Caring for a loved one at home is an act of devotion that comes with immense responsibility. Millions of families take on this role, with spouses often stepping up to provide care. However, caregiving is not only emotionally and physically taxing—it can also take a significant financial toll.
The cost of lost income, healthcare expenses, and caregiving supplies adds up quickly. Many states now offer programs that pay spouses to serve as caregivers to address this challenge. These programs help families stay financially stable while keeping their loved ones in a familiar, nurturing environment.
What states pay spouse caregivers in 2025? This question is more important than ever as the demand for in-home care grows. With Medicaid waivers and state-specific initiatives, families can receive financial assistance while actively participating in their loved one’s care. These programs assist spouses in providing the personalized support their partners need without sacrificing their financial well-being.
What States Pay a Spouse to Be a Caregiver?
As the need for caregiving rises, states have developed innovative solutions. Medicaid Home and Community-Based Services (HCBS) waivers allow individuals receiving care to hire family members—including spouses—as paid caregivers. These programs keep individuals out of long-term care facilities, prioritizing the flexibility of in-home care.
Colorado is a leader in this space, offering the Colorado In-Home Supportive Services (IHSS) Program. This program allows families to choose their caregivers, with spouses often stepping into these roles. Similarly, Arizona’s Self-Directed Attendant Care (SDAC) program enables families to hire and compensate loved ones for caregiving, including spouses. Both of these programs provide much-needed financial support while giving families greater control over their care plans.
States such as California, Oregon, and New York have also adopted consumer-directed care models. They enable families to adjust caregiving arrangements to their needs. These programs highlight the growing recognition of spousal caregiving as a key part of the healthcare system.
Medicaid Waivers: Spousal Caregiving Support
Medicaid waivers play an important role in funding spousal caregiving. These waivers give individuals the flexibility to hire family members as paid caregivers. They can do so by allowing recipients to “self-direct” their care.
Programs like the Children’s Home and Community Based Service (CHCBS) program support families caring for children with disabilities. It allows spouses and family members to provide high-quality, personalized care in a home setting. These waivers prioritize keeping individuals in their own homes. They reduce the reliance on costly institutional care.
In addition to HCBS waivers, some states have developed non-Medicaid programs to achieve similar goals. These state-funded initiatives provide stipends or direct payments to spouses in caregiving roles. This way, families can sustain care at home without financial hardship. This support can make a significant difference for families balancing caregiving responsibilities with daily living expenses.
Programs Supporting Veterans and Spousal Caregiving
Veterans and their families benefit from specialized initiatives providing financial support and caregiving resources. The Veterans-Directed Care (VDC) program allows veterans to choose their caregivers through a flexible model that accommodates individual care needs. This program funds personal care, homemaker services, and medical-related tasks.
Another option for veteran families is the Program of Comprehensive Assistance for Family Caregivers (PCAFC). This initiative provides monthly stipends to eligible spouses who care for veterans with serious injuries or illnesses sustained during service.
- Non-Medicaid State Programs
While Medicaid waivers dominate the spousal caregiving landscape, some states go beyond these options with non-Medicaid initiatives. For instance, Minnesota’s Consumer Support Grant (CSG) program offers families a monthly cash stipend to cover caregiving expenses. These flexible grants allow families to allocate funds for home modifications, personal care supplies, and even hiring spouses as caregivers.
Similarly, Kentucky’s Hart Supported Living Program and Oregon’s Independent Choices Program allow families to receive direct financial assistance for caregiving. These programs offer financial support for spouses and families who may not qualify for Medicaid. They help those who still need financial assistance to care for their loved ones at home.
- Financial Relief Through Statewide Medicaid Managed Care Programs
Statewide Medicaid-managed care programs offer additional support for spousal caregivers. A good example of these programs is Florida’s Statewide Medicaid Managed Care Long-Term Care Program. These programs integrate long-term care services with financial assistance. Spouses can often be hired through participating agencies. It enables them to provide hands-on care while being compensated for their time.
In Delaware, the Diamond State Health Plan – Plus takes a similar approach by combining managed care with consumer-directed services. These programs give families the tools to make caregiving financially feasible.
Expanding Access to Spousal Caregiving Support
States continue to explore new ways to provide financial assistance to spousal caregivers, with some even piloting innovative programs to expand access. As more states adopt flexible caregiving models, spouses can expect more opportunities to receive financial recognition for their essential roles.
Be it through Medicaid waivers, veterans’ programs, or state-funded initiatives, these options are changing caregiving from an unpaid responsibility into a sustainable path for families.
How Much Do States Pay Spouse Caregivers?
Pay rates for spousal caregivers vary widely, depending on the state and program. States that pay a spouse to be a caregiver typically base compensation on the level of care required. This payment can range from basic personal assistance to intensive medical support. Hourly rates often fall between $9 and $22, with full-time caregiving roles earning $600 to over $1,000 per week.
For example, Colorado’s IHSS program compensates caregivers based on hours worked and care complexity. In contrast, Arizona’s SDAC program allows families to set caregiver wages within Medicaid guidelines. These programs recognize the immense value of caregiving work. They aim to make it financially viable for spouses to dedicate their time to supporting loved ones.
It’s important to note that eligibility criteria vary by state and program. Medicaid waivers often have income and asset limits. Also, care recipients must meet specific medical or functional criteria. Despite these requirements, the financial support offered by these programs can significantly ease the burden on caregiving families.
The Importance of Paying Spouses as Caregivers
Spousal caregiving is an all-encompassing role that includes emotional support, medical care, and household management. The U.S.’s economic value of unpaid caregiving is estimated at nearly $600 billion annually. This data highlights the role that family caregivers play.
Paying spouses as caregivers acknowledges this contribution and provides families with the necessary resources to continue their work. These programs allow individuals to stay in their homes, preserving their independence and quality of life. Financial support can make all the difference for spouses. It helps them balance caregiving with other financial obligations.
At Voyager Home Health Care, we’ve seen firsthand how these programs can change families’ lives. Programs like Colorado’s IHSS and the CHCBS program provide financial stability and peace of mind for families. Knowing that their caregiving efforts are valued and supported allows spouses to focus on what matters most—caring for their loved ones.
States Leading the Way in Spousal Caregiving
More than 20 states across the U.S. have developed programs that compensate spouses for caregiving. These programs vary in their structure, scope, and eligibility criteria. However, all aim to assist families by making caregiving financially sustainable. Some of the most impactful initiatives are in states prioritizing consumer-directed models.
- California: Setting the Standard with IHSS
California’s In-Home Supportive Services (IHSS) program remains a benchmark for consumer-directed care, allowing families to hire spouses as paid caregivers. Under this program, individuals eligible for Medicaid can direct their care services by selecting and supervising caregivers.
IHSS provides a straightforward process for spousal caregiving, offering hourly wages and reimbursement for necessary caregiving supplies. This flexibility has made California a leader in supporting families who prefer to provide care at home rather than relying on institutional facilities.
- Oregon: Innovative Consumer-Directed Programs
Oregon has embraced consumer-directed care with multiple programs, including the K Plan and Community First Choice initiatives. These Medicaid-based programs allow spouses to be paid caregivers for individuals with disabilities or chronic health conditions. In addition to caregiving compensation, Oregon’s programs cover home modifications, medical equipment, and personal care supplies.
- New York: Consumer-Directed Personal Assistance Program (CDPAP)
New York’s Consumer-Directed Personal Assistance Program (CDPAP) is another example of a state that is leading the way in spousal caregiving. CDPAP gives Medicaid recipients complete control over their care by allowing them to hire, train, and pay caregivers of their choice. The program provides flexibility in determining wages and schedules. It enables families to design caregiving plans that work best for them.
How Voyager Home Health Care Support Spousal Caregivers
At Voyager Home Health Care, we are passionate about supporting families to care for their loved ones. Our programs provide financial support and guidance to spousal caregivers. Families should have access to the tools and resources needed to succeed in their caregiving journey.
We are here to support you in exploring options for becoming a paid caregiver, helping you provide care while being compensated for your time and dedication. Contact us today to learn more about our comprehensive services and how we can assist your family. Discover how caregiving can be transformed into a sustainable, fulfilling, and rewarding experience for you and your loved ones.
