Written & Reviewed by
Last updated: 27 May 2026
Bottom line: Vermont does not have one simple program that pays every family caregiver. For most seniors, the main path is Choices for Care, Vermont’s long-term care Medicaid program. Adult children and some other relatives may be paid in self-directed care, but the senior must qualify, the care plan must approve the work, and spouse rules are tighter.
Emergency help now
- If the senior is alone, unsafe, or cannot get basic care today, call 911 or ask the hospital, rehab center, doctor, or discharge planner for same-day social work help.
- Call the Senior Helpline at 1-800-642-5119. Say that the senior needs urgent caregiver, respite, or long-term care help.
- If Medicaid long-term care is likely, call the Benefits Service Center at 1-800-479-6151. You can also start through MyBenefits Vermont if you are ready to apply online.
Quick help box
| Need | Start here | Why it helps |
|---|---|---|
| First call for a senior or caregiver | Senior Helpline 1-800-642-5119 |
Connects families to the right Area Agency on Aging and local care options. |
| Long-Term Care Medicaid | Benefits Service Center 1-800-479-6151 |
Handles the financial side of many Medicaid and long-term care applications. |
| Health coverage questions | Vermont Health Connect 1-855-899-9600 |
Helps with Vermont health coverage questions and language help. |
| Payroll after approval | ARIS Solutions 1-800-798-1658 |
Handles many payroll, tax form, direct deposit, and timesheet tasks for self-direction. |
| Flexible Choices budget help | Transition II 866-572-7127 |
Helps Flexible Choices participants build and manage a self-directed budget. |
| Bad notice or appeal help | Health Care Advocate 1-800-917-7787 |
Free help with Medicaid and health coverage problems. |
Contents
- How paid care works
- Who may qualify
- Vermont options compared
- Main programs
- How much pay
- Start without wasting time
- Documents to gather
- Phone scripts
- Denied or delayed
- Local resources
How paid family caregiving works in Vermont
The real question is not just, “Can Vermont pay a family caregiver?” The better question is, “Can the senior qualify for a Vermont care program that allows self-direction?”
For most older adults, that program is Choices for Care. It can pay for long-term services at home, in a family member’s home, in Adult Family Care, in enhanced residential care, or in a nursing facility. The state says Choices for Care is for adults who need a nursing-home level of care. Age Well also describes the program as Medicaid-funded help for older Vermonters and adults with physical disabilities who need help with daily activities.
Self-direction is the part that matters for family pay. In a consumer-directed or surrogate-directed setup, the participant or approved helper may hire workers. A family member may fit if the person is not in a barred role and can pass required checks. If the family wants more control over a budget, Flexible Choices may be better.
ARIS is not the first eligibility door. ARIS becomes important after approval or when a case manager tells the family to start payroll steps. For broader Vermont senior benefits, the related Vermont senior guide can help families check food, housing, utility, and medical help that may be needed at the same time.
Who may qualify
For the main senior path, the senior usually must qualify for Long-Term Care Medicaid and Choices for Care High or Highest Needs services. Vermont Legal Aid’s eligibility guide says Choices for Care has both financial and clinical requirements. Both must be met.
Clinical need: DAIL reviews whether the person has physical issues that make daily activities hard. This can include getting out of bed, standing, walking, grooming, dressing, bathing, or eating. A nurse may visit to review needs.
Financial need: The Economic Services Division reviews income, resources, and transfers. Vermont Legal Aid’s income limits page explains that income can affect the patient share. Its resource limits page lists 2026 countable resource limits of $2,000 for one person in long-term care, $3,000 for two people, and $5,000 if you own and still live in your home. A spouse may have larger protections.
If the senior does not meet nursing-home-level care, ask about Moderate Needs and caregiver support through an Area Agency on Aging. These can still help, but they are not the same as a guaranteed paycheck for a family caregiver. For more Vermont disability-specific support, see the GFS guide to Vermont disability benefits.
Vermont options compared
| Option | Medicaid needed? | Adult child | Spouse | Best fit |
|---|---|---|---|---|
| Choices for Care self-direction | Usually yes | Often possible | Sometimes, with limits | Heavy daily care at home |
| Flexible Choices | Yes | Often possible | Sometimes, with the same limits | Families wanting more budget control |
| Adult Family Care | Yes | Sometimes, if not barred | No | Shared living in a provider’s home |
| Attendant Services Program | Yes | May be possible | Ask DAIL first | Severe permanent physical disability |
| Moderate Needs | Not always | Sometimes through flexible funds | Usually not a wage path | Lower care need, limited help |
| AAA caregiver support | No | Support, not usually wages | Support, not usually wages | Respite, counseling, local referrals |
Adult children are often easier to fit than spouses. But final approval depends on the care plan, worker age, background checks, payroll setup, and whether the family member is also a legal guardian, representative payee, or surrogate employer.
Main Vermont programs and paths
Choices for Care home-based self-direction
What it is: This is the main Vermont path for seniors who need a high level of daily help and want to stay at home. It may use agency services, consumer-direction, or surrogate-direction.
Who may qualify: Adults age 18 and older who meet Vermont’s clinical and financial rules for long-term care. Seniors age 65 and older may qualify based on care need. Adults age 18 to 64 usually need a physical disability.
Where to apply: Start through the Benefits Service Center or your Area Agency on Aging. If you already have a case manager, ask for consumer-directed or surrogate-directed personal care.
Reality check: The CFC manual says a legal guardian cannot be paid for personal care. It also says a spouse or civil union partner cannot be paid for IADL help under personal care, and cannot be paid for companion or respite services. So a spouse may be possible only in narrower situations.
Flexible Choices
What it is: Flexible Choices turns an approved home-based service plan into a self-directed budget. A participant or surrogate can use that budget for approved workers and some supports.
Who may qualify: People already eligible for home-based Choices for Care who want more control over who helps, when help happens, and how the budget is used.
Where to apply: Ask the case manager or Area Agency on Aging about Flexible Choices. Transition II helps with the budget side, and ARIS usually handles payroll steps.
Reality check: Flexible Choices gives more control, but it also gives the family more work. You must track hours, budget, worker forms, and timesheets. If your family is comparing agency help and hiring your own worker, the GFS guide to home care choices can help.
Adult Family Care
What it is: Adult Family Care is a shared-living option. The participant lives in another person’s home and receives 24-hour support there. It is not hourly care in the senior’s own home.
Who may qualify: A person must qualify for Choices for Care and need a family-home setting. The home provider must be approved and meet program standards.
Where to apply: Ask the case manager or Area Agency on Aging about authorized Adult Family Care agencies.
Reality check: The CFC manual says the home provider cannot be the participant’s parent, stepparent, adoptive parent, domestic partner, spouse, legal guardian, or representative payee. Adult children are not named in that exclusion list, but the agency must still approve the home and the role.
Attendant Services Program
What it is: The Attendant Services Program supports personal care for adults with a severe and permanent physical disability who need hands-on help to remain at home.
Who may qualify: This is usually for adults who can direct their own care and meet Medicaid-related rules. It is not always the right fit for age-related frailty, dementia, or general caregiver stress.
Where to apply: Start through the state disability and aging supports page or ask DAIL whether ASP fits the senior’s condition.
Reality check: Do not assume spouse or family rules are the same as Choices for Care. Ask DAIL before changing plans or counting on pay.
Moderate Needs and AAA caregiver support
What it is: Vermont’s Moderate Needs services can include limited homemaker, adult day, case management, and flexible funds. Area Agencies on Aging can also help with caregiver support, respite, meals, and local referrals.
Who may qualify: Moderate Needs is for people who do not meet nursing-home-level care but still need support. AAA caregiver support is often tied to older adult and caregiver needs, not a wage program.
Where to apply: Call the Senior Helpline and ask for the Area Agency on Aging that serves your town. The GFS Vermont AAA guide can help you match your county or town to the right agency.
Reality check: These programs can help a stressed caregiver, but they may not pay a family member regular wages. Funding can be limited.
Money Follows the Person
What it is: Money Follows the Person can help some nursing-facility residents move back to a community setting.
Who may qualify: It is for people already in a nursing facility who want to return home or move to another community-based setting.
Where to apply: Ask the nursing facility social worker, Choices for Care case manager, or Area Agency on Aging.
Reality check: This is not direct caregiver pay by itself. It may help set up the move that makes home care possible.
How much family caregivers may be paid
There is no one Vermont hourly wage for every family caregiver. The amount depends on the program, service type, approved hours, taxes, and budget.
| Program | Current public detail verified | What can change |
|---|---|---|
| Choices for Care self-direction | The CFC wage notice says the minimum wage became $15.49 per hour on 07/06/2025, with a minimum total hourly budget rate of $17.31. | Approved hours, service type, employer taxes, and the care plan. |
| Flexible Choices | The same notice says the Flexible Choices budget base rate increased to $1,719.03 on 07/06/2025. | The final budget and purchases must be approved. |
| Personal care budgets | The notice says personal care budgets use a $18.08 base rate, while companionship and respite budgets use $17.70. | The worker’s actual wage may differ from the budget rate. |
| Adult Family Care | Not a simple hourly wage. It uses a daily tiered shared-living payment structure. | Tier, agency contract, living arrangement, and tax treatment. |
| Moderate Needs or AAA support | No single statewide family-caregiver wage was verified for this guide. | Funding, local program rules, and service plan. |
Do not plan a family budget until the case manager or payroll contact confirms the approved hours, rate, and start date.
How to start without wasting time
- Use the right words. Say, “I want Long-Term Care Medicaid and Choices for Care. I also want to know if self-direction or Flexible Choices could pay a family caregiver.”
- Open both tracks. Clinical need and financial eligibility are reviewed separately. Keep notes on who asked for what paperwork.
- Name the possible worker early. Say if the worker is a daughter, son, spouse, sibling, niece, friend, guardian, representative payee, or surrogate employer.
- Ask about the best setting. Staying in the senior’s home is different from Adult Family Care in another person’s home.
- Use ARIS at the right time. ARIS handles payroll and forms. It does not decide Medicaid eligibility.
- Ask about EVV before work starts. ARIS says EVV rules apply to many home-based services when the worker does not live with the client and care is in the client’s home.
Families often need help with more than caregiver pay. If rent or housing is part of the crisis, use the GFS page on Vermont housing help. If the situation is urgent, the Vermont emergency guide may be a better first step.
Documents and facts to gather
- Photo ID and Social Security number for the senior.
- Medicare card, Medicaid card if any, and other insurance cards.
- Proof of Vermont address.
- Social Security letter, pension statements, VA benefit letters, wage stubs, or other income proof.
- Bank, investment, burial plan, life insurance, vehicle, and property records.
- Power of attorney, guardianship, representative payee, or advance directive papers.
- Recent hospital, rehab, home health, or doctor notes showing care needs.
- A written list of help needed with bathing, dressing, toileting, transfers, walking, eating, memory, meals, and medication.
- Name, phone, address, relationship, and direct-deposit details for the possible paid worker.
The GFS documents checklist can also help families prepare for Medicaid, housing, food, and other benefit applications.
Phone scripts that save time
Script for the Senior Helpline
“I am helping an older adult in Vermont who needs daily care at home. We want to know if Choices for Care, Moderate Needs, respite, adult day, or caregiver support fits. Can you connect me to the right Area Agency on Aging for this town?”
Script for Medicaid
“I need to apply for Long-Term Care Medicaid and Choices for Care. I need to know what forms and proof are needed for both financial eligibility and the clinical assessment.”
Script for the case manager
“The senior wants a family member to be the paid caregiver if allowed. Can you tell me whether consumer-directed care, surrogate-directed care, Flexible Choices, or Adult Family Care is the right path?”
Script for ARIS
“The case manager told us to start payroll steps. What employer forms, worker forms, direct deposit forms, timesheet rules, and EVV steps are needed before the first paid shift?”
Reality checks
- Most paid family caregiving in Vermont goes through Medicaid long-term care, not a simple senior grant.
- Approval does not turn every unpaid family hour into paid time.
- Home-based services may not cover care 24 hours a day.
- Spouse payment is narrower than many families expect.
- A legal guardian may be blocked from being paid for some services.
- Adult Family Care is a move-in shared-living model, not hourly care in the same home.
- Timesheets, EVV, and payroll dates matter. Late paperwork can delay pay.
- Moderate Needs can be useful, but funding is limited.
If the senior is also a veteran, ask the VA social worker about veteran-directed or home-care options. The GFS Vermont veteran guide can help with state and local veteran starting points.
Common mistakes to avoid
- Calling ARIS first and thinking that starts eligibility.
- Waiting too long to say the worker may be a spouse, guardian, or representative payee.
- Assuming Adult Family Care is the same as hourly home care.
- Ignoring notices because they are hard to read.
- Missing appeal deadlines.
- Not asking about respite, adult day, and meals while waiting.
- Using old senior-center links instead of the current Area Agency on Aging path.
What to do if denied, delayed, or overwhelmed
Ask for every denial, reduction, or delay reason in writing. The denial guide from Vermont Legal Aid says a person can request a DAIL Commissioner’s Review within 30 days of a clinical decision. It also says a person can appeal to the Human Services Board within 90 days.
If the problem is financial eligibility, missing proof, or confusing notices, call the Office of the Health Care Advocate at 1-800-917-7787. If the problem is poor long-term care service, unsafe discharge, or a Choices for Care complaint, contact the Long-Term Care Ombudsman at 1-800-889-2047.
While you wait, ask the Area Agency on Aging about respite, adult day, meals, transportation, caregiver counseling, and reassessment. For Medicare cost help that may free up money for care needs, the GFS Vermont MSP guide may also help.
Backup options if family pay does not work
- Area Agency on Aging caregiver support, respite, meals, and benefits screening.
- Adult day services, especially when the caregiver works during the day.
- Private-pay care with a written caregiver agreement if the family pays a relative directly.
- Home modifications or personal emergency response systems if approved in a care plan.
- Long-term care insurance, if the policy allows informal or family caregivers.
- Veteran-related home-care options if the senior receives VA care.
- Adult Family Care if the senior cannot live safely alone and a move-in setting makes sense.
Families raising grandchildren may have other benefit paths at the same time. The GFS page on Vermont kinship care covers TANF, kinship help, and related support.
Local Vermont resources
| Resource | Use it for | Contact |
|---|---|---|
| Age Well | AAA services in northwestern Vermont and statewide helpline access | 1-800-642-5119 |
| Central Vermont Council | AAA services in central Vermont | Use its helpline or contact page |
| NEK Council | AAA services in the Northeast Kingdom | Use its contact page |
| Southwestern Vermont Council | AAA services in southwestern Vermont | Use its contact page |
| Senior Solutions | AAA services in southeastern Vermont | Use its helpline or contact page |
| Vermont 211 | Local emergency, food, housing, and community referrals | Dial 211 |
Resumen en español
Vermont no tiene un programa simple que pague a cualquier familiar por cuidar a una persona mayor. Para muchas familias, la vía principal es Choices for Care, el programa de cuidado a largo plazo de Medicaid. Un hijo adulto u otro familiar puede ser trabajador pagado en algunas situaciones, pero la persona mayor debe calificar y el plan de cuidado debe aprobar el servicio.
El cónyuge puede tener reglas más estrictas. También hay límites si el familiar es tutor legal, representante de pago o empleador sustituto. Para empezar, llame a la Senior Helpline al 1-800-642-5119 y diga que necesita ayuda con Choices for Care, cuidado en casa, descanso para cuidadores o pago a un familiar.
FAQ
Can my daughter or son get paid to care for me in Vermont?
Often, yes, if you qualify for the right program and the care plan allows it. Adult children are often easier to fit into Vermont self-direction rules than spouses, but the worker cannot be in a barred role.
Can a spouse be paid as a caregiver in Vermont?
Sometimes, but not for every task. Choices for Care rules limit spouse payment for some services, including IADL help under personal care, companion care, and respite care.
Does the senior need Medicaid?
Usually yes for the main paid family caregiver path. Choices for Care is tied to Long-Term Care Medicaid. Moderate Needs and AAA support may help without the same Medicaid path, but they are not guaranteed wage programs.
What is Flexible Choices?
Flexible Choices is a self-directed Choices for Care option. It gives the participant or surrogate more control over an approved budget, workers, and some supports.
How much does Vermont pay family caregivers?
There is no single statewide amount. The latest public Choices for Care wage notice verified for this guide lists $15.49 per hour as the minimum wage effective 07/06/2025, but actual pay depends on the approved budget and service type.
Who handles payroll?
ARIS Solutions handles payroll and related forms in many Vermont self-directed programs. ARIS does not decide whether the senior qualifies for Medicaid or Choices for Care.
What if Choices for Care is denied?
Ask for the reason in writing. For clinical denials, Vermont Legal Aid says you may request a DAIL Commissioner’s Review within 30 days and may appeal to the Human Services Board within 90 days.
About This Guide
This guide uses official federal, state, local, and other high-trust nonprofit and community sources mentioned in the article.
Editorial note: This guide is produced based on our Editorial Standards using official and other high-trust sources, regularly updated and monitored, but not affiliated with any government agency and not a substitute for official agency guidance. Individual eligibility outcomes cannot be guaranteed.
Verification: Last verified 27 May 2026, next review 27 August 2026.
Corrections: Please note that despite our careful verification process, errors may still occur. Email info@grantsforseniors.org with corrections and we will respond within 72 hours.
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, and availability can change. Readers should confirm current details directly with the official program before acting.
Last updated: 27 May 2026
Next review: 27 August 2026
Choose your state to see senior assistance programs, benefits, and local help options.
About the Authors