Reduced
If CHC denies, reduces, or changes services, the written notice is the starting point. Current 2026 CHC grievance decision templates say a person already receiving the affected service can keep it continuing while review is pending if the required review or hearing request is made within 15 days from the date on the notice in the situations described there. See the current CHC notice.
The 15-day figure is not the only appeal deadline. Follow the exact notice and act early. For Medicaid or CHC legal help, call the Health Law Project at 1-800-274-3258.
If the problem is delay, ask which step is pending: assessment, financial eligibility, service-plan approval, worker onboarding, or staffing. The state also publishes long-term care contacts.
Backup Options If Family Pay Does Not Fit
If family pay does not fit, ask the AAA about OPTIONS, Caregiver Support, respite, meals, and transportation. Our respite care guide explains short-break options.
If disability-related needs shape the care plan, see disability help in Pennsylvania. If the family is facing an immediate bill, food, housing, or utility crisis, use emergency senior help while the longer care application is being resolved.
If the family will pay privately, use a written agreement and keep payment records. Before large gifts, asset transfers, or changes in legal authority, consider legal advice. Pennsylvania lists legal caregiver support, including the SeniorLAW Helpline at 1-877-727-7529.
Local and Official Resources
- PA Independent Enrollment Broker: 1-877-550-4227; TTY 1-877-824-9346. Start here for CHC long-term services enrollment.
- PA Link: 1-800-753-8827. Use it when you need help finding aging, disability, or long-term care resources.
- OLTL Participant Helpline: 1-800-757-5042 for Office of Long-Term Living service concerns.
- Department of Aging: 717-783-1550 to be connected with local aging services.
- Pennsylvania Health Law Project: 1-800-274-3258 for Medicaid and CHC legal help.
- SeniorLAW Helpline: 1-877-727-7529 for statewide legal information and referral for Pennsylvanians age 60 and older.
Phone Scripts You Can Use
Calling the IEB
“I am helping an older adult who needs hands-on help at home with daily activities. We want to know if they can apply for Medicaid long-term services and Community HealthChoices. What is the next step, and what documents should we prepare?”
Calling the CHC coordinator
“We want to ask about participant-directed services. We have a family member who may be the worker. Can you confirm whether that person’s relationship and legal roles are allowed, and explain the payroll and onboarding steps?”
Calling the local AAA
“I am caring for an older adult at home. Medicaid pay is not in place. Can you screen us for OPTIONS, the Caregiver Support Program, respite, meals, and any other in-home help available in this county?”
Calling after a reduction
“I received a notice reducing or denying services. I want to protect any right to keep current services while I appeal. What is the continuation deadline on this notice, how do I file, and can you give me written confirmation?”
Resumen en español
En Pennsylvania, la vía principal para que un familiar reciba pago por cuidar a un adulto mayor suele ser Medicaid y Community HealthChoices (CHC). La persona mayor debe cumplir las reglas clínicas y financieras.
Muchos hijos adultos, hermanos, nietos, amigos o vecinos pueden recibir pago. CHC no permite pagar al esposo o esposa, al tutor legal, al representante de pago ni a la persona que tiene poder notarial.
Para empezar, llame al Independent Enrollment Broker al 1-877-550-4227. Si Medicaid no es la mejor opción, llame a PA Link al 1-800-753-8827 o a su Area Agency on Aging para preguntar por OPTIONS y el Caregiver Support Program. Esos programas pueden ayudar, pero no siempre pagan un salario al familiar.
Si CHC reduce o niega servicios, lea la carta de inmediato. Los avisos actuales de CHC usan un plazo de 15 días en ciertas situaciones para pedir revisión a tiempo y mantener los servicios actuales durante el proceso. Siga siempre el plazo exacto que aparece en su aviso.
Frequently Asked Questions
Can I get paid to care for my parent in Pennsylvania if they only have Medicare?
Usually not through Medicare alone. Pennsylvania’s main route for paying a family caregiver is Medicaid long-term services through Community HealthChoices, if the older adult meets the program’s clinical and financial rules. If Medicaid is not in place, ask the local Area Agency on Aging about OPTIONS and the Caregiver Support Program while you check long-term care eligibility.
Can a spouse get paid as a caregiver through Community HealthChoices?
No for the family-provided CHC services covered by the current waiver rule. Pennsylvania’s CHC waiver says payment is not made when the service is furnished by the participant’s spouse. A spouse may still benefit from respite, care management, or other caregiver supports when the household meets those programs’ rules, but that is different from CHC caregiver wages.
Can an adult child with power of attorney get paid through CHC?
Not while that adult child is serving as the participant’s power of attorney under the current CHC family-provider rule. The same exclusion applies to a legal guardian and representative payee. Do not change an important legal or financial role only to create caregiver pay without getting qualified advice; ask whether another relative or friend can be the worker.
How much do family caregivers get paid in Pennsylvania?
There is no single statewide hourly rate for every family caregiver. Under participant-directed CHC services, the participant or common-law employer can have authority over the worker’s rate, subject to state and program limits. Ask the CHC plan and fiscal employer agent what rate range applies to the approved service and location before counting on a specific wage.
Can a live-in adult child be a paid caregiver?
Often yes if the adult child is otherwise allowed and the older adult has approved CHC services. Living in the same home does not by itself create payment, and only authorized tasks and hours may be billed. Current waiver rules also limit billing for general household chores when they are not solely for the participant.
Does the older adult need nursing-facility level of care?
For the main Medicaid long-term services route, the person must meet Pennsylvania’s long-term services clinical and financial eligibility rules. The Independent Enrollment Broker arranges the needs assessment, and the County Assistance Office handles the Medicaid financial determination. The responsible agencies make the final decisions.
What should I do if CHC reduces or denies services?
Read the notice the same day you receive it. Current 2026 CHC grievance notices use a 15-day service-continuation window for certain reductions, changes, or denials when the person wants existing services to continue while review is pending. Other filing deadlines can be longer, so follow the exact notice and ask the plan, the Pennsylvania Health Law Project, or another qualified advocate for help.
About This Guide
Sources
This guide uses official federal, state, local, and other high-trust nonprofit and community sources linked in the article.
Editorial note
This guide is produced under the GFS Editorial Standards using official and other high-trust sources. GFS is not affiliated with a government agency and is not a substitute for official agency guidance. Individual eligibility outcomes cannot be guaranteed.
Corrections
Despite careful verification, errors may occur. Email info@grantsforseniors.org with corrections.
Disclaimer
This article is for informational purposes only and is not legal, financial, medical, tax, disability-rights, immigration, or government-agency advice. Program rules, policies, funding, and availability can change. Readers should confirm current details directly with the responsible official program before acting.
Last updated: 15 September 2026 · Next review: 15 January 2027
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