Get Paid as a Family Caregiver: Top 10 Medicaid Self Directed Care Companies to Consider

If you’re helping your mom get dressed, managing your dad’s medications, or making daily meals for your adult child with disabilities, you’re already a caregiver. And you may not even realize it.

Millions of people across the country are quietly doing the work of caregiving, out of love, duty, or both. But what many don’t know is that in many states, Medicaid will actually pay you for this care. It’s called self-directed care, and it’s changing the lives of families just like yours.

Whether you’re new to this or you’ve been in the thick of it for a while, this post will help you understand how to become a Medicaid caregiver, how self-directed care works, and which companies are best equipped to support you.

Key Takeaways

• You can get paid to care for a family member through Medicaid’s self-directed programs.
• Programs vary by state, but many allow spouses, adult children, and even friends to provide paid care.
• Choosing the right self-directed care company helps you avoid red tape and get paid faster.
• FreedomCare, GT Independence, and PPL are among the most trusted companies for family caregivers.

What Is Self-Directed Care?

Self-directed care is a Medicaid program that gives individuals more control over how they receive care at home. Instead of being assigned a home health aide from a traditional agency, your loved one can choose their own caregiver, which could be you.

In other words, the person who needs care gets to pick someone they already trust. And the caregiver (you) gets paid for your time, effort, and support.What Does a Medicaid Caregiver Do?

A Medicaid caregiver provides daily assistance to someone who qualifies for Medicaid and needs help at home. That care can include:

• Bathing, dressing, and grooming
• Cooking meals and feeding
• Medication reminders
• Mobility support and transfers
• Housekeeping and laundry
• Shopping and errands
• Companionship

Even if this sounds like what you’re already doing, you may be eligible to get paid for it under your state’s Medicaid program.

Can You Really Get Paid to Take Care of a Family Member?

Yes. And thousands of people already are.

Medicaid is a state and federally funded health program for people with low income and/or disabilities. Many states offer self-directed Medicaid caregiver programs, which allow recipients to hire their own caregivers, including family members in most cases.

Some of the most well-known self-directed Medicaid programs include:

• CDPAP (New York): Consumers Direct Personal Assistance Program
• IHSS (California): In-Home Supportive Services
• Home Help Program (Michigan)
• PAS (Personal Assistance Services) in Texas
• HCBS Waivers (nationwide)

Each program has slightly different eligibility rules, but most require:

• A Medicaid-eligible care recipient
• A need for daily assistance with activities of daily living (ADLs)
• A willing caregiver (like you!)
• State approval through an assessment or waiver program

How to Become a Medicaid Caregiver

Here’s a general roadmap for becoming a paid Medicaid caregiver:

Step 1: Make Sure Your Loved One Is on Medicaid

They must be approved for Medicaid to qualify for self-directed services.

Step 2: Apply for a Self-Directed Care Program

This may be through a waiver or direct Medicaid service. Each state has its own path. You’ll typically need to work through an approved Fiscal Intermediary or self-directed care company (more on that below).

Step 3: Choose a Caregiver (That’s You)

Your loved one will select you as their caregiver. Some programs allow spouses or legal guardians; others don’t.

Step 4: Complete Any Training or Background Checks

Most programs require some onboarding steps to ensure safety and compliance.

Step 5: Start Getting Paid

Once approved, you’ll log hours, submit timesheets (often through an app), and get paid just like any other home health worker

How to Choose the Right Self-Directed Care Company

Not all companies are created equal. A great self-directed care provider doesn’t just process paperwork, they make the caregiving process smoother for both you and your loved one.

Here’s what to look for:

• Speed of enrollment: How quickly can they get you started and paid?
• Same-day pay options: Some companies let you get paid the same day you work.
• Ease of use: Do they have a caregiver app or dashboard?
• Customer service: Will someone answer the phone if you have questions?
• Coverage area: Are they approved in your state?

Top Self-Directed Care Companies to Consider

Let’s break down the most trusted names in self-directed care, based on ease of use, caregiver support, and Medicaid expertise.

1. FreedomCare

Best for: Fast pay, ease of use, and family caregiver support

FreedomCare is the #1 self-directed home care provider in New York and has expanded to fifteen states, including Michigan, Illinois, Nevada, and Ohio. Known for its same-day pay, user-friendly caregiver app, and compassionate customer support, FreedomCare makes it simple to become a Medicaid caregiver for your loved one.

They’re also the largest CDPAP Fiscal Intermediary in New York and offer guidance through every step of enrollment, assessments, and pay setup.

States Covered: NY, MI, IL, OH, NV, and expanding

Why Families Love FreedomCare:

• Easy enrollment and help with Medicaid applications
• Real-time support and same-day caregiver pay
• Mobile app for scheduling and timesheets
• Trustworthy and experienced with family caregiver programs

2. GT Independence

Best for: Personalized service and rural access

GT Independence is a family-owned company that helps people with disabilities and older adults get care at home through self-direction. They work in multiple states and are known for one-on-one customer support and resources that empower families.

States Covered: Over 20, including WI, MI, TX, PA

Pros:

• Offers financial management, payroll, and reporting tools
• Dedicated care coordinators
• Online and phone-based support

3. Public Partnerships (PPL)

Best for: National presence and long-standing track record

PPL is one of the largest Financial Management Services (FMS) providers for self-directed programs in the U.S. With decades of experience and partnerships in over 30 states, they’re a reliable but sometimes slower-moving option.

States Covered: Nationwide

Pros:

• Trusted by Medicaid programs nationwide
• Experience with complex care needs
• Good for long-term home care situations

4. Acumen Fiscal Agent

Best for: Tech-savvy caregivers and straightforward management

Acumen is another well-established FMS provider that supports thousands of Medicaid caregivers through digital tools and responsive service. If you’re comfortable with online onboarding and tracking, Acumen is worth considering.

States Covered: AZ, NV, OR, CO, and more

Pros:

• Good online dashboard
• Clear payroll systems
• Training and compliance support

5. Consumer Direct Care Network (CDCN)

Best for: Flexibility and customized services

CDCN offers self-directed care in a range of states and is particularly well-suited for families needing custom scheduling and support with multiple caregivers. They also work closely with veterans and individuals with disabilities.

States Covered: MT, WA, ID, VA, and more

Pros:

• Works with both Medicaid and VA programs
• Flexible scheduling
• Strong advocacy and caregiver education

6. Tempus Unlimited

Best for: Personal assistance services in Massachusetts and expanding states

Tempus Unlimited (formerly Cerebral Palsy of Massachusetts) provides financial management services for self-directed care programs. Known for accessibility and responsiveness, especially for people with disabilities.

States Covered: MA, FL, NJ, and others

Pros:

• Deep knowledge of PCA and FI programs
• Strong disability advocacy history
• Easy forms and payroll system

7. MySupport (powered by Palco)

Best for: Caregiver matchmaking and hiring guidance

MySupport is a tech-enabled platform that helps Medicaid recipients choose their caregivers, manage hours, and simplify onboarding. It’s particularly helpful in states where finding a caregiver is a challenge.

States Covered: AR, MO, KS, others

Pros:

• Match caregivers with recipients
• Full FMS and enrollment support
• Offers employer and employee onboarding tools

8. EOR Alliance (Employer of Record Services)

Best for: Families who want control but need payroll help
EOR Alliance is a national Fiscal Employer Agent (F/EA) and provides backend payroll and tax processing for families using self-direction. They’re ideal for families who want to hire someone they trust but don’t want the hassle of managing taxes.

States Covered: Multiple, including WI, OR, and CA
Pros:

• Handles payroll and insurance
• Transparent pricing
• Works directly with state Medicaid programs
  

9. Morning Sun Financial Services

Best for: States with complex waiver programs
Morning Sun specializes in Financial Management Services (FMS) for self-direction in states with large waiver populations. They’re highly experienced with Colorado, New Mexico, and Utah Medicaid systems.

States Covered: CO, NM, UT, and others
Pros:

• Knowledgeable about waiver programs
• Strong relationships with state agencies
  
• Clear communication with families
  

10. Vela (formerly AvailCare)

Best for: App-based tracking and independent caregivers
Vela offers a clean, app-first experience that simplifies how caregivers log hours and track pay. If you’re looking for a modern, tech-forward solution, especially in Arizona or the Southwest, this is one to explore.

States Covered: AZ, TX, CA, others
Pros:

• Caregiver mobile app
• Real-time pay tracking
• Streamlined onboarding
  

Don’t Wait: Get the Help (and the Pay) You Deserve

Too often, caregivers burn out because they don’t realize there’s help available. You might be skipping meals, losing sleep, or worrying about how to pay the bills, while giving your loved one everything you’ve got.

Being a caregiver is love in action. But it’s also real work. You deserve recognition and support.

How to Get Started as a Medicaid Caregiver

Here’s what to do today:

1. Find Out If Your Loved One Has Medicaid

If not, visit Medicaid.gov or your state Medicaid office to apply.

2. Reach Out to a Self-Directed Care Company

Start with a trusted provider like FreedomCare to check eligibility and get guidance on enrollment.

3. Prepare Documents

You may need:

• Proof of Medicaid enrollment
• Care needs assessment or doctor’s letter
• ID and contact information
• Bank info for direct deposit
  

4. Complete Training (if required)

Some states require brief training or a background check.

5. Start Logging Hours and Get Paid

Once approved, you’ll track your hours (often via app), and get paid regularly, sometimes even instantly.

Final Thoughts

Caring for a family member can feel overwhelming, especially when it’s unpaid. But Medicaid’s self-directed programs are changing that. If you’re already helping someone you love, you may be able to get paid for what you’re already doing.

And you don’t have to figure it out alone.

Companies like FreedomCare have helped thousands of families navigate the process with compassion and care. Whether you’re just starting or ready to enroll, take that first step today.

You care for them. Let someone care for you, too.