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.

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.

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.

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.

 


1 day ago, said...

I am the caregiver of my 4 year old autistic grandson. I gave up my job to care for him and am currently getting healthcare benefits from Medicaid. Is there compensation available as well? I live in NJ and care for him around the clock. I am the caregiver of my 4 year old autistic grandson. I gave up my job to care for him and am currently getting healthcare benefits from Medicaid. Is there compensation available as well? I live in NJ and care for him around the clock. Hide


18 days ago, said...

Hello I wanted to know how do I get some benefits for being my fiancess cargiver. H e has a bad heart and kidnney? Hello I wanted to know how do I get some benefits for being my fiancess cargiver. H e has a bad heart and kidnney? Hide


21 days ago, said...

My son lives with me. He can not walk straight because he can't keep his balance when he walks I have to cook for him and help him when he needs me to help him and when he finds a doctor I have to start taking him to the doctor how do I go about getting help for taking care of my son My son lives with me. He can not walk straight because he can't keep his balance when he walks I have to cook for him and help him when he needs me to help him and when he finds a doctor I have to start taking him to the doctor how do I go about getting help for taking care of my son Hide


about 1 month ago, said...

I am taking care of my brother in-law from 3.00 pm until 1.30 or longer. my sister work those hr, He has lung and brain cancer and afraid to stay by himself, have to give medicine because he will take too much,have to fix his food so I am trying to see if I can get paid for that ,I am his care taker/ I am taking care of my brother in-law from 3.00 pm until 1.30 or longer. my sister work those hr, He has lung and brain cancer and afraid to stay by himself, have to give medicine because he will take too much,have to fix his food so I am trying to see if I can get paid for that ,I am his care taker/ Hide


2 months ago, said...

I've been taking care of my mother pretty much my whole.entire life,and it's starting to weigh down on me,I'm getting incredibly stressed out,money has been scarce,been trying in vain to get outside work,OK? So how would I go about getting paid for my assistance? Any info would be much appreciated. Thank you very much for your cooperation. Best Regards,JLH II I've been taking care of my mother pretty much my whole.entire life,and it's starting to weigh down on me,I'm getting incredibly stressed out,money has been scarce,been trying in vain to get outside work,OK? So how would I go about getting paid for my assistance? Any info would be much appreciated. Thank you very much for your cooperation. Best Regards,JLH II Hide


2 months ago, said...

I've been taking care of my mother pretty much my whole.entire life,and it's starting to weigh down on me,I'm getting incredibly stressed out,money has been scarce,been trying in vain to get outside work,OK? So how would I go about getting paid for my assistance? Any info would be much appreciated. Thank you very much for your cooperation. Best Regards,JLH II I've been taking care of my mother pretty much my whole.entire life,and it's starting to weigh down on me,I'm getting incredibly stressed out,money has been scarce,been trying in vain to get outside work,OK? So how would I go about getting paid for my assistance? Any info would be much appreciated. Thank you very much for your cooperation. Best Regards,JLH II Hide


2 months ago, said...

can i get paid for taking care of my uncle who has cancer , taking him to his appointments, feeding him and all other needs? where would i have to apply at? can i get paid for taking care of my uncle who has cancer , taking him to his appointments, feeding him and all other needs? where would i have to apply at?
 Hide


2 months ago, said...

Hello! I'm trying to find how/where to go in Longview, tx for information on getting paid for being my ex-husbands caregiver. He is 55 yrs old on full disability and at this time doesn't qualify for Medicaid. Hello! I'm trying to find how/where to go in Longview, tx for information on getting paid for being my ex-husbands caregiver. He is 55 yrs old on full disability and at this time doesn't qualify for Medicaid. Hide


2 months ago, said...

I have been taken care of my dad for two years now an not getting a dime my dad has lost both legs so now I take him to doctors appointment make the meals in the house an everything else I do the shopping u name it I do it for him so am I eligible to be paid I have been taken care of my dad for two years now an not getting a dime my dad has lost both legs so now I take him to doctors appointment make the meals in the house an everything else I do the shopping u name it I do it for him so am I eligible to be paid Hide


3 months ago, said...

I have been a assistant to a Lupus relative and a diabetic elderly parent. I do need financial assistance, because cutting back on working is hard. I have been a assistant to a Lupus relative and a diabetic elderly parent. I do need financial assistance, because cutting back on working is hard. Hide


3 months ago, said...

I have been caring for my significant other for the last 4 or 5 yrs and has never gotten paid by him or anyone else for doing this. Had to quit my job in order to do this is their any recourse that I can take. He has taken me off our joint bank acct. and left me penniless. Is there anything I can do to go back for the last 5 years and get some kind of compensation from this gentleman. We have been together as a couple for 8 years. I know in some states being together for that long the women... Show more I have been caring for my significant other for the last 4 or 5 yrs and has never gotten paid by him or anyone else for doing this. Had to quit my job in order to do this is their any recourse that I can take. He has taken me off our joint bank acct. and left me penniless. Is there anything I can do to go back for the last 5 years and get some kind of compensation from this gentleman. We have been together as a couple for 8 years. I know in some states being together for that long the women can get something for herself but I live in the state of Oregon and I don't know if something exists in this state for this. We did live in the state of Montana for a year to take care of his elderly parents I know something exists there for this. When we moved back to the state of Oregon and that is when all his illnesses started he came down with COPD, diabetes,he had high blood pressure, he is on insulin for his diabetes, he had a heart attack last year and is not very mobile so I have done everything for him. All his S.S stuff, doctors apps.,insurance, all his medication stuff and picking them all up for him, shopping, laundry, just about everything except bathing him. I have never been paid.for doing all this. He keep a roof over my head and paid my car insurance. While we were waiting that year that it takes to get S.S. And Medicare, I worked and paid all the bills in that time. Then he made me quit my job to take care of him. Hide


3 months ago, said...

I Bettie Howard had to stop work three years ago to take care of my husband who has Alzheimers and can't be left alone anymore. I take care of all his needs these day's. We live with my youngest daughter to have a little help. We only have S.S. to live on so it's hard to make end's meet. Hope to hear from you soon. Thanks Bettie Howard. I Bettie Howard had to stop work three years ago to take care of my husband who has Alzheimers and can't be left alone anymore. I take care of all his needs these day's. We live with my youngest daughter to have a little help. We only have S.S. to live on so it's hard to make end's meet. Hope to hear from you soon. Thanks Bettie Howard. Hide


3 months ago, said...

i been a care taker for my mom and dad for 4 years now .and not received a dime my dad passed away on sept 20 2014 and my mom had a major stroke and I am now 24/7 all day and night caring for her .my savings have disappeared.. I use to have $ 5000.00 saving .before I moved to Miami from west palm beach 4 years ago .I gave up what little life I had up there .now my savings is just about gone and I need help asap i been a care taker for my mom and dad for 4 years now .and not received a dime my dad passed away on sept 20 2014 and my mom had a major stroke and I am now 24/7 all day and night caring for her .my savings have disappeared.. I use to have $ 5000.00 saving .before I moved to Miami from west palm beach 4 years ago .I gave up what little life I had up there .now my savings is just about gone and I need help asap Hide


4 months ago, said...

my father is 93, he stopped talking and walking since june 2015. I am his caregiver and as I write this note, I am in the need of installing a servillance video camara. I need assistance because I do not have internet in his apartment, recomended by his social worker due to abuses from homeaids that he has suffer. IT is very difficult to find people that hve a heart for needy elderly. my father is 93, he stopped talking and walking since june 2015. I am his caregiver and as I write this note, I am in the need of installing a servillance video camara. I need assistance because I do not have internet in his apartment, recomended by his social worker due to abuses from homeaids that he has suffer. IT is very difficult to find people that hve a heart for needy elderly. Hide


5 months ago, said...

I live in N.C. , one of the states that doesn't offer the Cash and Counciling Program unfortunately. My 84 yr. old mother moved in with me, my husband & two children 5 years ago. She has Lewy Body Dementia and it's been a long 5 years. I'm an only child, my father is deceased and mom's relatives are as old or older than she is & all live in other states. I applied for mom to receive Medicaid and she does qualify...but ALL the assisted living facilities in our area require a person "self... Show more I live in N.C. , one of the states that doesn't offer the Cash and Counciling Program unfortunately. My 84 yr. old mother moved in with me, my husband & two children 5 years ago. She has Lewy Body Dementia and it's been a long 5 years. I'm an only child, my father is deceased and mom's relatives are as old or older than she is & all live in other states. I applied for mom to receive Medicaid and she does qualify...but ALL the assisted living facilities in our area require a person "self pay" for the first 6 months ( approx. $4000. Per month for a shared room = $24,000. that we don't have!!) BEFORE they will accept all of mom's SS check and a small payment from Medicaid. It took me several trips to human services, about 40 phone calls and 2 months to find out I'd completely wasted my time even applying for Medicaid... So she's here in my home and can't be left alone because of her dementia. I cook for her, clean her room, do her laundry, do her hair, pick up her prescriptions, buy her supplies, toiletries, disposable underwear, take her to the doctor, dentist, eye Dr., etc. I can't even take my 12 &14 yr. old children camping next month because we have no one to watch grandma and no place to put her.... So another trip for my kids cancelled again... This has been going on for them since they were 7 & 9 years old, basically ruining their childhood. A lady at human services agreed the system in N. C. Isn't fair, and said we might qualify for some in home care... I made 11 phone calls this week...only reached answering machines and no one has ever called me back. Went back to Human Services today and was told there is a 2 year wait for in home care if Medicaid pays for it...and they never pay for all of it she said. So I put mom on the 2 year wait list... Rediculous really. She is already 84 and might not even be alive in 2 years!, which is probably what Medicaid is hoping for. Honestly, I am at my wits end. Our system is broken. Completely and totally broken. And I am exhausted. Hide


5 months ago, said...

What if the person who has been being paid to care for an individual thru medicaid has dementia/memory loss? This person does not realize the degree of her health issues, and the person receiving care is unwilling to have anyone else work with them. What if the person who has been being paid to care for an individual thru medicaid has dementia/memory loss? This person does not realize the degree of her health issues, and the person receiving care is unwilling to have anyone else work with them. Hide


6 months ago, said...

I live in the UK and we also have a method by which we can c are for our loved ones whether they are young or old. Its called and Individual Budget. A support plan is designed to assess the needs and then a Budget is allowed by the Government. You can either let your local Council manage it and provide the care or you can have the Budget and employ Personal Assistants. I am the Mother of a son age 37 who has Downs Syndrome. The budget pays for 5 days at a Day service that he likes and I... Show more I live in the UK and we also have a method by which we can c are for our loved ones whether they are young or old. Its called and Individual Budget. A support plan is designed to assess the needs and then a Budget is allowed by the Government. You can either let your local Council manage it and provide the care or you can have the Budget and employ Personal Assistants. I am the Mother of a son age 37 who has Downs Syndrome. The budget pays for 5 days at a Day service that he likes and I employ a P.A. to take him on social events. Hide