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 1 hour ago, said...

Can medicaid force me to provide 24/7 care for my mother-in-law, if the nursing home cannot take her in? This is in South Carolina. The Medicaid rep from the nursing home told my sister in law this was the Law.


5 days ago, said...

My parents are in they're late 80's . My mother has Alzheimer's and my dad can no longer take care of her on his own. He wants me to quit my job and stay at home taking care of them. Which I would love to do. But I looked into financial aide so that I could get paid to stay home and take care of them and they do not qualify as they're income is too much. Is there not anything out there to assist financially to the care giver? How sad is that? I am willing to sacrifice my good paying job that I have to take care of my parents who have always taken care of me and yet there is nothing out there to support that. I don't feel that a nursing home is the answer either although insurance will cover a portion of that but they deserve better care than that. What can be done to help assist families in caring for they're loved ones?


5 days ago, said...

Hello my name is Latisha how can I go by caring for my mom? She doesn't except outside home health aides in her house what can I do ?


5 days ago, said...

I have been staying with and caring for my uncle for the past 1-1/2 years. I am unable to work outside the home and he makes too much money for me to qualify to get paid to care for him. It is not fair to me to lose income and yet the state will not help me because he makes too much but all his money pays the bills in the household. What kind of life is that for me? I would love to be able to find some financial help for myself through this process. I have even considered getting certified as a nursing aide so as to possibly get paid but I do not have the financial means even for that. Where can I get help in this situation.


11 days ago, said...

Moved my sister into my home to help her as her dementia progresses. License revoked so I drive her to appointments, etc.. how do I get licensed to take care of her as she slowly forgets?


12 days ago, said...

I have been caring for my grandma I give her her meds and insulin every single day I had actually moved my family and myself out of our home because she only wanted me to care for her so that's what I did took her out of nursing home and still here.I have been doing this since I've known her of course she's my daughters great grandma but I look at her as my own ..I need some kind of income I have four kids!!! I have had the run around on having this job since prego when I moved in last Dec .. with my fourth who is now nine months old. I've got her on track I was doing everything she was so off not even herself I will care for her regardless but I have to care for myself and family too yes she has Medicare but that's been the prob since she s not Medicaid please contact me !!


17 days ago, said...

My sister draws her disability, can she get paid to care for our parents?


18 days ago, said...

My Mother would like to move back "home" and live with my Sister. Mom lives in Arizona now. My sister is retiring this year, and has a spare bedroom that we can set up for her. She will be taking care of Mom, (food/bath/general care). Mom gets Medicaid and VA Survivor benefits, and lives in a LTC Memory Care Facility. She has Dementia pretty bad. Can my sister receive any compensation for being her caregiver? Will Mom loose her VA Benefit Money, or can it be used to pay compensation to my sister for Home Care?


25 days ago, said...

I'm looking for a home health care for my mom and myself her daughter take care of her


about 1 month ago, said...

I'm not looking for a place for my parents (99 and 96). I am wondering if financial aid is available. They have Martin's Point Insurance (Medicare/Medicaid) and Dad was in the Merchant Marines during WWII in the South Pacific.


about 1 month ago, said...

I am taking care of my father who fell while on the job. He has pemenant brain damage and had surgery on his neck in 2014. He can barely walk and has fallen in the shower and also had a small stroke. He can't do anything. He is currently on workman's comp and is still under the care of a doctor because they are confused why his leg will not work properly. Who would I contact. Thank you.


about 1 month ago, said...

Hi my name is Teresa. My daughter Nikki has been taking care of me and my home since March 7th 2016. I had a very serious neck surgery where I received 2 rods and 1 more plate with screws on top of the 3 I already had. Just recently I've had another surgery on my right shoulder. Within a month or so I will have my 2nd cataract surgery. After that I will be having left shoulder surgery. With all this happening my daughter has helped me everyday. She does still live at home, she is 26, but this has stopped her from going back to college or from getting a job. Can anyone tell me how I can get pay for her for doing what I'm supposed to be doing in life. I still have a long way to go. With my neck surgery I cannot drive myself anymore. My husband drives now. I need your help on how to get at least my daughter some kind of pay for her help. Thank you.


about 1 month ago, said...

hello. my mom has frontal lobe dementia. I don't know where to start to find help/care that might be covered. she has medicare/atena. anyone's help is appreciated. thanks.


2 months ago, said...

I recently cared for an ex that passed away, I received no benefits, I had poa that claimed I get everything, in the end hopice is under investigation for several things


2 months ago, said...

I have been taking care of my husband, who has cancer. I have been taking care of him for while now. Our money is tight with two kids to take care of as well. Is there a program that can help.


3 months ago, said...

Want to apply for spouse caregiver assistance cause my wife has cycle dease also had stroke which left her paralized on her whole right side along with a clubed foot and i have to assist her in cooking along with batheing, taking short walks!


3 months ago, said...

Just transitioned special needs from ma ton he. He was there since birth had all services and me his foster sister caretaker received some pay. How does this work inn have do I need to wait for nh to fund him? Very confusing


3 months ago, said...

i want i to take care of me when i get older.


4 months ago, said...

I have been caring for my significant other, live in boyfriend, friend of 7-8yrs. This care started in 2014 when he started with a neurological disease. He cannot not work or drive anymore. I have to cook for him serve him, as he cannot walk well, do his laundry, clean up after him and drive him to all doctor visits etc. We live in NY on Long Island and his neurologist is in Manhattan, 60+ mi. away. Gas, tolls, parking all expensive. Can I claim anything on my taxes? I do not have not kept any receipts. He gets SSD and is on medicare. He does give me money towards rent. I pay for food and all the expenses for the visits, gas, tolls, parking.