How to Get Paid to Care for a Parent in Tennessee (2026): TennCare CHOICES

ElderHearth offers general information, not financial, tax, or legal advice. Program rules and pay change, so confirm the details with TennCare or your CHOICES care coordinator.

If you are caring for an aging parent in Tennessee, the state's Medicaid program can pay you for it. The main route to get paid to care for a parent in Tennessee is TennCare CHOICES, which offers a consumer-directed option that lets your parent hire and direct their own caregiver, and an adult child can fill that role. This guide covers how CHOICES works, who qualifies, what it pays, and how to apply.

How to get paid to care for a parent in Tennessee: TennCare CHOICES

TennCare CHOICES is Tennessee's Medicaid long-term services program for adults who need a nursing-facility level of care but want to stay home. Its Consumer Direction option lets your parent become the employer, hiring and directing their own caregiver, with a Fiscal Employer Agent (Consumer Direct Care Network Tennessee, CDTN) handling payroll and taxes. Your parent can also use an Agency with Choice model, where an agency employs a qualified relative.

Tennessee allows an adult child, sibling, or friend to be the paid caregiver. A spouse is generally excluded.

What does CHOICES pay a family caregiver?

Two numbers decide what reaches your account: the hourly rate, and how many hours are authorized. The hours come from your parent's assessment. The rate we would rather be straight about than guess at, because TennCare's CHOICES page publishes no hourly figure for consumer-directed workers and we could not find one published elsewhere by the state. Treat any specific range you find quoted online, including the tidy ones, as unverified until your parent's plan gives you a number in writing.

What is documented is the arrangement the rate sits inside. Under Consumer Direction your parent is the employer, not the agency: "In Consumer Direction, you become the employer of the people who provide your home care services, allowing you to hire, train, and schedule workers yourself instead of going through a provider agency". The payroll runs through a state-contracted intermediary, since "Consumer Direct Care Network Tennessee (CDTN) is the Fiscal Employer Agent (FEA) in Tennessee". Hiring a relative is allowed rather than exceptional, though TennCare adds a caution worth asking about early: "Although you can hire family members, friends, neighbors, or other acquaintances to provide care in Consumer Direction, there may be some limitations".

If your parent goes through a provider agency instead of directing the care themselves, being a relative changes nothing about the hiring standard. TennCare states that "the same rules and requirements apply to the hiring and ongoing employment of family members as all other qualified individuals employed by provider agencies", so expect the same background check and paperwork any other employee faces.

States differ in how much of this they put in writing. Kentucky, for one, sets the budget in regulation at last year's costs minus five percent, so a family there can read the method before they call. In Tennessee, two calls produce a real figure: your parent's MCO care coordinator, who authorizes the service and the hours, and CDTN, which cuts the checks. Ask both, and get the rate in writing before you cut back your own working hours to do this.

Who qualifies

Eligibility runs through your parent:

• Your parent must qualify for TennCare Medicaid and meet the clinical criteria for CHOICES Group 1 (a nursing-facility level of care) or the relevant at-risk group.
• You, the caregiver, can be an adult child, sibling, or friend. A spouse generally cannot be the paid caregiver.
• You enroll as the caregiver through CDTN or the provider agency, completing the background check and paperwork.

How to apply in Tennessee

The process runs through TennCare and a managed care organization:

1. Apply for TennCare for your parent if they are not already enrolled.
2. Request a CHOICES assessment through your parent's managed care organization, which determines the level of care and services. See TennCare CHOICES eligibility for the income limits and level-of-care rules.
3. Ask for Consumer Direction so your parent can hire you as the caregiver, or Agency with Choice if you prefer an agency to employ you.
4. Enroll as the caregiver with CDTN (the fiscal employer agent) or the agency, so your hours can be paid.

Other ways to get paid to care for a parent in Tennessee

CHOICES is the main path, but not the only one:

• VA programs, if your parent is a veteran, can pay a family caregiver (including a spouse) through Veteran-Directed Care or the Program of Comprehensive Assistance for Family Caregivers, which is one route when a spouse needs to be the caregiver.
• A personal care agreement, if your parent can pay from their own savings, sets the hours, duties, and pay in writing, which matters for family clarity, taxes, and any future Medicaid application.

For the full national picture of every program and how they compare, see our main guide to how to get paid to care for an elderly parent. Many families weigh a stair lift at the same time; see what helps pay for one in Tennessee. If the yearly property tax is a strain on the household, Tennessee's property tax relief for seniors can lower it, and if the home needs a ramp or grab bars, see home modification grants for seniors in Tennessee.

Frequently Asked Questions

Can I get paid to care for my parent in Tennessee? Often, yes. The main way is TennCare CHOICES Consumer Direction, which lets your parent hire and direct a family caregiver such as an adult child, paid hourly through the fiscal employer agent. Your parent must qualify for TennCare at a nursing-facility level of care.

Can an adult child be paid to care for a parent in Tennessee? Yes. Under CHOICES Consumer Direction, an adult child, sibling, or friend can be the paid caregiver. A spouse is generally excluded.

How much does TennCare CHOICES pay family caregivers? Pay is an hourly wage for the authorized hours, but Tennessee does not post the rate on its CHOICES page the way some states post a statewide figure. Ask your parent's MCO care coordinator and Consumer Direct Care Network Tennessee, the fiscal employer agent, for the current rate in writing.

Does Tennessee Medicaid pay family caregivers? Yes, through TennCare CHOICES Consumer Direction and Agency with Choice, which pay an adult child or other non-spouse relative or friend. The VA also pays family caregivers of eligible veterans.

Can I be paid as an in-home caregiver for my parent in Tennessee? Yes. TennCare CHOICES Consumer Direction pays a family member, such as an adult child, to provide in-home care for a parent who qualifies for a nursing-facility level of care. You are paid an hourly wage for the authorized in-home hours set by your parent's assessment, with the rate confirmed through the plan and the fiscal employer agent. A spouse is generally excluded.

Where to start

The fastest first step is to make sure your parent is enrolled in TennCare, then request a CHOICES assessment through their managed care organization and ask for Consumer Direction. If your parent is a veteran, or if a spouse needs to be the caregiver, look at the VA programs. Getting set up to get paid to care for a parent in Tennessee is a realistic way to keep aging in place affordable.

This guide is part of our Tennessee senior care resources, which cover every program that helps a parent age in place in the state.

If you would rather not think it through alone, you are welcome to write to us; we read every message.

Sources

• TennCare, CHOICES in Long-Term Services and Supports, Consumer Direction, the member as employer, and the fiscal employer agent.
• TennCare, Provider Agency Information for Hiring Family Caregivers, the employment rules that apply to family members.
• U.S. Department of Veterans Affairs, Caregiver Support Program.