Can Medicaid Pay You to Care for a Family Member in Texas?
Yes, in some cases. If your relative qualifies for Medicaid attendant care in Texas (through STAR+PLUS, Primary Home Care or Community Attendant Services), they can pick the Consumer Directed Services (CDS) option and hire their own attendant. That attendant can be an adult child, another relative, a friend or a neighbor. The relative can't be their spouse (with one exception), their legal guardian, or the person they appoint to run the CDS paperwork for them (Texas HHS). Medicare doesn't pay family caregivers.
Programs that can pay a family member
The person who needs care has to qualify for the program first. The family member is then hired through CDS. These are the Texas programs most relevant to older adults:
- STAR+PLUS: Texas Medicaid managed care for adults 21 and older with disabilities and people 65 and older. Personal assistance services can be delivered through CDS (STAR+PLUS Handbook §8200).
- STAR+PLUS HCBS: home and community services for people who would otherwise need a nursing home. In-home respite is also available through CDS (§8212).
- Primary Home Care (PHC): attendant help with bathing, grooming, meals and housekeeping for people with full Medicaid (HHS handbook §4600).
- Community Attendant Services (CAS): the same kind of attendant help for people who don't get regular Medicaid but have income at or under $2,982 a month (individual) and resources of $2,000 or less in 2026 (HHS Appendix XI).
For PHC and CAS, the person must score at least 24 on the HHS needs assessment and generally need at least six hours of help a week. A practitioner must sign a statement of medical need (§4633–4634). CDS is offered in all four programs (HHS, Employer Option).
CDS works only when the person lives in their own home or a family member's home. It isn't available in assisted living or adult foster care (§8212).
Who can and can't be paid
Under CDS, the person getting care (or their guardian) becomes the employer. Texas HHS lists the people who can't be hired (How CDS Works):
- the person getting services
- their spouse, except in the Consumer Managed Personal Attendant Services program
- their legally authorized representative, which for an adult means a court-appointed guardian
- the guardian's spouse
- the designated representative, if one is appointed, and that person's spouse
Two more rules from HHS Form 1726: in Primary Home Care and Community Attendant Services, the person's primary caregiver can't be the paid attendant. A common-law spouse counts as a spouse. Hiring someone who isn't allowed may count as Medicaid fraud, so check with the financial management services agency before anyone starts.
So an adult daughter, son, grandchild, sibling or friend can usually be hired, as long as they aren't the guardian or designated representative. Every worker must be 18 or older and pass the same criminal history and background checks as agency staff (Texas HHS).
How pay works
The employer chooses a financial management services agency (FMSA). The FMSA helps build the budget, runs payroll and pays employment taxes (HHS, Employer Option). The employer sets the wage within the budget and can use budget funds for raises or benefits (§8213.1).
We couldn't find an official family-caregiver wage. The closest official figure: HHSC's attendant rates starting Sept. 1, 2025 are built to support an average attendant wage of $13.00 an hour (HHSC Information Letter 2025-11). Your relative's actual pay depends on the budget and the hours approved.
How to apply in Dallas
- Call the Dallas ADRC (Aging and Disability Resource Center) for free help sorting out programs: 888-743-1202 or toll-free 855-937-2372. 1345 River Bend Drive, Suite 200, Dallas, TX 75247 (Texas HHS ADRC list).
- Apply for Medicaid online at Your Texas Benefits or by calling 2-1-1 (Texas HHS, STAR+PLUS). Income and asset limits are on paying for home care.
- Ask for an assessment for attendant services. Hours are set with Form H2060, the needs assessment (§8200).
- Ask for the CDS option. In STAR+PLUS, the health plan's service coordinator handles this. You'll pick an FMSA from a list.
- Hire your relative through the FMSA. They fill out the employment forms, including Form 1734 on relationships, and pass the background checks before they can be paid.
Veterans: Veteran Directed Care
VA's Veteran Directed Care program gives eligible veterans a budget to hire their own workers for help with bathing, dressing, meals and other daily tasks. Those workers can include a family member or neighbor (VA.gov). Start by asking a VA social worker. The VA pension with Aid & Attendance is a separate benefit that pays the veteran, not the caregiver. The VA's family caregiver programs are covered on does the VA pay for home care?
Medicare doesn't pay family caregivers
Medicare doesn't cover personal care such as bathing, dressing or using the bathroom when that's the only care someone needs, and it doesn't pay for 24-hour care at home (Medicare.gov). It has no program that pays relatives for this help. More: does Medicare pay for home care?
Frequently asked questions
Can Medicaid pay me to take care of my mother in Texas?
Possibly. If your mother gets Medicaid attendant care through STAR+PLUS, Primary Home Care or Community Attendant Services, she can choose the Consumer Directed Services (CDS) option and hire her own attendant, including an adult child. You can't be hired if you are her court-appointed guardian (Texas HHS).
Can a spouse be paid as a caregiver under Texas Medicaid?
Generally no. Texas HHS says the spouse of the person getting services can't be hired under the CDS option. The exception is the Consumer Managed Personal Attendant Services (CMPAS) program.
How much does Texas Medicaid pay a family caregiver?
There is no set family-caregiver wage. In CDS, the employer sets the attendant's pay within the service budget. HHSC's attendant rates effective Sept. 1, 2025 are designed to support an average attendant wage of $13.00 an hour (HHSC Information Letter 2025-11).
Does Medicare pay family members to be caregivers?
No. Medicare doesn't pay for personal care like bathing and dressing when that's the only care someone needs, and it has no program that pays relatives for that help (Medicare.gov).
Can the VA pay a family member to be a caregiver?
Yes, through Veteran Directed Care. Eligible veterans get a budget and can hire their own workers, which can include a family member or neighbor (VA.gov). Ask a VA social worker whether the program is available to you.
Related guides
- Does the VA pay for home care?
- Does long-term care insurance pay for home care?
- Paying for home care in Dallas
- Does Medicare pay for home care?
- Dallas home care cost
Sources
- Texas HHS, How Consumer Directed Services Works
- Texas HHS, Form 1726, CDS Relationship Definitions (PDF)
- Texas HHS, STAR+PLUS Handbook §8200, Consumer Directed Services
- Texas HHS, STAR+PLUS
- Texas HHS, CDS Employer Option
- Texas HHS, Community Care Services Eligibility Handbook §4600, PHC and CAS
- Texas HHS, Appendix XI, 2026 Income and Resource Limits
- Texas HHSC, Information Letter 2025-11, attendant rates effective Sept. 1, 2025 (PDF)
- Texas HHS, Find an ADRC
- Your Texas Benefits
- VA.gov, Veteran Directed Care
- Medicare.gov, Home health services
This is general information, not medical, legal or financial advice. Prices, ratings and program rules change, so confirm with the agency, the VA or Texas HHS before you decide. No agency pays to appear on this site.