Guides → Wyoming

Getting paid to care for a parent in Wyoming

Updated 2026-08-10 · Every figure below is dated and sourced · Rules change — confirm with the agency
The short answer: Wyoming's door is Community Choices Waiver (CCW) — Participant-Direction option, run by Wyoming Department of Health, Division of Healthcare Financing, Home and Community-Based Services (HCBS) Section. Pay: Medicaid pays for participant-directed Personal Support Services (billing code S5125 with modifier U5) at $3.80 per 15 minutes — about $15.20 an hour. That rate is unchanged in the current CCW Fee Schedule and CCW Service Index, both effective July 1, 2026, which replaced the older 4/1/2023 service index the state used to post (checked 8/9/2026). Important: $15.20 is the Medicaid BILLING rate paid into your parent's service budget, not your paycheck. Your actual wage is set within that budget and paid through the state's fiscal agent, ACES$, which takes employer payroll taxes out first — so your take-home lands somewhat below $15.20/hr. A participant-directed employee cannot work more than 40 hours a week per employer, and personal support is capped at 8,320 fifteen-minute units (2,080 hours) per plan year. For comparison, when an agency sends a worker the rate is $8.91 per 15 minutes (about $35.64/hr) — but that money goes to the agency, not to you. Since July 1, 2026, four more services can also be participant-directed and hired the same way: respite ($10.36 per 15 min), non-medical transportation ($7.59 per 15 min), companion services ($7.35 per 15 min), and homemaker ($6.49 per 15 min).

Who can be the paid caregiver

Under participant direction, any adult 18+ who passes background screening can be hired — including adult children, siblings, grandchildren, other relatives, and friends. Key exclusions: the person serving as the participant-directed employer (employer of record) and that employer's spouse; the case manager and the case manager's spouse; and anyone with legal authority over the participant's finances (financial POA, guardian, conservator). Practical gotcha: if you are your parent's financial POA, you generally cannot also be their paid caregiver — another adult must hold one of the two roles.

The spouse question

Mostly no, with a narrow exception. Wyoming historically barred paying spouses, and older guides still say so. The current official rule: a spouse may be hired only if the spouse has no legal authority over the participant's financial decisions and circumstances make it necessary. The CCW renewal effective July 2026 keeps this: a participant-directed employer may hire a spouse "if there is no evidence of financial decision-making authority." For an adult child caring for a parent this rarely matters, but the parent's own spouse (your other parent) can only be paid under these narrow conditions.

Waitlist reality

Better news than you may have read elsewhere. The Community Choices Waiver is a 1915(c) waiver, so it is not a legal entitlement the way regular Medicaid is — but Wyoming's approved waiver, renewed effective July 1, 2026, does not cap how many people it serves at one time. In the waiver application the state checks the box saying it "does not limit the number of participants that it serves at any point in time during a waiver year," and it sets aside no reserved capacity. The number you may see quoted elsewhere — about 2,891 — is the state's projected count of people served in the first year (rising to about 2,901 by year five), not a fixed set of slots that fills up. Several secondary websites still describe a CCW waiting list; the current approved waiver does not create one, and people are enrolled in order of when their eligibility is determined. The state does not publish a live count, so it is still worth asking the HCBS Section (1-800-510-0280) about current timelines on your first call before you count on the income — but do not let "the waiver might be full" keep you from applying. Regular Medicaid enrollment has no waitlist. The non-Medicaid Wyoming Home Services program can sometimes help while your parent's eligibility is being decided, but it sends services through contracted local providers — it does not pay family.

Worth knowing: Disqualifiers to name plainly: (1) If you hold your parent's financial power of attorney, guardianship, or conservatorship, you cannot be the paid caregiver — Wyoming bars anyone legally authorized to make the participant's financial decisions from being hired, and the participant-directed employer and that employer's spouse are barred too, as are the case manager and the case manager's spouse. Families usually solve this by having one adult child hold the POA or serve as employer and another adult child take the paid caregiver job. (2) Your parent must need nursing-facility level of care, confirmed by the LT-101 assessment and rechecked annually — needing "some help" is not enough. (3) Financial limits: income at or below 300% of the SSI federal benefit rate, which is $994/month in 2026, so roughly $2,982/month, and about $2,000 in countable assets for a single applicant. Families over the income line should ask the Long Term Care Eligibility Unit about a Medicaid income trust (Miller trust). (4) Caregivers must be 18 or older, pass a background screening, complete the required training, log visits through electronic visit verification, and stay under 40 hours per week per employer. Recent change: the CCW renewal effective July 1, 2026 expanded participant direction to homemaker, respite, and non-medical transportation, added companion services and assistive technology as new waiver services, and retitled "employer of record" as "participant-directed employer" — the narrow spouse exception (no financial decision-making authority) is retained. The renewal did NOT change the personal support rates: $3.80 per 15 minutes participant-directed and $8.91 agency both carried over unchanged. The $15.20/hr figure is the Medicaid reimbursement rate, not a wage — the caregiver's pay is set within that budget after ACES$ withholds employer taxes, so tell families "somewhat under $15/hr take-home" verbally while quoting the fee-schedule number in writing. On waitlists: the approved waiver does not cap point-in-time enrollment and reserves no capacity, so do not repeat the "slots are full" warning that some secondary guides still carry — but the state publishes no live enrollment data, so have families confirm current timelines with the HCBS Section on the first call.

Other doors in Wyoming

ProgramWhat to know
Veterans in Charge (Veteran-Directed Care), Wyoming Independent LivingIf your parent is a veteran enrolled in VA health care with a VA primary care team, this VA-funded self-directed program gives a monthly budget to hire caregivers — family members, and under VDC nationally even spouses, can typically be paid. Run statewide by Wyoming Independent Living, (307) 266-6956 (offices in Casper, Cheyenne, Gillette, Laramie, Sheridan).
Wyoming Home Services Program (WyHS)Non-Medicaid state program through the Aging Division's Community Living Section: care coordination, personal care, homemaker, chore, respite, adult day. Helps people who don't qualify for Medicaid, but services come through contracted local providers — it is not a pay-the-family program. (307) 777-7995 or (800) 442-2766.
National Family Caregiver Support Program (Wyoming Aging Division)Respite, counseling, training, and small supplemental services for unpaid family caregivers — support, not wages. Access via the Aging Division, (800) 442-2766.
Structured family caregivingWyoming has NO structured family caregiving / adult foster care daily-stipend model. The CCW participant-direction hourly route is the only Medicaid path.
VA Aid & Attendance / Program of Comprehensive Assistance for Family Caregivers (PCAFC)For veteran parents: Aid & Attendance adds cash to a VA pension that can informally pay family; PCAFC pays a monthly stipend to caregivers of eligible veterans via VA Cheyenne or Sheridan health care systems.

Wartime veteran or surviving spouse in the family? VA Aid & Attendance stacks on top of state programs — see the national guide.

How to apply — step by step

  1. 1. Call the Wyoming Medicaid Long Term Care Eligibility Unit at 1-855-203-2936 to start your parent's Medicaid long-term-care financial eligibility. The income limit is 300% of the SSI federal benefit rate — the federal benefit rate is $994/month in 2026, so the cap works out to about $2,982/month — with countable assets generally under $2,000 for a single applicant. Ask them about applying online; the state runs an online benefits portal, but confirm the current web address with the eligibility unit rather than typing in one you found on a guide.
  2. 2. Call the HCBS Section at 1-800-510-0280 or (307) 777-7531, or email ccw.waivers@wyo.gov, and submit the CCW application (CCW Form-01) — by mail to 122 West 25th Street, 4 West, Cheyenne, WY 82002, by fax to (307) 777-8685, or by email or in person.
  3. 3. A state assessor completes the LT-101 assessment to confirm your parent needs nursing-facility level of care (age 65+, or 19-64 with an SSA-verified disability). This is redone every year.
  4. 4. Choose a case management agency from the provider list for your county — the application requires you to pick one and get their signature — and build the person-centered service plan. Tell the case manager you want the Participant-Direction option with you as the paid caregiver.
  5. 5. Enroll with ACES$, the state's fiscal/employer agent, at (844) 500-3815 or supportWY@mycil.org. You pass a background screening, complete the required training, and clock shifts through electronic visit verification (EVV) to get paid.

Where to start: Wyoming Department of Health HCBS Section — 1-800-510-0280 or (307) 777-7531, ccw.waivers@wyo.gov (Medicaid financial eligibility: LTC Unit 1-855-203-2936); program info: health.wyo.gov/healthcarefin/hcbs/

Do it yourself vs. get help

Free, accredited help first, always: your Area Agency on Aging (eldercare.acl.gov) walks families through these applications at no charge, and your county Veterans Service Officer files VA claims free. Where Resbit fits: if you're working a job and don't have hours for hold music, Resbit finds what your family qualifies for, fills out the paperwork down to the signature line, and does the chasing — flat $49/month, and the screener that starts it is free.

Find out what your family qualifies for

Free · 10 questions · No account needed · Honest when the answer is "not yet"

Try the free screener Join the waitlist
No spam. Unsubscribe anytime.
You're on the list. 🌿
Sources & dates checked: Program rules and payment rates change. Everything here is educational — real eligibility is decided by the agencies, based on your family's details.