How to Get Paid to Care for a Family Member in Indiana

If you're reading this, there's a good chance you're already doing the work. You're the one who picks up the prescriptions, who notices when Mom seems more confused than last week, who sleeps with one ear open in case Dad gets up in the night. Nobody hired you. Nobody trained you. It just became your job, the way it does for millions of families.

Here's the part most people in Indiana don't know: the state will pay you for that care. Not as a favor, and not as charity — through an established Medicaid program built specifically to keep older and disabled Hoosiers at home instead of in a nursing facility. The pay is weekly, and for most family caregivers, it's tax-free.

This guide walks through exactly how that works in 2026: which program does it, who qualifies, how much it pays, how long it takes, and the one requirement that trips most families up. We'll be honest about the parts that are slow or frustrating, because pretending otherwise helps no one.

The Program That Pays Family Caregivers

The program is called Structured Family Caregiving, or SFC. It's funded by Indiana Medicaid and designed around a simple idea: when someone needs daily help to stay safely at home, the person already providing that help — usually a family member — should be supported and paid, rather than replaced by a stranger or a facility.^[1]

Under SFC, a primary caregiver lives with the person who needs care and provides their daily support. In return, the caregiver receives a flat daily stipend. It is not an hourly wage and there is no timesheet. The program assumes that when you live with and care for someone who needs assistance, you're effectively on call around the clock, so it pays a set daily rate instead of asking you to clock in and out.^[2]

SFC isn't a standalone benefit you sign up for at a desk. It's a service offered through several of Indiana's Medicaid Home and Community-Based Services (HCBS) waivers — most commonly the PathWays for Aging Waiver (for those 60 and older) and the Health and Wellness Waiver (for those 59 and younger with disabilities).^[3] We break these down in our guide to Indiana's Medicaid waivers explained, because understanding them is how you understand whether your family qualifies.

Who Qualifies: The Caregiver and the Person Receiving Care

Indiana is more generous than most states about who can be paid. The caregiver must:

• Be at least 18 years old
• Be physically and mentally capable of providing the care
• Pass a criminal background check
• Live full-time in the same home as the person receiving care^[4]

Within those rules, a wide range of people qualify. Adult children caring for a parent. Siblings. Grandchildren. Nieces and nephews. Even close friends who live with the person. And unlike many states, Indiana allows spouses to be paid caregivers under SFC.^[5] If you're caring for a husband or wife who needs daily help and you live together, you may qualify — which is not true in states like Georgia or Massachusetts, where spouses are barred from this kind of compensation.^[6] We walk through the spousal rules in detail in can I get paid to care for my spouse in Indiana?

The live-in requirement is the one that surprises people, so sit with it for a moment: to be paid through SFC, you have to live with the person you care for. If you drive across town every day to help your mother but you each keep your own home, SFC isn't the right fit — though another program, Attendant Care, might be. More on that distinction shortly.

The other half of the equation: who qualifies to receive the care

The other half of the equation is the person receiving care. They must:

• Be an Indiana resident
• Be enrolled in Indiana Medicaid and qualify for an HCBS waiver
• Meet a nursing facility level of care — meaning, without help, they'd need the kind of care a nursing home provides^[7]

In practice, "nursing facility level of care" usually means the person needs hands-on help with the activities of daily living — things like bathing, dressing, eating, using the bathroom, or moving safely around the house. A nurse assessment, arranged through the program, determines whether the person meets this threshold and, if so, how much help they need.^[8]

There are also financial limits, because this is a Medicaid program. In 2026, the income limit for an applicant is generally around $2,982 per month, and the asset limit is generally $2,000 for an individual.^[9]

If those numbers sound impossibly low, don't stop reading. Income and asset limits come with a lot of nuance — a non-applicant spouse's income usually isn't counted, certain assets like a primary home and a car are typically exempt, and Indiana offers a "spend-down" pathway and Medicaid-compliant trusts that help many families who are slightly over the limit still qualify.^[10] We cover the 2026 Indiana Medicaid income and asset limits in detail separately. Whether your family qualifies financially is rarely as simple as the headline number suggests, and it's worth getting a real answer rather than assuming.

How Much Does It Pay?

SFC pay is tiered. After the nurse assessment, the care recipient is assigned one of three care levels, and each level carries a fixed daily rate the state pays the agency. As of 2025, those rates are $77.54 per day (Level 1), $99.71 per day (Level 2), and $133.44 per day (Level 3) — set by the Indiana Health Coverage Programs.^[9] We break down what each tier means, and how to move up one, in the 3 SFC payment levels in Indiana.

Here's the part that matters most and that most families never learn: that daily rate is paid to the licensed provider agency, not directly to you. The agency keeps a portion to cover oversight, training, and compliance, and passes the rest to you. But Indiana now sets a floor on how much they must pass along. Under a 2025 state rule, SFC providers must pass at least 60% of the daily rate through to the caregiver.^[10] Some agencies pass through more, which is one of the few things families can actually compare when choosing a provider.

At the highest tier, before the agency's share, the daily rate works out to roughly $930 a week.^[9] What you actually receive depends on your tier and how much above the 60% minimum your agency passes through.

And then there's the tax advantage, which is genuinely significant. For caregivers who live in the same home as the person they care for, SFC stipends are usually treated as "difficulty of care" payments under IRS Notice 2014-7, which are excluded from federal income tax.^[11]

The IRS will treat certain Medicaid waiver payments as difficulty of care payments excludable from gross income... as long as the individual care provider has the same home as the eligible person receiving care.

That exclusion changes the math more than people realize. A taxable $48,000 of income might leave you with substantially less after federal and state tax. If the same amount qualifies for the difficulty-of-care exclusion, far more of it stays in your household.^[11] We always recommend confirming your specific situation with a tax professional, since the exclusion depends on living arrangements and individual facts — but for most live-in family caregivers, this is a real advantage.

The One Requirement Families Always Miss: You Need a Licensed Provider

Here is the rule that catches almost everyone off guard. Indiana Medicaid does not pay family caregivers directly. You cannot sign up for SFC on your own, bill the state, and collect a check. The state pays licensed provider agencies, and the agency handles your payment, your tax paperwork, the required home visits, and compliance with the program's rules.^[12]

In other words, to be paid through SFC, you have to work with an approved agency. The caregiver becomes a contractor through that agency, and the agency becomes the link between your family and the state Medicaid system. Without one, you can't participate.

This isn't red tape for its own sake. The agency structure is what lets the state verify that care is actually being delivered, that caregivers are trained and background-checked, and that the program is being run honestly. A caregiver coach or registered nurse from the agency visits regularly to check in, update the care plan, and make sure things are going well.^[13] For a stressed family, a good agency is the difference between drowning in paperwork and simply being supported.

We'll be straight with you about our role here: Tender Home Care is one of those licensed agencies. We're not the only one, and later in this series we compare the major Indiana SFC providers honestly, including where larger competitors have advantages we don't. We do make two promises worth knowing: we'll match any competitor's caregiver pay rate, and new caregivers who enroll with us receive a $250 sign-up bonus. But the takeaway for this guide is structural, not promotional: whoever you choose, you'll need a provider to access SFC at all.

How Long Does It Take?

This is where honesty matters most, because the other agencies' websites tend to gloss over it.

For many families, enrollment takes around six weeks. For others, it takes several months, and in some cases longer than a year.^[14] The variability comes down to a few things: how quickly your loved one's Medicaid eligibility can be confirmed, how fast the nurse assessment gets scheduled, and — the big one — whether there's a waitlist for the waiver you need.

As of early 2026, more than 11,000 seniors were on the waiting list for the PathWays for Aging Waiver, with the state inviting people from the list month by month.^[15] Someone transitioning home from a nursing home or hospital is given priority. The waitlist is real, and a provider who promises you'll be paid in two weeks flat is not being straight with you. The honest answer is that timelines vary, and the best thing a good provider does is keep you moving and keep you informed through the wait. For a stage-by-stage breakdown, see how long Indiana Medicaid and SFC approval takes.

When SFC Isn't the Right Fit

Plenty of families read this far and realize SFC isn't built for their situation. That's worth saying plainly.

SFC won't work if:

• You don't live with the person you care for. The live-in requirement is firm. If you provide daily care but maintain separate homes, look at Attendant Care instead, which pays hourly and doesn't require cohabitation.
• Your loved one doesn't meet nursing facility level of care. If they're largely independent and need only occasional help, they may not qualify yet — though needs change, and a reassessment later may tell a different story.
• Your loved one isn't Medicaid-eligible and can't become so. SFC is a Medicaid program. If income or assets are far above the limits and can't be brought into range through legitimate planning, this pathway may be closed.
• You need around-the-clock skilled medical care — IV therapy, ventilator management, complex wound care. SFC is daily personal care and supervision, not skilled nursing.

None of these are reasons to give up. They're reasons to get an honest assessment of your specific situation rather than assuming either a yes or a no.

Why Indiana Built This

It helps to understand that SFC exists because the state wants it to. In July 2024, Indiana launched PathWays for Aging, a Medicaid managed care program now serving more than 123,000 Hoosiers aged 60 and older.^[16] The explicit goal was to make it easier for older residents to stay in their own homes rather than enter institutions. In the words of FSSA Secretary Dan Rusyniak, M.D.:

Now, individuals need only one point of contact for assistance, making it easier for more Hoosiers to stay in their homes, surrounded by family and friends.

The reasoning is partly compassionate and partly financial. The average nursing home in Indiana costs roughly $7,885 a month.^[17] Keeping someone at home with a family caregiver costs the state far less and, by most measures, produces better outcomes for the person being cared for. SFC is how Indiana puts that preference into practice — by paying the people the evidence consistently identifies as the most committed caregivers a person can have: their own family.

What This Means for Your Family

If you're already providing daily care for an aging parent, a spouse, or another loved one in Indiana, the question isn't really whether you're qualified to do the work. You're already doing it. The question is whether your family meets the program's requirements, and whether getting paid for that care would change what's possible — fewer hours at a second job, a little breathing room in the budget, the ability to keep doing this without quietly going broke.

That's the conversation worth having. At Tender Home Care, we help Indiana families figure out whether SFC is a fit, handle the Medicaid paperwork, and manage the program side so you can focus on your loved one. We'll tell you honestly if it's not right for your situation. The conversation costs nothing, and you're under no obligation to enroll.

Sources

1. [1] Indiana Family and Social Services Administration (FSSA). "Structured Family Caregiving (SFC)." Office of Medicaid Policy and Planning fact sheet, 2025. Link.

2. [2] Indiana FSSA. "Structured Family Caregiving and Home Health Services FAQ." 2024. Link.

3. [3] Indiana FSSA. "Medicaid Strategies: PathWays for Aging and HCBS Waivers." 2026. Link.

4. [4] Indiana FSSA. "Structured Family Caregiving Frequently Asked Questions for Waiver Individuals and Families." 2024. Link.

5. [5] Indiana FSSA. "Attendant Care and Structured Family Care Relationship Guidance." Per Indiana Code 12-10-17.1-10(b). Link.

6. [6] Internal Revenue Service. "Certain Medicaid Waiver Payments May Be Excludable From Income (Notice 2014-7).". Link.

7. [7] Indiana FSSA. "Structured Family Caregiving Frequently Asked Questions for Waiver Individuals and Families." 2024. Link.

8. [8] Indiana FSSA. "Providing Structured Family Caregiving — Provider Training." 2024. Link.

9. [9] Indiana Health Coverage Programs. "Bulletin BT2025105: IHCP updates policy regarding direct caregivers for personal care services." July 10, 2025. Link.

10. [10] Indiana Health Coverage Programs. "Bulletin BT2025105," per House Enrolled Act (HEA) 1120. July 10, 2025. Link.

11. [11] Internal Revenue Service, Taxpayer Advocate Service. "Certain Medicaid Waiver Payments May Be Excludable From Income.". Link.

12. [12] Indiana FSSA. "Structured Family Caregiving (SFC)." 2025. Link.

13. [13] Indiana FSSA. "Structured Family Caregiving (SFC)" — caregiver coach and quarterly RN home visits. 2025. Link.

14. [14] Indiana Capital Chronicle. "PathWays for Aging launches for 123,000 eligible senior Hoosiers." July 2, 2024. Link.

15. [15] Medicaid Planning Assistance (American Council on Aging). "Indiana Pathways for Aging Program — waiting list data." 2026. Link.

16. [16] Indiana FSSA. "FSSA announces launch of Indiana PathWays for Aging Medicaid managed care program." 2024. Link.

17. [17] Genworth/CareScout Cost of Care Survey, Indiana nursing home data, 2024–2025. Link.