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Paid Family Caregiving FAQs
Eligibility & Waiver Program Basics
In Indiana, “Family Caregiving” under the Medicaid Home- and Community-Based Services (HCBS) waivers allows family members to be hired and paid to provide the daily-living assistance their loved one needs, so that person can remain safely at home rather than enter a facility. Eligibility and the exact hours are set by the Bureau of Disabilities Services after an assessment, and the provider agency (i.e. Guardian Care) handles training, payroll, and ongoing support. The process must start with a Area Agency on Aging (AAA) for everyone.
To qualify for a Medicaid Waiver in Indiana, your loved one must:
1) Be an Indiana resident and eligible for Medicaid based on income and assets,
2) Have a documented medical or developmental condition that requires a level of care typically provided in a facility (such as a nursing home or group home), and
3) Complete an assessment through the appropriate state agency (like the Bureau of Disabilities Services or Area Agency on Aging) to determine waiver eligibility and service needs.
Each waiver (e.g., Health & Wellness, PathWays for Aging, TBI) has specific criteria, but all aim to help individuals receive care at home rather than in an institution. If you have any questions, our Care Coordinators can help walk you through eligibility requirements to ensure you’re not missing any benefits.
In Indiana, the best way to find out which Medicaid Waiver applies to your situation is to start with an intake assessment through the appropriate agency:
For adults with physical or intellectual disabilities, contact the Bureau of Disabilities Services (BDS)
For older adults (60+), contact your local Area Agency on Aging (AAA).
For individuals with a traumatic brain injury, contact BDS or AAA, depending on age and needs.
These agencies will evaluate your loved one’s needs and guide you to the right waiver program, such as Health & Wellness, PathWays for Aging (60+), or TBI. Guardian Care can also help you get connected to the right agency.
In Indiana, Medicaid Waiver eligibility is based on the income and assets of the person needing care, not the entire household. This means your income as a caregiver usually does not affect your loved one’s eligibility. However, for minor children, parental income may be considered in some cases. An official Medicaid assessment will determine eligibility.
Your loved one will need to have a Level of Care assessment (LCAR) done to determine if they qualify for a Medicaid Waiver. This includes medical and functional evaluations to confirm they need care typically provided in a facility.
You’ll also need to submit documents like:
- Proof of Indiana residency
- Medicaid application or approval
- Medical records or diagnoses
- Income and asset information (for the person needing care)
If you become a paid caregiver, you’ll complete additional onboarding forms, background checks, and basic training.
- Non-waiver applicants: 4–6 weeks (max ~8 weeks)
- FSW/CIH waiver transfers: 2–4 weeks
You’re first approved for the Pathways or H&W Waiver (4–6 weeks). Medicaid takes another 4–8 weeks depending on your finances.
Care managers assess based on need:
- Level 1: 1–20 hrs/week
- Level 2: 21–40 hrs/week
- Level 3: 41+ hrs/week
It’s a flat daily payment when care is delivered, not based on hourly logs.
No. The caregiver must consistently meet daily care needs.
Caregiver Eligibility & Provider Guidelines
You may qualify to become a paid family caregiver through a Medicaid Waiver program if your loved one is eligible for services and needs help with daily activities (also known as: ADLs, Activities of Daily Living).
Depending on the waiver and assessed needs, approved family members—including parents of minor children, adult children, spouses, siblings, or other relatives—can be paid to provide care.
Eligibility is determined by the state after an assessment, and you must work with an approved provider agency like Guardian Care.
The key differences between these services are where the caregiver lives, how they are paid, and the level or type of care provided. In Indiana’s Medicaid Waiver programs:
Structured Family Caregiving is a live-in care model where a family caregiver (usually living with the person receiving care) provides daily support and oversight. The caregiver receives a daily stipend and ongoing training and support.
Attendant Care involves hands-on help with daily activities like bathing, dressing, or mobility. Caregivers (including some family members) are paid hourly, and do not have to live in the same home.
Personal Care Services are similar to Attendant Care but typically involve less complex tasks and may be provided under different waivers or service plans.
Home & Community Assistance, for helping with laundry, errands without client, cleaning house, “hands-off” tasks.
In Indiana, the only certifications you need to become a paid family caregiver through a Medicaid waiver are CPR & TB. However, you must complete basic onboarding requirements (such as background checks and caregiver training) through an approved provider agency like Guardian Care before you can begin providing paid care. Some specific programs, like Home Health Aide, have different training requirements.
Spouses, foster parents, significant others (not necessarily married), and household members can qualify.
Yes. These are part of the minimum requirements per Indiana Administrative Code.
Yes, you may request to change caregivers or provider agencies at any time.
Yes, if they all meet eligibility criteria.
Service Plan & Schedule
There is no strict cap if your client’s condition supports it. The exact number of hours is determined during the state’s Level of Care assessment (LCAR). Policies around caregiver hours are subject to change based on state and federal decisions. Guardian Care stays up to date on these shifts and will guide you through what applies at the time you enroll.
Your Medicaid Care Manager is your first point of contact. They help with service plans, supplies, and navigating Medicaid options.
No – PAC isn’t applicable for the waivers we service (H&W, PathWays, TBI). PAC hours are only applicable on SFW/CIH waivers.
ADLs and IADLs including:
- Bathing, grooming, dressing
- Toileting, feeding, mobility
- Household chores, light cleaning
- Transportation to non-medical activities
No skilled care (e.g., administering medications, tube feedings, or therapy tasks) may be logged under Attendant Care.
You can submit a detailed schedule and justification to the state. Approval depends on client need, not a fixed hour cap. However, your specific Notice of Assessment (NOA) dictates the amount of hours and which services for which a caregiver can be paid.
You may continue providing and logging unskilled care tasks, assuming no overlap with outside services.
Yes, if all qualify.
Yes, you can! In Indiana, you can be a paid family caregiver even if you work another job – as long as you’re able to provide the approved care hours for your loved one. We’ll work with you to create a schedule that fits your availability and meets your loved one’s needs.
Onboarding & Orientation
One of our Care Coordinators will contact you within 1–2 business days. We’ll help you understand any next steps, like connecting with your local Area Agency on Aging or completing an eligibility assessment. Once you’re on track, we’ll guide you through the entire process. Some steps depend on the state’s timeline, but we’ll keep you informed throughout the process.
Typically 3–5 business days. It can be done online or in person.
- Guardian Care culture, meeting your dedicated Care Manager
- Hygiene, safety, EVV setup
- Logging visits, using the mobile app or call-in system
- Understanding caregiver responsibilities
- How to raise questions, concerns or other
EVV & Documentation
You’ll use the EVV (Electronic Visit Verification) app to clock in/out, take breaks (e.g., for skilled care), and log tasks. No paper or faxing required.
You can use a toll-free number to call in and log time manually.
Not internationally, but domestically you can document hours as long as you’re actively providing care.
No. Medicaid prohibits two providers billing for care simultaneously. Log a break during these times.
Skilled vs. Unskilled Care
- Medication setup/injection
- Tube feeding
- Trach or catheter care
- Wound care
Even if you’re trained or licensed, skilled care must be logged as a break from Attendant Care duties.
Respite & Home Health Services
SFC provides 15 respite days per year, with care provided by someone familiar with the individual’s needs. Respite care needs a separate authorization from SFC. Reach out to your Medicaid Care Manager for more information.
You may request skilled respite through your waiver care manager.
They can occur on the same day but not concurrently or by the same caregiver.
Yes, if schedules don’t overlap and duties are separate.
No. That is considered a duplication of services and is not allowed.
Payroll, Benefits & Taxes
Paid family caregivers through Guardian Care are paid twice a month – half-way through the month and again on the last business day. Payments are made through direct deposit or paycard, depending on your preference. We’ll help you get set up during onboarding so your payments are smooth and on time.
2–3 weeks after Orientation. Then, at the middle and end of the month (on a business day).
Yes. In Indiana, caregiver pay through Guardian Care is considered taxable income. We withhold federal and state taxes from your paycheck, and you’ll receive a W-2 at the end of the year for tax filing. SFC is a contracted caregiver, who get a 1099. You can update your withholding preferences through UKG.
You can elect exemption in UKG if eligible. Consult a tax advisor first.
No, not currently.
It might. In Indiana, being a paid caregiver can affect benefits like SNAP, SSI, or SSDI depending on your household income and the type of benefits you receive. Every situation is different, so we recommend speaking with a benefits counselor to understand how your caregiver pay may impact other supports.