Getting Paid to Care for a Family Member in Florida (SMMC-LTC / PDO)

Florida's Medicaid long-term care program lets SMMC-LTC enrollees choose the Participant-Directed Option, which can pay a family member — including a spouse — to provide care.

Program name
Participant-Directed Option (PDO) within Florida's SMMC-LTC
Can a spouse be paid?
Yes

Florida is one of the few states where a spouse can be paid as a Medicaid caregiver through the Participant-Directed Option — a genuine exception compared to most other states.

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Three quick questions. Pick what matters most right now and we'll help you find your next step.

1. What is your relationship to the person you care for?

What the Participant-Directed Option is

The Participant-Directed Option (PDO) lets a Florida Medicaid long-term care enrollee choose and direct their own caregiver. That includes hiring a family member — and, unlike most other states, Florida also allows a spouse to be paid through this option under the Statewide Medicaid Managed Care Long-Term Care program (SMMC-LTC).

Could your family member qualify?

  • Must be enrolled in Florida Medicaid's SMMC-LTC program.
  • As of 2026, a single applicant's monthly income generally cannot exceed $2,982, with countable assets capped at $2,000.
  • If married, spousal impoverishment protections apply and the rules are more complex.

Not sure about any of these? Don't guess.

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Can you be the paid caregiver?

  • Family members, including spouses, can be paid under PDO — a genuine exception compared to most other states.
  • Must pass required background checks and be legally authorized to work in the U.S.
  • Must accept the Medicaid hourly compensation rate for the service provided.

Are you the spouse of the person receiving care?

Spousal rules vary a lot by state and by program — don't assume you're disqualified or automatically eligible.

See the spouse answer for this state

How pay works

Florida's Medicaid-funded caregiver rate was raised to a minimum of $15 per hour (as of a 2022 increase; confirm the current rate for the year you are applying).

Ready to apply? Here's where to start

  1. Confirm the care recipient's Medicaid/SMMC-LTC eligibility, or apply through Florida Department of Children and Families (DCF).
  2. Request a long-term care assessment through your local Aging and Disability Resource Center (ADRC).
  3. Once approved, select the Participant-Directed Option through your managed care plan.
  4. Identify and designate the family caregiver (spouse or otherwise).
  5. Complete required background checks and enrollment.
  6. Begin services, and keep ongoing documentation of hours for renewals and audits.

Getting approved is only part of it. Family caregivers often need to keep track of care hours, documents, reassessment dates and other benefits — FeatherKeep helps keep that organized in one place.

See how FeatherKeep helps

A note on program stability

Federal Medicaid funding changes taking effect from late 2026 onward may affect optional home-and-community-based programs like this one over time. Check the current program status directly with Florida's Agency for Health Care Administration.

What you'll need to keep track of once approved

  • Timesheets and hours submitted to the managed care plan.
  • Background check and enrollment records.
  • Ongoing eligibility documentation for renewals.

Keeping this organized

Once approved, keeping accurate timesheets and documentation for renewals is an ongoing responsibility. FeatherKeep organizes this automatically as you go.

Questions about getting paid to care for a family member in Florida

Don't qualify for this program? Don't stop here.

A no on one program doesn't mean a no everywhere. These are the other categories most worth investigating — a case manager or the free benefits check can tell you which apply to your situation.

  • Medicaid home- and community-based services generally — other programs and self-directed options may fund in-home support even where this one doesn't fit.
  • Respite support — short-term relief so you can rest, sometimes funded separately from ongoing care. How respite care works
  • Veterans benefits — if the person you care for is a veteran, veterans' caregiver programs run on their own rules and eligibility.
  • Tax-related caregiver benefits — credits and deductions you may be able to claim, which is a different question from being paid.
Check what else you may qualify for

Next steps

Other states

This is general information to help you get started — not legal or financial advice.Participant-Directed Option (PDO) within Florida's SMMC-LTC rules and payment rates in Florida change, so Florida Agency for Health Care Administration or your local Area Agency on Aging can confirm the current details before you apply.