Can Parents Be Paid Caregivers for Their Children?

Yes — many states allow parents to be paid caregivers for their children with disabilities through Medicaid waiver programs. This is especially common in programs designed for individuals with developmental disabilities, intellectual disabilities, autism spectrum disorder, and complex medical needs.

Historically, some states excluded parents of minor children from paid caregiver programs, but many have changed these rules. Parents of adult children with disabilities are generally eligible in most states.

Programs for Children with Disabilities

Several types of Medicaid programs may pay parents to care for a child with a disability:

• Medicaid HCBS Waivers for Children — targeted at children with complex medical needs or developmental disabilities
• Developmental Disabilities (DD) Waivers — available in most states for individuals with intellectual or developmental disabilities
• Technology-Dependent Children Programs — for children who require medical equipment like ventilators or feeding tubes
• Children's Medicaid Waiver Programs — state-specific programs for children who would otherwise require institutional care
• Katie Beckett / TEFRA Programs — allows children with disabilities to qualify for Medicaid based on their own income, not their parents'

The Katie Beckett Program

One of the most important programs for families of children with disabilities is the Katie Beckett option (also called TEFRA). This program allows children with significant disabilities to qualify for Medicaid based on their own income and assets — not their parents' income.

This is significant because many families with a disabled child earn too much to qualify for standard Medicaid, but their child's care needs are substantial. The Katie Beckett program removes the parental income barrier for Medicaid eligibility.

What Services Can Be Covered?

Once your child is enrolled in a Medicaid waiver program, the services covered depend on the specific program and your child's assessed needs. Common covered services include:

• Personal care and attendant services
• Respite care for family caregivers
• Behavioral support services
• Habilitation services (skill-building)
• Skilled nursing care at home
• Assistive technology and home modifications

Age Considerations

Rules differ for minor children versus adult children with disabilities. For minor children, some states require that the parent demonstrate that the care provided goes beyond typical parental duties. For adult children (18 and older), most states treat the parent-child relationship the same as any other adult family caregiver relationship.

If your child is approaching adulthood, it's important to plan ahead and transition to adult waiver programs before they age out of children's programs.

How to Apply

Start by contacting your state's Medicaid office or Department of Developmental Services to ask about waiver programs for children with disabilities. You can also reach out to your child's pediatrician or a social worker at your local hospital — they often have experience navigating these programs and can provide referrals.