How to Get Paid for Being a Family Caregiver

Where to find the funds and how to settle on the terms for providing in-home care.
Mother and daughter

If you're one of more than 70 million people who provide unpaid caregiving for a family member or friend -- either in that person's home or in your own -- you know that the time and energy burden can be enormous. In fact, you may have cut back or given up your paying job. Your smaller (or now nonexistent) paycheck may be pinching you hard. If so, it might be possible for you to get a small but regular payment for your caregiving work.

Here's how: If the parent, spouse, or other person you're caring for is eligible for Medicaid, its Cash and Counseling program, available in some states, can provide direct payments that could go to you. A few other states have similar programs for low-income seniors, even if the person receiving care doesn't quite qualify for Medicaid. Also, if the person you're caring for has long-term care insurance that includes in-home care coverage, in some cases those benefits can be used to pay you.

If the person you're caring for will be paying you from any source, it may be a good idea -- for both of you -- to draft a short written contract setting out the terms of your work and payment.

SEE ALSO: Find In-Home Care Help Near You

Medicaid in-home care assistance for people with little money

People with low income and few assets other than their home may be eligible for Medicaid (called Medi-Cal in California) healthcare coverage. This includes in-home care, which can mean some low-level healthcare monitoring and services but which usually consists mostly of personal care -- the same kind of care you probably provide: help with bathing, dressing, cooking, cleaning, eating, moving around, and similar activities of daily living.

When Medicaid provides in-home care, it usually does so through a licensed home health care agency. Medicaid pays the agency, which sends its care aides to the senior's home on scheduled visits. This arrangement works well for many people. But for others, in-home care through an agency isn't the best arrangement. Many in-home care agencies are overstretched, with high worker turnover. This can mean that in-home care visits are sometimes irregular, with changing caregivers who don't know the senior's needs and preferences. And if you (or another family member) are already providing most of the care, the occasional presence of an outsider may not be that helpful.

SEE ALSO: Find In-Home Care Help Near You

In-Home Care on Medicaid: How Cash and Counseling Programs Can Help

Experts in in-home care understand that family members often make the best caregivers. Knowing this, and recognizing that professional home care agencies aren't always able to provide consistent care, Medicaid in some states runs a program called Cash and Counseling, which pays seniors directly to cover their in-home care. The amount the senior receives depends on a Medicaid assessment of need and the prevailing pay rate for in-home care aides in that state.

Seniors can then use the money to pay anyone of their choosing -- including you or other family members -- to provide care. They can also use some of the money to buy things for the home that would make life more comfortable, such as kitchen items, a new vacuum cleaner, safety equipment, or the like. Or they can use some of the money to pay for services such as cleaning, meal delivery, or transportation.

Cash and Counseling programs are currently in effect in the following states: Alabama, Arkansas, Florida, Illinois, Iowa, Kentucky, Michigan, Minnesota, New Jersey, New Mexico, Pennsylvania, Rhode Island, Vermont, Washington, and West Virginia. Other states have programs similar to Cash and Counseling, offering cash for in-home care to seniors who have little money but whose income or assets are slightly too high for them to qualify for Medicaid in that state.

How the cash assistance programs work

Cash assistance programs have several components and application processes and eligibility vary among states:

  • Eligibility. If the seniors you're caring for don't already have Medicaid coverage, you can help them apply for Medicaid or another cash assistance program. This means gathering bank, tax, and other records that show how much they have in income and assets. Medicaid (or the other relevant cash assistance program) can then determine if they're financially eligible.
  • Assessment. If the seniors you're caring for are financially eligible, the program will come to their residence to assess their in-home care needs. They'll speak with you and other caregivers about the care currently provided, and they may speak to their doctor.
  • Determination. Based on the assessment of needs, the Cash and Counseling or other program determines how many monthly hours of in-home care assistance it would approve if the care were coming from an in-home care agency. Using the rate that in-home care workers are paid in the state, it then figures out how much in total it will directly pay to the seniors every month to help with in-home care.
  • Plan. The seniors decide who they want to provide the care and how much they'll pay you or other caregivers out of the program's monthly payment. (It has to be at least minimum wage, but it can be any reasonable amount you and they agree on.) They can also decide how else they might want to spend some of the money. The program helps seniors work out this plan, including paperwork and taxes.

Finding out about state programs where you live

To find out whether your state has a consumer-directed cash assistance program for seniors, contact your local Medicaid, human services, or social services office. To find the nearest Medicaid or other state office that handles in-home care programs, contact your nearest Area Agency on Aging and ask them who to call in your state to learn about direct payment programs for in-home care.

SEE ALSO: Find In-Home Care Help Near You

Long-Term Care Insurance and Family Care Agreements

Veteran's benefits

Veterans needing home-based care may be eligible for Veteran-Directed Home and Community-Based Services (VD-HCBS). This program serves veterans of any age who are at risk for institutional placement by providing home and community-based services that allow vets to continue to live independently in their own homes. Beneficiaries can choose the mix of goods and services that best meet their needs and manage their own flexible spending budgets for personal care services, which can mean hiring their own workers, including family and friends. For more information on VD-HCBS and to find program contacts in each state, visit the partner organization web site National Resource Center for Participant-Directed Services.

Long-term care insurance benefits to family caregivers

If, on the other hand, the policy requires that payment be made only to a state-certified in-home care aide, check with the National Family Caregivers Association or the Family Caregiver Alliance to find out the requirements in your state for getting this type of certification yourself. Often, low-cost certification classes are offered at local adult schools or community colleges.

Drawing up a personal care agreement

If the person or people you're caring for are going to pay you (from any source, including independent funds) for caregiving, it's a good idea to draw up a simple contract that sets out the terms of the care and payment. This can help avoid uncertainty and disagreement about what you're supposed to be doing and when. Also, it can help avoid misunderstandings with other family members about who's supposed to be providing care and where the money is going. If the person or people you're caring for ever need to enter a nursing home and aren't already on Medicaid, the agreement will show that these payments to you were legitimate, and not just an attempt to "hide" funds in order to qualify for Medicaid. To find out more about why a personal care agreement can be a good idea, and how to draft one, see this article.

Dependent tax exemptions

If none of the direct pay options apply to you, investigate whether you're eligible to claim your parent or other qualifying relative as a dependent on your income tax return. Your relative does not have to live in your residence, but in order to qualify, you must cover more than 50 percent of their basic living expenses, including housing, food, medical services, and clothing. Several requirements must be met. For example, your relative’s earned income must be less than $3,900 (2013 tax year). Non-taxable income such as Social Security does not count toward this limit. For more information and to see if you qualify, check with your tax professional or view IRS information on the subject.


about 12 hours ago, said...

My fiancé & I have been together 9 yrs. almost and I just turned 36 and for the whole time we've been together, I'm totally disabled and live in GA..I need to know what he can do to get paid to take care of me bc I had home health before and I had 4 different people who came to take care of me and he's the one who knows what I need and has to physically carry me some days and some of the people the company sent couldn't hv physically done that, I go to pain management but meds hv stopped helping and I hv a back brace, both knees, a rare syndrome and go to specialists and everybody is too scared to touch me bc of my deformities. My fiancé can't work, we hv a 5 yr. old, and he also has to try to take care of him also, they said my condition would never get better can someone please help us!?!

2 days ago, said...

live in Missouri, my brother s already on (Medicare/medicaid) lives with me and I care for him. I'm paid by an agency an hr. rate for 26hours and 25 min a week. They also provide a nurse who visits once a week who claims vitals, sets up pills. I want to move to Florida, and will bring my brother along, how do I sign up for your Fl. Program so my brother can get the help he needs?

7 days ago, said...

How do I get paid to take care of my boyfriend he is disabled and it's hard to find out how.

22 days ago, said...

My situation I have a 22 try old disabled son. He lives at home with me. My soon to be ex-husband wants to place him in a home . I believe he's better in home with me. I'm a stay at home mom. Please help me to be able to keep him home

23 days ago, said...

Hey i was woundering how I can get my husband to work for home so he can keep a eye on me cus I can't be a lone due to i faint at any moment please can anyone help

about 1 month ago, said...

I'm taking care of my boyfriend at home,(he is laid up for about 3 months or longer)I was wondering if I can get paid by the state to care for him while he gets better(this just temporary)or until the doctor says differently.

about 1 month ago, said...

I am getting ready to go home from a nursing facility. Does medicaid pay to help me to get back on my feet, I.e.. rent, food, transportation, electricity

about 1 month ago, said...

I am a member. I get emails from people on this site with questions. when I follow the link to here, sign in, and try to find the article it is not here. Since I go to many of the conversations on your site how can I find the person that is contacting me? i have put his name in the above search engine but nothing comes up. Darlene

about 1 month ago, said...

hello im was wondering if there program in state on nj that pays u to take care of my son ? my son has downsydrome/pfo/thyroid condtion and its almost impossible to get job cause he needs 24/7 around care . we are constantly going from dr to dr visits

about 1 month ago, said...

Hi my Mom has Alzheimer's Disease and between my sister and I we are both Mom's caregiver 24 hrs a day 7 days a week. I was wondering living in the State of California if there is a program that we could get paid caring for Mom. My Mom needs help with everything of course.

2 months ago, said...

i want to get my license for taking care of babies and children in their last dying days in my home ,can any one tell me what all i need to do

2 months ago, said...

Hi my name is Mirna I'm a parent of a autistic adult son I was wondering if I can get paid for taking care of him Chicago IL

2 months ago, said...

After reading all of the articles about possible payment for caring for my parents, I still don't know what procedures to follow to see if this is available to me. I left a career to care for both parents and do not regret it at all. It's the least I can do for my parents but assistance would help me a lot. Does anyone know what forms or site to begin this process to see if my parents qualify? They have medicare & medicaid but I didn't see any mention of researching it further. Anyone? We are in South Carolina.

2 months ago, said...

I want to take care of my son and work I just need the funds to do it because I don't want to stay home

3 months ago, said...

im looking into being caregiver for my grandma and was wondering how many hours on average they pay for.

4 months ago, said...

I had my mom move in with me almost 8 years ago due tomher poor health shes nw 82 and cant do most things on her own. Im disabled as well i have crohns disease arthritis ms and am on ssi . I do everythg for my mother as sick as i am. Can i recieve money for taking car of her ? Or can my 22year old son who offered to help her now thats hes in between jobs . Just wondering if we can get help financially with her its alot but thankful i can have her with me as she took care of me most of her life. Shes on medicare and we live in pennsylvania

4 months ago, said...

I'm 21 with horrible depression and anxiety, and I'm the only one out of my family who's able to help my grandmother. I can't get or keep a job because of my many, many disorders, but I love spending time with my grandmother. She has vertigo and it seems to be getting worse, and it would help a lot if I was somehow able to get paid. I feel horrible when she hands me money, and I hate to ask my mother or her boyfriend for a few dollars here and there. We live in Lancaster, SC. She has medicare and tricare. I'm not trained at all, but I've been helping her since I was able to drive, because my mother goes to school and had a job. If there's any easy way to let me know if getting paid is possible, I'd really appreciate it. The article above was sort of confusing for me. Straight forward answers are pretty great. Thanks.

5 months ago, said...

I am a certified cna? I take care of my spouse ,son,mother,and brother homecare all disabled how could I get paid doing this instead of working a job and doing this to trying to hold a job I want to take care if them like I've been doing but can I get paid to do so