Can I Get Paid to Care for My Aging Parent in PA? A Guide to CHC Waivers
You're Already Doing the Work — You Deserve to Be Paid for It
If you've cut back your work hours, rearranged your schedule, or put your own life on hold to care for an aging parent, you're not alone — and Pennsylvania has a program designed specifically to recognize and compensate your effort.
Millions of adult children across Pennsylvania quietly step into the role of full-time caregiver every year. They help Mom get dressed in the morning, drive Dad to medical appointments, prepare meals, manage medications, and provide round-the-clock supervision — all while trying to maintain their own careers and families. The financial strain is real: lost wages, unpaid leave, and the quiet sacrifice of your own economic stability.
The good news is that Pennsylvania's Medicaid system acknowledges this burden. Through the Community HealthChoices (CHC) waiver program, qualifying seniors and individuals with disabilities can receive professional home care services — and in many cases, they can choose a trusted family member as their paid caregiver. You do not have to do this for free.
- Caregiving is the equivalent of a full-time job — often more than 40 hours per week with no overtime or benefits
- PA's CHC program was created specifically to support home- and community-based care as an alternative to nursing home placement
- Family caregivers who are formally hired through an approved agency receive regular paychecks, just like any other employee
- Being paid does not reduce your loved one's benefits or care hours — it formalizes work you're already doing
- Dream Home Care LLC specializes in helping families navigate this process from start to finish
The Short Answer: Yes, Through Medicaid — Not Medicare
Many families are surprised to learn the distinction between Medicare and Medicaid when it comes to home care. Understanding the difference is the first step toward accessing the right program.
Medicare is the federal health insurance program most people over 65 automatically receive. It covers doctor visits, hospital stays, and short-term skilled nursing care after a hospitalization — but it does not cover long-term daily home care, personal assistance, or custodial support on an ongoing basis.
Pennsylvania Medicaid (called Medical Assistance in PA) is a state and federally funded program for individuals with limited income and assets. Through Pennsylvania's Community HealthChoices (CHC) managed care program, Medicaid pays for long-term services and supports (LTSS) provided in a person's home or community — not just in a facility.
- The CHC program is Pennsylvania's primary HCBS (Home and Community Based Services) waiver for adults who require nursing-home-level care
- CHC allows participants to receive that same level of care at home — preserving independence and family connection
- One of CHC's most important features is participant-directed care: your loved one can choose who provides their care, including family members
- Approved home care agencies like Dream Home Care LLC act as the employer of record — managing payroll, taxes, and compliance on behalf of the family caregiver
- Medicare and CHC Medicaid can be active at the same time; they serve different purposes
- CHC is available statewide and administered through three managed care organizations (MCOs): UPMC Community HealthChoices, AmeriHealth Caritas, and PA Health & Wellness
Who Can (and Cannot) Be a Paid Caregiver?
Pennsylvania's CHC waiver program has specific rules about who is eligible to serve as a paid caregiver. Knowing these rules upfront will save you time and set realistic expectations.
- Adult children (son or daughter, age 18+)
- Grandchildren of the care recipient
- Siblings and step-siblings
- Nieces and nephews
- Close family friends (non-relatives)
- Other adults not legally responsible for the patient's support
- Legal spouses (husbands or wives)
- Legal guardians of the participant
- Power of attorney holders (in certain cases)
- Individuals under 18 years old
- Anyone who does not pass the required background screening
Once eligibility is confirmed, all family caregivers must meet a baseline set of requirements before they can begin receiving compensation:
- Must be at least 18 years of age at the time of hiring
- Must pass a Pennsylvania criminal history background check (Act 169 clearances)
- Must pass a child abuse history clearance (Act 31) and FBI clearance if applicable
- Must complete a tuberculosis (TB) screening test — results must be on file before care begins
- Must complete agency-required orientation and skills training provided by Dream Home Care
- Must maintain reliable communication and document care hours accurately through our system
- Must be physically and mentally capable of providing the services outlined in the participant's plan of care
Patient Eligibility: How Does Your Loved One Qualify?
Here's an important clarification: it is the care recipient — your parent or loved one — who must qualify for the CHC waiver, not the caregiver. Eligibility is determined by two separate hurdles that must both be cleared.
Hurdle 1: Clinical eligibility
- Must require a "nursing home level of care" as determined by state assessment
- Must need hands-on help with at least some Activities of Daily Living (ADLs)
- ADLs include bathing, dressing, grooming, toileting, eating, and mobility
- Cognitive impairment or dementia-related needs may also qualify
- A formal assessment is conducted by a state-contracted assessor — not self-reported
- Medical records and physician documentation may be requested
Hurdle 2: Financial eligibility
- Must meet Pennsylvania Medicaid income and asset limits
- As of 2025, the general countable asset limit for a single applicant is $2,000
- Some assets are exempt (primary home, one vehicle, certain burial funds)
- Monthly income limits apply and are adjusted periodically — always verify current figures
- A spend-down or Medicaid planning strategy may be available if assets are slightly over the limit
- Consulting a PA elder law attorney is strongly recommended for borderline cases
- Both clinical and financial eligibility must be confirmed before the CHC waiver is approved — meeting only one is not sufficient
- Eligibility is re-evaluated periodically; changes in health or finances must be reported to the MCO
- Approval timelines vary; applying early is always recommended — care needs don't wait
- Dream Home Care can help you understand what documentation to gather before starting the application process
How the Process Works: Step-by-Step
The path from "interested" to "getting paid" involves several steps, but each one is well-defined. Here's exactly what the journey looks like:
The parent applies for the CHC waiver
The process begins with the care recipient (your parent), not the caregiver. The first call is typically to the Pennsylvania Independent Enrollment Broker (IEB) at 1-877-550-4227.
- The IEB is a free, neutral resource — they do not represent any MCO or agency
- They walk you through the enrollment process and explain your options
- Applications can also be initiated through the local County Assistance Office (CAO)
- Gather Social Security card, proof of income, bank statements, and medical records before calling
The state conducts medical and financial assessments
Once the application is received, a state-contracted assessor will perform a Level of Care (LOC) evaluation and a financial review to determine eligibility.
- A trained assessor visits the home or contacts the applicant for an in-person or phone evaluation
- The LOC assessment reviews ADL needs, cognitive status, and overall health
- Financial documents are reviewed for income and asset eligibility
- This step can take several weeks — be patient and respond promptly to any documentation requests
Your loved one selects a managed care organization (MCO)
Once approved, the participant chooses one of Pennsylvania's three CHC Managed Care Organizations to coordinate their long-term care services.
- The three MCOs are: UPMC Community HealthChoices, AmeriHealth Caritas, and PA Health & Wellness
- The MCO assigns a Care Manager to develop the participant's plan of care
- The MCO determines the number of approved service hours per week based on the assessment findings
- Dream Home Care LLC works with all three MCOs across Pennsylvania
The participant selects an approved home care agency
The participant exercises their right to choose who provides their care — including which licensed home care agency manages the service.
- Participants have the right under CHC to select any MCO-approved provider
- Dream Home Care LLC is licensed by the PA Department of Health and approved under CHC
- Our team helps the family understand the participant-directed care option and the caregiver hiring process
- We coordinate directly with the MCO and Care Manager to get services started quickly
Dream Home Care formally hires the family caregiver
Once the agency is selected, the family caregiver officially becomes an employee of Dream Home Care LLC. We handle the entire onboarding and payroll process.
- We process all required clearances: PA criminal history, child abuse, FBI (if applicable), and TB screening
- We complete new hire paperwork, W-4, and I-9 employment verification
- Caregivers are paid weekly or bi-weekly via direct deposit for all approved, documented hours
- We provide EVV (Electronic Visit Verification) training so hours are logged accurately and compliantly
- Our staff is available to answer questions throughout the entire employment relationship
Ready to Get Started? We're Here to Help.
If your loved one already has a CHC Medicaid waiver and you want to become their paid caregiver, contact Dream Home Care LLC today. We'll walk you through every step — at no cost to you or your family.
📞 717-431-4083Dream Home Care LLC · Serving CHC/Medicaid LTSS Waiver Patients Across Pennsylvania
Frequently Asked Questions
Can I get paid to take care of my mother or father in Pennsylvania?
Yes. Through Pennsylvania's Community HealthChoices (CHC) Medicaid waiver, adult children can be hired as paid caregivers for their aging parents. You must be formally employed through an approved home care agency like Dream Home Care LLC, which handles payroll, taxes, and compliance.
What is the CHC waiver in Pennsylvania?
Community HealthChoices (CHC) is Pennsylvania's Medicaid managed care program for long-term services and supports (LTSS). It allows eligible individuals who need nursing-home-level care to receive that care at home through approved agencies, including the option to select a family member as their caregiver.
Can a spouse be a paid caregiver under CHC?
No. Pennsylvania's CHC program does not allow spouses to be compensated as caregivers. However, adult children, grandchildren, siblings, nieces, nephews, and close family friends may be eligible to serve as paid caregivers.
How much do family caregivers get paid in PA?
Compensation varies based on the number of approved service hours and the rate established by the managed care organization (MCO). Caregivers are paid weekly or bi-weekly via direct deposit for all documented, approved hours. Contact Dream Home Care LLC at (717) 431-4083 for current rate information.
What are the requirements to become a paid family caregiver?
You must be at least 18 years old, pass Pennsylvania criminal history and child abuse background checks, complete a TB screening, and finish agency-required orientation training. You must also be hired through an MCO-approved home care agency.
How does my parent qualify for the CHC waiver?
Your parent must meet two criteria: clinical eligibility (requiring nursing-home-level care based on a state assessment of their Activities of Daily Living needs) and financial eligibility (meeting Pennsylvania Medicaid income and asset limits). Both must be satisfied for the waiver to be approved.
Does getting paid as a caregiver reduce my parent's Medicaid benefits?
No. Being formally hired as a paid caregiver does not reduce your loved one's CHC benefits or approved care hours. It simply formalizes the caregiving work you are already performing and provides you with fair compensation.
How do I get started with Dream Home Care LLC?
Call Dream Home Care LLC at (717) 431-4083. If your loved one already has a CHC Medicaid waiver, we can begin the caregiver hiring process immediately. If they haven't applied yet, we'll help you understand what documentation to gather and guide you through the steps.