Structured Family Caregiving in Indiana: Get Paid To Care For A Family Member

Yes. This is one of the things that sets Indiana apart. Under Structured Family Caregiving specifically, a spouse who lives with the participant can be the paid caregiver and receive the daily stipend. That is different from Indiana's hourly Attendant Care benefit, where spouses are not allowed to be paid - a distinction that trips up a lot of families. So if a husband or wife needs daily hands-on help and the two of you live together, SFC is usually the right path for a spouse to get paid, not Attendant Care. Beyond spouses, adult children, siblings, grandchildren, nieces, nephews, in-laws, and even close friends can serve as the paid SFC caregiver, as long as they share the home and pass a background check. The one non-negotiable rule is that the caregiver and the participant must live together full time.

SFC pays a daily stipend rather than an hourly wage. As of 2025, Indiana Medicaid reimburses SFC agencies roughly $77.54 per day at Level 1, $99.71 at Level 2, and about $131 at Level 3, with the level set by a care assessment of how much help the participant needs. The agency keeps a share for coaching and oversight and passes the rest to the caregiver - commonly 50% to 65% - so a caregiver stipend often lands somewhere around $45 to $85 per day, or roughly $1,300 to $2,500 per month. Because the caregiver lives in the same home as the participant, the stipend usually qualifies as tax-free "difficulty of care" income under IRS Notice 2014-7, which can make it worth more than an equivalent taxable wage. These are approximate ranges; your exact stipend is set by your SFC agency and the assessed level, so confirm the current figure with the agency you choose.

Plan for a few months from start to finish. The Medicaid eligibility determination alone can take up to about 90 days, and that runs alongside the functional assessment your Area Agency on Aging arranges to confirm a nursing-facility level of care. If a waiver waiting list applies - which is common for the PathWays for Aging Waiver - you may wait additional weeks or months for FSSA to send an invitation letter to complete enrollment. Once you have a waiver slot and have chosen an SFC agency, getting the caregiver set up (background check, care coach assignment, and paperwork) usually takes a couple of weeks. You can move faster by gathering documents early: proof of Indiana residency, identification, Social Security numbers, and financial records showing income and assets. Starting the Medicaid application and calling your AAA on the same day is the best way to keep both tracks moving in parallel.

No professional license or certification is required to be an SFC caregiver. You do not need to be a CNA, home health aide, or nurse. What Indiana requires is that the caregiver be at least 18, be physically and mentally capable of providing the care, and pass a criminal background check through the SFC agency. The agency provides orientation and ongoing support through a care coach or nurse who checks in regularly, answers questions, and helps the caregiver handle changing needs. The caregiver is also expected to keep a daily care log or notes documenting the support provided, which the agency reviews. This coaching relationship is a core part of SFC and is meant to make family caregiving sustainable and safe - not to gatekeep it behind a clinical exam. Families who have been quietly caring for a relative for years often find they already do most of what SFC asks.

Both are Indiana Medicaid waiver services that can pay a family member, but they work differently. Structured Family Caregiving pays a flat daily stipend to one live-in caregiver, goes through an SFC agency with a care coach, and allows a spouse to be paid; the stipend is usually tax-free because the caregiver lives with the participant. Attendant Care pays by the hour (roughly $13 to $20 per hour) for a set number of Medicaid-authorized hours, does not require the caregiver to live in the home, and does not allow a spouse to be the paid caregiver - though adult children and other relatives can be. Attendant Care wages are generally taxable. Which one fits depends on your situation: full-time live-in caregiving by a spouse points to SFC, while part-time help from an adult child who lives elsewhere may fit Attendant Care better. Some families evaluate both with their case manager before deciding.

Yes - for Structured Family Caregiving, sharing a home is required. The caregiver and the participant must live together full time in one household, which can be either the caregiver's home or the participant's home. This shared-residence rule is central to how SFC is designed: the program assumes the caregiver is providing around-the-clock live-in support, which is also why it pays a daily stipend instead of hourly wages and why the payments usually qualify as tax-free difficulty-of-care income. If you cannot or do not want to live with the person you care for, SFC will not fit, but Indiana's hourly Attendant Care benefit under the same waivers does not have a live-in requirement and may be an option for an adult child or other relative (though not a spouse). Your Area Agency on Aging case manager can help you figure out which service matches your living arrangement.

Not necessarily. Indiana allows an SFC caregiver to hold an outside job, but caring for the participant must be their main priority. In practice, that means the arrangement has to genuinely work: the participant needs reliable daily support, and the care coach will be checking that it is happening. If the participant's needs are heavy enough that they truly require full-time attention, an outside full-time job may not be realistic. But many caregivers manage part-time or flexible work alongside SFC, especially when the participant is more independent during certain hours. It is worth being honest with the SFC agency about your work situation up front so they can help structure things appropriately and confirm the participant's needs are covered. Keep in mind the SFC stipend itself is modest and paid daily, so families often think of it as support for caregiving they are already doing rather than a full replacement for a salary.

For most SFC caregivers, the stipend is tax-free. Because SFC requires the caregiver to live in the same home as the Medicaid participant, the payments generally qualify as "difficulty of care" payments under IRS Notice 2014-7. That notice excludes qualifying Medicaid waiver payments made to a caregiver who lives with the care recipient from federal gross income, and Indiana follows the federal treatment for state income tax. This is a meaningful advantage: a tax-free daily stipend can be worth noticeably more than the same amount paid as a taxable wage. That said, tax situations vary, and the exclusion depends on the caregiver and participant genuinely sharing a home. The SFC agency that processes the payments can tell you how they report the stipend and whether they treat it as difficulty-of-care income. For anything complicated - for example, if living arrangements change during the year - it is worth checking with a tax professional so the exclusion is applied correctly.