Key takeaway
Utah offers several paid caregiver paths through Medicaid waivers, the Personal Care Services benefit, and federal VA programs.
- Medicaid: The Aging Waiver and New Choices Waiver fund in-home support for adults who would otherwise need nursing-home care.
- Personal Care Services: A Medicaid state plan benefit that authorizes hours of attendant care, including through family.
- Veterans: Aid & Attendance and Veteran Directed Care can pay family caregivers; VDC can pay spouses.
- Private: Long-term care insurance may reimburse family caregivers if policy terms allow.
Overview
Utah's Department of Health and Human Services oversees Medicaid and aging programs that help families care for older adults and adults with disabilities at home. The Aging Waiver and New Choices Waiver are the two HCBS waivers most commonly used to pay family caregivers, while the Personal Care Services benefit provides attendant hours under the Medicaid state plan.
Most paid-caregiver paths require the care recipient to meet a nursing-home level of care and to qualify financially. Adult children, grandchildren, and other relatives may typically be paid; spouses are generally excluded under Medicaid but may be eligible under VA Veteran Directed Care. Utah also funds limited state and Older Americans Act programs for residents not yet on Medicaid.
Programs that pay family caregivers in Utah
| Program (Type) | Care recipient eligibility | Paid family caregiver provisions |
|---|---|---|
| Aging Waiver (Medicaid HCBS Waiver) | Age 65+ who would otherwise need nursing-facility care; income up to ~300% of SSI; assets generally ≤ $2,000 for an individual. | Funds personal care, attendant services, homemaker, respite, and adult day. Family members may serve as paid caregivers through approved providers; spouses are not allowed. |
| New Choices Waiver (Medicaid HCBS Waiver) | Adults transitioning from a nursing facility or licensed assisted living to community living; meets level of care; financial criteria similar to Aging Waiver. | Provides personal care, attendant services, and supportive housing assistance. Family members may be hired as caregivers. |
| Personal Care Services (Medicaid state plan) | Medicaid-eligible adults who need help with activities of daily living; functional assessment required. | Authorizes attendant care hours. Family members other than spouses or legal guardians may be paid. |
| Aid & Attendance Pension (VA benefit) | Wartime veteran or surviving spouse who needs help with activities of daily living and meets VA pension income/asset rules. | Increases pension to help pay for in-home care; can pay adult children and other relatives. Spouses not paid directly. |
| Veteran Directed Care (VDC) (VA program) | Veteran in VA health care who needs nursing-home level care and lives near a participating VAMC (e.g., Salt Lake City). | Provides a flexible monthly care budget to hire caregivers, including spouses. |
| Long-Term Care Insurance (Private) | Policy must cover in-home personal care and pay benefits to the policyholder or chosen provider. | May reimburse a family caregiver if terms allow. Otherwise a licensed agency may be required. |
Utah Medicaid programs
Utah Medicaid funds long-term services and supports through HCBS waivers and state plan benefits. The Aging Waiver, New Choices Waiver, and Personal Care Services are the main routes a family member can be paid for caregiving at home.
Aging Waiver
The Aging Waiver supports adults age 65 or older who would otherwise need nursing-facility care but want to stay home. It funds personal care, attendant services, homemaker, respite, adult day, and home modifications.
- Age 65 or older with documented need for nursing-home level of care.
- Income limits up to ~300% of the SSI federal benefit rate.
- Asset limit generally ≤ $2,000 for an individual.
- Family members other than spouses or legal guardians may be hired.
New Choices Waiver
New Choices supports adults transitioning from a nursing facility or licensed assisted living back into the community. It also serves adults at risk of institutional placement.
- Must meet nursing-facility level of care.
- Common pathway for residents currently in a facility who want to come home.
- Family caregivers may be hired through approved providers.
Personal Care Services
Personal Care Services is a state plan benefit that authorizes attendant care hours for Medicaid-eligible adults who need help with daily activities.
- No waitlist in most cases since this is a state plan benefit.
- Functional assessment determines authorized hours.
- Family caregivers other than spouses may serve as paid attendants.
State-funded and aging network options
For Utahns who are not yet Medicaid-eligible, the Division of Aging and Adult Services and local Area Agencies on Aging coordinate limited state and federal aging services.
Offers respite, training, and limited financial assistance to family caregivers of older adults under the Older Americans Act.
Utah's state-funded alternative to nursing-home care for older adults who do not yet qualify for Medicaid waivers but still need in-home help.
Who qualifies
- Utah residents 60 or older or adults with disabilities who need help with daily activities.
- Households above strict Medicaid thresholds but unable to fully afford private care.
- Family caregivers who need respite or training support.
Veterans' programs
Veterans in Utah and their surviving spouses can fund in-home care and pay family caregivers through VA benefits. The two main paths are Aid & Attendance and Veteran Directed Care.
Aid & Attendance Pension
A&A increases the VA pension for qualifying veterans (or surviving spouses) who need help with daily activities. The payment goes to the veteran, who can use it to pay a family caregiver.
- Wartime service, financial limits, and documented care needs required.
- Adult children and relatives can be paid.
- A spouse cannot be paid directly because household income is combined.
Veteran Directed Care (VDC)
VDC provides a VA-funded monthly budget that the veteran manages. The Salt Lake City VA Medical Center may participate, though local capacity determines availability.
- Requires nursing-home level of care and VA health care enrollment.
- Self-directed with a financial management services provider.
- Spouses may be paid caregivers under VDC.
Long-term care insurance
A qualifying long-term care insurance policy may pay benefits that the policyholder can use to compensate a family caregiver. Coverage details vary widely.
What to check in the policy
- Confirm coverage includes in-home personal care, not just facility care.
- Determine whether benefits are paid to the policyholder (cash/indemnity) or only to licensed agencies.
If the policy only reimburses licensed agencies, some families set up a small licensed home care agency under Utah licensing rules so benefits can flow to the family caregiver.
How to apply in Utah (step-by-step)
- Decide which path fits best: Aging Waiver, New Choices Waiver, Personal Care Services, state-funded Alternatives, VA benefits, or LTC insurance.
- Gather documents: ID, Social Security number, proof of income and assets, medical records, medication list, and military service records if applicable.
- Contact the right agency:
- Aging Waiver / New Choices / Personal Care Services: apply through the Utah Department of Health and Human Services Medicaid Long-Term Care office.
- State-funded supports: contact the Division of Aging and Adult Services or your local Area Agency on Aging.
- VA paths: contact the Salt Lake City VAMC or a Utah Veteran Service Officer.
- LTC insurance: call the insurer to confirm caregiver-payment rules and documentation.
- Complete the level-of-care assessment and financial review.
- Select your family caregiver, complete background checks and required training, and enroll with the provider or fiscal agent.
- Begin services. Submit time sheets, keep care logs, and prepare for annual reassessment.
Utah paid caregiver FAQs
What is the difference between the Aging Waiver and the New Choices Waiver in Utah?
The Aging Waiver serves adults age 65+ who want to remain at home, while the New Choices Waiver focuses on people transitioning out of a nursing facility or licensed assisted living. Both can fund family caregivers through approved providers.
Can a spouse be paid as a caregiver in Utah?
Not through Medicaid waivers or Personal Care Services. Veteran Directed Care, however, can pay spouses for eligible veterans.
How long does it take to be approved?
Typical timelines run 60 to 120 days, depending on the assessment schedule, waitlist activity for waivers, and the documentation gathered.
Do I need a license to be a paid family caregiver in Utah?
Formal licensure is not usually required for personal care attendants, but background checks, basic training, and provider enrollment are mandatory.
Can I be paid through Medicaid to care for my parent in Utah?
Yes. If your parent qualifies for the Aging Waiver, New Choices Waiver, or Personal Care Services, you can be hired as their paid caregiver through an approved provider.
