Virginia's caregiver stipend has three payment tiers based on how many hours you work each month

Virginia's Caregiver Stipend Program, run through the Department of Medical information Services (DMAS), pays family members who provide personal care to relatives with disabilities or chronic illnesses. The program uses three tiers to set your monthly payment. Your tier depends on the number of hours you work caring for the person each month — not on your relationship to them, not on their diagnosis, and not on your income.

The three tiers are: Tier 1 for caregivers working 1 to 40 hours per month, Tier 2 for 41 to 80 hours per month, and Tier 3 for 81 or more hours per month. Each tier has a different hourly rate. The exact dollar amounts change each year, so you should confirm the current rates with DMAS or your local Department of Social Services office before you expect your first payment.

Key Takeaways

  • Virginia's caregiver stipend has three tiers based on monthly hours worked: Tier 1 (1–40 hours), Tier 2 (41–80 hours), and Tier 3 (81+ hours).
  • Each tier pays a different hourly rate, and the rates are adjusted annually by DMAS.
  • Your tier is determined only by the hours you document each month — moving between tiers is normal as your caregiving needs change.
  • You must submit timesheets or other proof of hours worked to receive payment for any tier.
  • The person you care for must be enrolled in a Virginia Medicaid waiver program for you to receive stipend payments.

How hours determine which tier you fall into

Virginia counts the hours you work in a calendar month to place you in a tier. If you work 35 hours in January, you are in Tier 1 for that month. If you work 60 hours in February, you move to Tier 2 for February. The tiers are not permanent — you move up or down based on what you actually work each month.

Hours include direct personal care: bathing, dressing, toileting, meal preparation, medication reminders, transportation for medical appointments, and supervision. Hours do not include household chores unrelated to the person's care, yard work, or time spent managing paperwork. You must track and document your hours, usually on a timesheet that your local Department of Social Services provides or approves.

Tier 1: 1 to 40 hours per month

Tier 1 is for caregivers working between 1 and 40 hours in a calendar month. This tier covers part-time caregiving — perhaps you help with morning care before work, or you provide weekend support while another family member handles weekday care. The hourly rate for Tier 1 is lower than the other tiers because you are working fewer hours overall.

You still need to submit documentation of the hours you worked. Many caregivers in Tier 1 are working alongside a paid home health aide or splitting duties with another family member. There is no minimum number of hours required to receive payment in Tier 1 — even 5 hours in a month qualifies, as long as the person you care for is enrolled in a waiver program.

Tier 2: 41 to 80 hours per month

Tier 2 covers caregivers working 41 to 80 hours per month — roughly 10 to 20 hours per week. This is the middle tier and represents substantial part-time or part-time-plus caregiving. Many caregivers in Tier 2 are working a job outside the home and providing care in evenings, mornings, or weekends. The hourly rate is higher than Tier 1 because you are providing more consistent care.

To stay in Tier 2, your documented hours must fall between 41 and 80 in the month. If you work 81 hours in a month, you move to Tier 3 for that month. If you work only 35 hours, you drop to Tier 1. Your tier can change month to month depending on the care needs and your availability.

Tier 3: 81 or more hours per month

Tier 3 is for caregivers working 81 or more hours per month — roughly 20 hours per week or more. This tier covers full-time or near-full-time family caregiving. The hourly rate for Tier 3 is the highest of the three because you are providing the most intensive care. Many caregivers in Tier 3 are not working outside the home, or they have significantly reduced outside work to manage caregiving.

Tier 3 has no upper limit on hours. Whether you work 81 hours or 200 hours in a month, you receive the Tier 3 hourly rate for all documented hours. You still must submit timesheets or other proof of hours worked each month to receive payment.

How payment works across the tiers

You submit your hours to your local Department of Social Services, usually on a form they provide. The department verifies the hours, calculates your payment based on the tier your hours place you in, and processes the stipend. Payment typically arrives by direct deposit or check within a few weeks of submission, though timing varies by locality.

The person you care for does not pay you directly — the state pays you through DMAS. The stipend is meant to recognize your work and help offset the cost of providing care. It is not a replacement for a full-time job wage, and the hourly rates are set by the state, not negotiated between you and the person you care for.

What happens if your hours change between tiers

Moving between tiers is normal and expected. If you work 50 hours one month and 90 hours the next, you will be paid at the Tier 2 rate for the first month and the Tier 3 rate for the second month. There is no penalty for moving between tiers, and you do not have to notify DMAS in advance — you straightforward report your actual hours each month.

Some months you may work fewer hours because the person's health improves or because another caregiver is available. Other months you may work more because of a health crisis or a change in the person's needs. The tier system is designed to reflect these real changes in caregiving intensity.

Frequently Asked Questions

Do I have to stay in the same tier every month?

No. Your tier changes each month based on the hours you actually work. If you work 35 hours in January and 85 hours in February, you will be in Tier 1 for January and Tier 3 for February. There is no requirement to maintain a certain tier or to give notice when your hours change.

What counts as caregiving hours?

Direct personal care counts: bathing, dressing, toileting, meal preparation, medication reminders, medical transportation, and supervision. Household chores, yard work, and administrative tasks do not count. Ask your local Department of Social Services for their specific list of what qualifies, because some localities may have slightly different guidance.

Can I work more than 80 hours and still get paid?

Yes. Tier 3 covers 81 or more hours per month with no upper limit. All hours you work and document are paid at the Tier 3 hourly rate. If you work 150 hours in a month, you receive payment for all 150 hours at the Tier 3 rate.

How do I know the current hourly rates for each tier?

Contact your local Department of Social Services or call DMAS directly. The rates are adjusted annually and vary slightly by region in some cases. Your local office can tell you the exact rate for each tier and help you estimate what you will receive based on your expected hours.

What if I work fewer than 40 hours one month — do I still get paid?

Yes, as long as you work at least 1 hour and the person you care for is enrolled in a waiver program. Even 5 hours in a month qualifies for Tier 1 payment. You must document those hours on a timesheet or other proof that your local office accepts.