Caregiver Reimbursement

How to Get Reimbursed for Family Caregiving

By Jill Gilbert
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Many of us will gladly take Mom to her doctor's appointments, administer medications, and check in if the need arises without a second thought. But with millions of loyal children caring for aging parents out of their own pockets, a little financial relief is welcome. Few family caregivers are aware that you can get paid—however small the amount may be—to care for Mom and provide homecare services. Due to the long working hours, however, some adult children caregivers have been forced to leave their full-time jobs or even scale back their hours spent on the clock, leading to a significantly reduced cash flow. Fortunately, if being a caregiver is causing a noticeable financial strain, there are homecare reimbursement programs that can help alleviate some of the burden. Keep in mind, however, that you must practice patience when applying for these programs—make sure that your application is up-to-date and all the necessary attachments are included before you send it so that delays aren’t any longer than necessary.

Long-Term Care Insurance (LTCI) Reimbursement

Long-term care insurance, which functions as an indemnity program, only pays the insured the amount that was contracted at the outset, and regardless of homecare services that are received, will only pay that specified amount.

LTCI, which covers nursing home, home health care, adult day care services, assisted living facilities, and hospice care, offers payments to in-home family caregivers, though the insurance must include in-home care and/or homecare services coverage. In certain instances, LTCI requires that family caregivers complete a basic training program on homecare services and/or caregiving for elderly patients. Though almost all LTCI contracts include skilled, intermediate, and custodial long-term homecare services, you shouldn’t rely on this type of insurance to be your only fallback when it comes to paying for in-home health care. Though, for clarification, you should contact your LTCI company directly for details on its family caregiver reimbursement policies as well as what is needed to qualify.

Medicaid Cash and Counseling Program

A state-administered program, Medicaid is only available to low-income individuals and families who meet certain federal and state law eligibility requirements. In other words, if you have limited income and resources, applying for Medicaid relief is advisable; however, you must be able to meet specific eligibility criteria. Persons over the age of 65 with limited income and resources immediately become eligible as well as those who are terminally ill or live in a nursing home.

Fortunately, if the person you're caring for is either eligible for or is currently enrolled in the Medicaid program, you may be able to receive direct payments from its Cash and Counseling program, though it is available only to family caregivers in select states, including but not necessarily limited to Alabama, Arkansas, Florida, Illinois, Iowa, Kentucky, Michigan, Minnesota, New Jersey, New Mexico, Pennsylvania, Rhode Island, Vermont, Washington, and West Virginia. In some cases, the person you're caring for may have too high an income, excluding him or her from the Medicaid program; some states, such as Georgia, Maine, Nebraska, North Dakota, Oklahoma, and Oregon, have accounted for this oversight and offer similar programs (the National Family Caregiver Support Program is one).1

Medicaid, aware that family caregivers are often the best care providers for Mom or Dad, will send a check directly to the recipient to reimburse for homecare services rendered, though this amount depends upon various assessments of overall needs and the average cost of in-home health care for that particular state. This money can also be used by family caregivers to purchase supplies, medical equipment, or even to pay for ADLs (activities of daily living). To find out if your loved one is eligible or for more information on the Cash and Counseling program, please call the National Program Office at 617-552-2809.

Making the Arrangement with Mom Official

Since money is involved, it's recommended that family caregivers draw up some sort of short, typed contract that outlines the terms of the caregiving situation in depth, including the pay rate and frequency, job description and homecare services that will be provided, and how various expenses will be reimbursed (if applicable). Hiring an attorney or other legal professional will help all family caregivers involved create a legal document that prevents sticky situations from arising.

It's also important to remember that this payment is viewed as income by the government, so all family caregivers must report their earnings each year as taxable income. Though the money received for providing homecare services is negligible, it will help to offset many of the costs associated with providing Mom (or Dad) with a loving, stable, and comfortable home.


1http://www.nga.org/Files/pdf/0406AgingCaregivers.pdf