Can a live-in family member be a paid caregiver?

Tell us who lives in the home

Explain the relationship to the Medicaid member, whether the proposed caregiver shares the residence, and who else regularly helps. Virginia participation standards address payment to relatives under the same roof and require supporting documentation in the applicable circumstances.

A spouse or parent of a minor also needs review under the legally responsible individual rules. That is a separate issue from simply being a live-in relative.

Separate a shift from ordinary household life

Paid care follows the authorized plan and actual services delivered. Sleeping in the home, being available, and helping another household member are not automatically billable care. Ask the agency how the schedule and daily records should work in your situation.

If multiple people help, discuss how the approved tasks and shifts will be covered. Do not assume two caregivers can bill for the same time or that another relative can take over informally as an employee.

Live-in EVV requirements change October 1, 2026

DMAS has announced the end of the live-in exemption. Effective October 1, agency-directed aides and consumer-directed attendants providing the covered services must use an EVV-compliant way to record shifts. Ask your agency or fiscal employer agent which method applies.

Our EVV update links to the official bulletin. Do not rely on older online advice that living in the same home eliminates electronic visit verification.

Talk about the arrangement before expecting payment

A to Z can review the member’s authorization, relationship, and proposed caregiver’s qualifications. The discussion should happen before assuming a start date or income. Explore paid family caregiver options and check the member’s next step.