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.


2 days 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

4 days 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.

17 days 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!

23 days 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

27 days ago, said...

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

about 1 month 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.

about 1 month ago, said...

I would like to find a support group to attend and a counselor to meet with in the Englewood area. Of course, Englewood is preferred, but I am also open to other areas as well. Thanks in advance for your response and assistance.

3 months ago, said...

if my parents living abroad, but need assistance, can i still get some help for taking care of my own parents?

3 months ago, said...

I live in Orange County I want to know how to obtain mine caregiver degree and if you don't have one how much do get paid live in 24/7?

4 months ago, said...

hi my dad is not well like he use to, but I'm trying to care for him, so what can i do, and who can i talk to?

4 months ago, said...

I live in NY state with a lady who has dementia....we are not related. Can I get caregiver benefits from medicare for taking care of her?

4 months 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?

4 months 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

5 months 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/

6 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

6 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

6 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?

6 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.

6 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

6 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.

6 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 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.

6 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.