Wealth Wise is Kiplinger’s advice column on navigating retirement-related dilemmas. Got a question? See below for how to send it to us.
Dear Wealth Wise: My mother suffers from MS and now needs daily help. I’m starting to look into programs that will pay me to be a caregiver. Am I allowed to keep my regular job or will I be forced to quit? I’m a freelance consultant with flexible hours, but I can’t give up that income (or not easily). I assume the pay to be a caregiver isn’t great. — Squeezed
Dear Squeezed: As the U.S. population ages, a growing number of Americans are finding themselves thrust into a role they may not be prepared for — caregiving.
Sign up for Kiplinger’s Free Newsletters
Profit and prosper with the best of expert advice on investing, taxes, retirement, personal finance and more – straight to your e-mail.
Profit and prosper with the best of expert advice – straight to your e-mail.
Latest Videos FromKiplinger
AARP reports that one in four U.S. adults is a caregiver, with the majority caring for another adult. Additionally, one in three caregivers is under 50, which means they may be trying to balance providing care for a loved one with maintaining a career during their peak earning years and keeping up with retirement savings goals.
Here, we have a reader who wants to step in and care for her ailing mother. But every hour she spends providing care is an hour she can’t earn income through her consulting business.
While there are programs that may pay her to care for her mother, the question is: Will the income be enough to cover her lost wages? Here’s what our experts say someone in this situation needs to know.
You probably won’t have to quit your job
For people with strict working hours, juggling a full-time job and caregiving may not be possible. For someone with flexible hours who isn’t tethered to an office, it may be doable.
Faris Flournoy is the CEO at Flournoy Health Systems, a home care management company. And he says that in this situation, you definitely do not need to rush to quit your consulting job.
“One of the biggest misconceptions about family caregiving is that you have to choose between caring for your mother and keeping your career,” he says. “There are programs that may allow you to do both. Some states offer programs that compensate family caregivers while they continue working another job, particularly if they have flexible schedules.”
Before reducing your work hours, contact your state’s Medicaid office or Area Agency on Aging to determine exactly which caregiver programs are available, how many hours are covered, whether your parent qualifies and whether family caregivers are eligible for payment. Rules differ by state, so don’t assume a program available elsewhere is the same where you live.
Don’t expect caregiver pay to replace your income
As our reader correctly assumes, the wages associated with caregiver programs do not tend to be overwhelmingly generous. Plus, Flournoy cautions, “Many programs cap the number of paid hours, even if you are providing significantly more care than that.”
Flournoy explains that while being paid as a family caregiver can certainly help offset some of the financial burden, it’s rarely enough to replace a full-time income. And even with a flexible job, it may be challenging.
“Some caregiver programs require you to provide care during approved hours or meet minimum hour requirements, which can make managing another job more challenging,” Flournoy says. “Before making any financial decisions, get clear on exactly what the program expects, how many hours it will cover, and whether those requirements fit with your current work schedule.”
Flournoy also emphasizes the importance of looking out for your own financial best interests while trying to help.
“The financial impact of caregiving extends well beyond today’s paycheck,” he warns. “Many family caregivers reduce their work hours, pass on promotions, or leave the workforce entirely, which can affect retirement savings, Social Security benefits, and long-term financial security. Those are sacrifices families often do not anticipate until they are already making them.”
Evan Farr, Certified Elder Law Attorney and retirement planner, agrees that caregiving can have more long-term financial consequences than expected.
“While the immediate costs include lost income for this calendar year, the true cost includes compounded losses from reduced savings and reduced career longevity due to interrupted employment,” he insists.
Medicaid is what usually pays, but there are other solutions too
Medicaid: While getting paid to be a caregiver may be an option, there are requirements to meet. And one of those may be qualifying for Medicaid.
“Most paid family caregiver programs are funded through Medicaid, not Medicare, and each program has its own financial and medical eligibility requirements,” Flournoy says.
Depending on the program, some Medicaid caregiver payments may receive favorable federal tax treatment.
Flournoy commonly sees families land in situations where they’ve saved too much money to qualify for Medicaid but not enough to comfortably pay for ongoing home care.
Flournoy also says that for the most part, Medicare does not have paid caregiver programs in place, nor does it pay for custodial care — the ongoing personal assistance many people need with bathing, dressing, meal preparation, and other daily living activities.
Special cases: “Some Medicare Advantage plans, veterans’ benefits, and long-term care insurance policies may provide additional support, but families should not assume Medicare alone will cover long-term daily caregiving,” he says.
To be clear, some Medicare Advantage plans (Part C) cover limited in-home support services or respite benefits, but they generally do not pay family members as ongoing caregivers. They may, however, cover adult daycare.
Veterans’ benefits are available only if the care recipient is an eligible veteran (or, in some cases, a qualifying spouse).
Become your parent’s employee: Finally, if your mother has sufficient assets to pay you directly, you could consider setting up a personal care agreement. Your compensation must be set at a “reasonable” rate, or what you would typically pay someone else to do caretaking. The national average for non-medical in-home care was $35 per hour in 2025, according to CareScout. If you happen to be a trained nurse, you can charge more, or $90 per hour on average.
However, be aware of the “nanny tax.” If your parent hires you as a household employee, payroll tax rules may apply once annual wages exceed the IRS threshold. Check current IRS rules or consult a tax professional.
The devil’s in the details when it comes to Medicaid
A big reason not to rush into a caregiving arrangement is that the nuances can be complicated, Farr says. As he explains, it’s important to determine whether you can legally perform the authorized care within the authorized time frame and properly keep records of that care.
“Medicaid-paid family caregiving is not merely a family-arranged situation where Medicaid sends you a check. It is a regulated form of caregiving,” Farr insists.
“The mother must meet medical requirements and financial requirements to receive Medicaid-funded LTC,” Farr continues. “The state must also approve a care plan. The caregiver may be required to register through an agency, fiscal intermediary, or through the consumer-directed model.”
Farr says that, in addition, to become a caregiver, you’ll typically need a background check and training. You’ll also need to see how many hours of care Medicaid actually approves.
“One of the largest misconceptions is that the family decides what hours of care need to be performed and then expects Medicaid to pay for those hours,” Farr explains. “This is not how Medicaid-paid family caregiving works.”
Rather, Farr says, each state determines what hours are allowed in the approved care plan.
Flournoy says that one challenge of becoming a caregiver is that each state administers these programs differently.
“One of the biggest differences from state to state is how many caregiving hours are eligible for reimbursement. Documentation requirements also vary,” Flournoy says.
Some programs, he explains, require detailed time logs and care plans, while others have a more straightforward reporting process. Eligibility rules can also differ, including which family members can be paid.
“In some cases, spouses or legal guardians may not qualify,” Flournoy cautions.
Build a robust care plan for your mom — and a financial plan for yourself
While it may be possible to get paid to care for your mom, both Flournoy and Farr recommend looking beyond the caregiver paycheck and instead focusing on a holistic care plan.
“I have seen too many families spend valuable time searching for one program that will cover everything, when the better approach is combining the right services at the right time,” Flournoy says. He says that in this situation, a comprehensive plan may include personal care, skilled nursing, therapy services, hospice, and palliative care.
“The sooner families can identify what level of care their loved one needs and which programs can help along the way, the more flexibility they will have to build a care plan that supports both their loved one and their own financial stability,” Flournoy says.
Farr, meanwhile, recommends consulting with an experienced elder law attorney to ensure that your mother maintains eligibility for Medicaid benefits and advise on the legal side of things.
He also says it’s important to protect your family’s financial well-being in addition to your own.
To that end, you may want to sit down with a financial planner to discuss how your caregiving role may affect your long-term financial goals. Even if you’re able to continue working as a consultant, juggling both roles may force you to forgo income that impacts your retirement savings and future plans.
It’s noble to want to step in and help your mother. But it’s important not to sacrifice your financial security in the process.
Not all questions submitted will be published, and some may be condensed and/or combined with other similar questions and answers, as required editorially. The answers provided by our writers and experts in this advice column are for general informational purposes only. While we take reasonable precautions to ensure we provide accurate answers to your questions, this information does not and is not intended to constitute independent financial, legal, or tax advice. You should not act, or refrain from acting, based on any information provided in this feature. You should consult with a financial adviser regarding any questions you may have in relation to the matters discussed in this article.