Caregiver Jobs in the USA With Visa Sponsorship: The Real Routes

America needs caregivers. Its population is getting older, and the Bureau of Labor Statistics (BLS) expects jobs for home health and personal care aides to grow much faster than average over the next ten years.

So you'd think sponsorship would be easy. It isn't. There's no special caregiver visa, and the routes that do exist can take years.

This guide walks through each one honestly: who it suits, what caregivers really earn, how long it takes, and how to spot the scams that target people in this field. Check the details on the official USCIS and State Department pages before you act on them.

The honest picture first

You've probably seen posts saying US families are queuing up to sponsor overseas caregivers, with a start date in weeks. That's not how it works.

• Most caregiver jobs don't fit temporary work visas. The H-1B needs a degree-level specialty job, and the H-2B is for temporary needs.
• The main route is a green card. For care aides, that usually means EB-3 "other workers", which has a small annual allocation and long queues.
• Nurses are the exception. Registered nurses have a well-used, faster-moving path, but it requires a nursing degree, a US licence exam and credential checks.

If you need something quicker, look at our guide to caregiver jobs in Canada. Canada has caregiver programmes of its own.

What caregivers earn in the US

Care work matters enormously, but entry-level pay is modest. These are national medians from the BLS Occupational Outlook Handbook for 2025. Half of workers earn more and half earn less.

The BLS counted about 4.7 million home health and personal care aide jobs in 2025 and projects 18% growth from 2025 to 2035. Pay is usually higher in states with a high cost of living, but so is rent.

Route 1: The EB-3 green card for care aides

EB-3 is an employment-based green card with three subcategories. USCIS describes them as:

• Skilled workers: jobs needing at least two years of training or experience.
• Professionals: jobs needing a US bachelor's degree or foreign equivalent.
• Other workers: jobs needing less than two years of training or experience.

Most personal care aide and home health aide jobs fall under other workers.

How it works

1. The employer offers a permanent, full-time job. Temporary or part-time roles don't qualify.
2. The employer gets a prevailing wage determination from the Department of Labor (DOL) and runs a recruitment process to test the US labour market.
3. The employer files PERM labor certification (Form ETA-9089) with DOL.
4. After certification, the employer files Form I-140 with USCIS.
5. You wait for a visa number. Your place in line is your priority date, and it becomes usable when the monthly Visa Bulletin shows it as current.
6. You complete the final stage, either at a US consulate or, if you're lawfully in the US, through adjustment of status.

Your spouse and unmarried children under 21 can come with you as dependants.

For a wider comparison of green card categories, see our guide to EB visas and how long each takes.

Route 2: Nursing, the clearer path

If you're a qualified nurse, or willing to train as one, the picture gets much brighter.

Registered nurses are on the DOL's Schedule A list of occupations with recognised shortages. USCIS says Schedule A jobs don't need a DOL-approved PERM labor certification. The employer files the I-140 directly with USCIS, which removes months from the process.

You still need to meet these requirements:

• A nursing education that meets US standards.
• A licence route in the state where you'll work. For registered nurses, that means passing the NCLEX-RN exam, and each state board sets its own rules.
• Health care worker certification. USCIS explains that foreign-trained nurses need a certificate from an authorised body. The Commission on Graduates of Foreign Nursing Schools (CGFNS) can certify nurses, and Josef Silny and Associates is also authorised for nurses.
• English proficiency, usually shown through an approved test as part of the certification.

Nurses usually enter through EB-3 professionals or, with an advanced degree, EB-2. The queue for a visa number still applies, but it has generally moved faster than other workers. For more on pay and licensing across health jobs, read our guide to high-paying healthcare jobs in the USA.

Route 3: The H-2B, and why it rarely fits

The H-2B lets employers hire foreign workers for temporary non-agricultural jobs. USCIS says the employer must show one of four temporary needs: a one-time occurrence, a seasonal need, a peak-load need or an intermittent need.

Most caregiving is a permanent, year-round need, so it usually doesn't qualify. A few other facts to know:

• The annual cap is 66,000, split into 33,000 for each half of the fiscal year.
• Since 17 January 2025, USCIS no longer limits the H-2B to nationals of designated countries.
• Employers can't collect any fee or other payment from you related to the H-2B job, including through wage deductions.
• You can stay in H-2B status for up to three years in total before you must leave for at least 60 days.

So if someone offers you an "H-2B caregiver visa" for a permanent home-care job, start asking hard questions.

Route 4: The J-1 au pair programme

The J-1 au pair programme is the one US route aimed at childcare in private homes. According to the State Department:

• Au pairs must be 18 to 26, proficient in spoken English and a secondary school graduate or equivalent.
• They work no more than 45 hours a week and 10 hours a day.
• The programme lasts 12 months, with possible extensions of 6, 9 or 12 months.
• Pay follows Fair Labor Standards Act rules, and host families contribute up to $500 towards required study.
• Au pairs must complete at least six hours of academic credit per year.

It's a cultural exchange, not an immigration route. It doesn't lead to a green card, and you must apply through a designated sponsor organisation.

All four routes compared

How to go after a sponsored caregiver job

1. Pick your route honestly. Are you applying as an aide, a nurse or an au pair?
2. Get your training recognised. Collect certificates, transcripts and reference letters, and have them translated where needed.
3. Research state rules. Home health aides in federally funded agencies need formal training and a test, and some states license aides.
4. Look for employers with a sponsorship record. The Department of Labor's disclosure data shows which employers have filed PERM applications for care roles.
5. Ask the right questions. Is the job permanent and full-time? Who pays the PERM and petition costs? What wage will be offered?
6. Get a written offer that states the job title, duties, wage, hours and location.
7. Track your priority date in the Visa Bulletin once your I-140 is filed.
8. Prepare for the interview or adjustment with a valid passport, police certificates and medical exam.

What it costs you

Under PERM rules, the employer must pay its own costs for labor certification, including legal fees for that stage. You shouldn't be asked to reimburse them. Other costs usually fall to you:

• Credential evaluation, translations and licensing exam fees for nurses.
• The immigrant visa fee and medical exam at the consulate.
• Flights and your first month's rent plus a deposit.
• Health insurance until your employer's plan starts.

On arrival, apply for a Social Security number, open a bank account and start a credit history. If you'll support family at home, compare transfer providers on the total cost, including exchange rates. Remember that a care aide's median pay leaves little margin in expensive cities.

Scams and red flags

Few fields attract as much visa fraud as caregiving. Walk away if you see:

• A "caregiver visa" fee. There's no such visa, and PERM costs belong to the employer.
• Promises of a start date in weeks. EB-3 other workers takes far longer.
• Guaranteed approvals. Only USCIS and the State Department decide.
• Requests for payment to a personal account, crypto or gift cards.
• Recruiters who keep your passport or ask you to sign a contract you can't read.
• Pay that sounds too good. Offers far above the BLS median for entry-level aide work deserve suspicion.

Your checklist

• Decide which route fits: EB-3 aide, nurse, H-2B or au pair.
• Check the BLS pay data so you know what's realistic.
• Confirm the job is permanent and full-time for EB-3.
• Nurses: start credential certification and NCLEX preparation early.
• Check the current Visa Bulletin for your category and country of birth.
• Keep copies of every certificate, reference and contract.
• Never pay for a job offer or a "guaranteed" visa.

Caregiving can lead to a US green card, but it takes patience and the right route. Before you commit, make sure you understand the rules on working legally in the United States, so you don't damage your case while you wait.