Getting paid to care for a family member in Tennessee
Depends.
In Tennessee, whether a family member can be paid depends on the program's rules, which are below with their sources.
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Medicaid waiver
CHOICES
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Who qualifies
Adults 65 or older, and adults 21 or older with a physical disability, who need help with daily living activities and qualify financially for Medicaid long-term services and supports (or receive SSI). To get home care instead of nursing home care (Group 2) you must need the level of care a nursing home provides. Group 3 is for people who do not need that level of care but are at risk of needing it unless they get home care.
To qualify financially, your income can't be more than $2,982 per month for 2026 (if it is, you may be able to set up a Qualifying Income Trust), what you own can't be worth more than $2,000 (the home where you live doesn't count), and you can't have given away or sold anything for less than it is worth in the last five years. As of July 1, 2025, Group 3 has an enrollment target of 3,750 for people who do not receive SSI.
CHOICES Group 2 and Group 3 members whose Care Coordinator finds, in a needs assessment, that they need Attendant Care, Personal Care Visits, In-Home Respite Care or Companion Care (Companion Care is for Group 2 only). You hire, train and schedule your own workers and are their employer, or you name a qualified Representative to do it for you.
Rule 1200-13-01-.05(9). Members must use the state's contracted fiscal employer agent for payroll and supports brokerage; TennCare names it as Consumer Direct Care Network Tennessee (CDTN). Your benefit does not grow because you choose Consumer Direction.
Depends.
Yes, with limits. You may hire family members other than your spouse. A family member is not paid for care they would otherwise have given without pay, and no one who lives with you can be paid for Personal Care Visits, Attendant Care or In-Home Respite Care. Companion Care cannot be given by an immediate family member or by anyone you live with or have lived with in the last five years.
Workers must be 18 or older and pass a background check. Your Representative for Consumer Direction cannot be paid for that role and cannot be your worker. For Companion Care, immediate family means a spouse, parent, grandparent, child, grandchild, sibling, or in-law, including adopted and step relatives.
Contact your local Area Agency on Aging and Disability (AAAD). It helps people not yet enrolled in TennCare apply. If you are already a TennCare member, contact your health plan: BlueCare 888-747-8955, UnitedHealthcare Community Plan 800-690-1606, Wellpoint 833-731-2153.
If you are in CHOICES Group 2 or 3 and assessed to need one of these services, you can choose Consumer Direction at any time. You complete a self-assessment tool that shows whether you need a Representative, and you sign a Consumer Direction participation form.
If you cannot make or communicate the decision, only a legally appointed representative can choose Consumer Direction for you.
