Can I get paid to care for my spouse in Tennessee?
Not directly in Tennessee today — but read on.
Tennessee's programs generally will not pay a husband or wife directly — the old Medicaid rules treat a spouse's care as a family duty rather than a job. That is not the end of it. Other relatives usually can be paid, and the rules do change.
Who can be paid instead
- An adult son or daughter — the most common paid caregiver in every state.
- A sibling, a grandchild, a niece or nephew, or an in-law.
- A close friend or neighbor, in most self-directed programs.
- A spouse in a different program year — Tennessee's rules are reviewed regularly, and we watch them.
What Tennessee pays family caregivers
$11–$19.16/hr
Your exact pay is set by the program and your care plan. We'll tell you your real number before you enroll.
Source: Tennessee Medicaid program data · Updated September 2026
What Tennessee's rule actually says
no — spouses, legal guardians, and powers of attorney cannot be hired; adult children and other relatives can
The programs this runs through in Tennessee: TennCare CHOICES consumer direction, ECF CHOICES, Katie Beckett (children). Who runs them: TennCare Long-Term Services & Supports (LTSS) Division; AAAD intake 1-866-836-6678; LTSS Help Desk 1-877-224-0219
1.3 million people in Tennessee are 65 or older. Most of them are cared for at home, by a relative — usually without being paid for it.
How to start in Tennessee
Current TennCare members contact their managed care organization (health plan); everyone else calls their local Area Agency on Aging and Disability at 1-866-836-6678 to start CHOICES screening.
consumer-directed, but all consumer-direction payroll must run through the fiscal employer agent Consumer Direct Care Network Tennessee (CDTN)
See if you qualify →Spouse questions in Tennessee, answered
Can I get paid to care for my husband or wife in Tennessee?
Generally not directly. The published rule: no — spouses, legal guardians, and powers of attorney cannot be hired; adult children and other relatives can Other relatives can usually be paid, and that is worth checking.
Why do some states allow this and others don't?
Medicaid has long treated care between spouses as a family duty rather than paid work. Self-directed programs changed that in many states by making the person who needs care the employer — they choose their own worker, and in some states that can be a spouse. It is a state-by-state policy choice, not a federal rule.
How much would I earn in Tennessee?
Reported pay in Tennessee runs around $11–$19.16/hr, though your exact rate is set by the program and the care plan.
Does my spouse need Medicaid first?
Yes. These are Medicaid programs, so your spouse has to qualify for Tennessee Medicaid and need long-term care help. Many families assume they earn too much and never apply. The rules for long-term care are not the same as regular Medicaid — check before you rule yourself out.
Is there a waitlist in Tennessee?
not an entitlement — CHOICES Groups 2/3 have limited enrollment slots and a waitlist can form
How do we start?
Current TennCare members contact their managed care organization (health plan); everyone else calls their local Area Agency on Aging and Disability at 1-866-836-6678 to start CHOICES screening.
Sources: tn.gov · medicaidplanningassistance.org · Updated September 2026. Rules change — always confirm with the program.
Where most Tennessee caregivers are
Counties with the most residents aged 65 and older. The rules are the same everywhere in Tennessee — pick yours for the local picture.
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