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:

SEE ALSO: Find In-Home Care Help Near You

  • 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

SEE ALSO: Find In-Home Care Help Near You

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. Find out more about why a personal care agreement can be a good idea, and how to draft one.

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 am caring for my elderly husband who has congenital heart failure. I had to quit my job because I have no family to help us here in Orlando. So times are getting hard for us. I am beginning to stress and feel depressed. If the is some kind of financial help available for us please let me know. Thank you in advance


2 days ago, said...

I have missed many hours at work to sit with my father in law, granted it's not about the money but I also have bills to be paid. So I'm looking to become his full time caregiver to have a little income coming in. Can anybody help me


2 days ago, said...

I need someone help so i can get paid for takin care of my mother in law.i am with her 24/7 days aweek She has dementia.in her middle stage.i do everything for her.My husband works.i need alittle income so i can help pay for stuff and get a


3 days ago, said...

Hi my mom is 62 year's old and she has copd and and mad problems with her legs.she can't do to much on her own.i have been taking care of her how do i see if i can get paid for this


3 days ago, said...

How do i have my daughter get paid to watch her fater full time. He is in a nursing home and are not happy since he has been placed in a Behavor mgmt program due to his being angry after two weeks of placing him, My daughter is a 4th year nursing student and has a full time job in a behavor hospital and now wants to come home and watch her dad we are not happy with him being confined now diapered when he went there he wasnt


13 days ago, said...

Hello my mother is 62 years old with copd who is in and out of the hospital she also recently had a stoke She's in a nursing home now but she will be coming home in a week I will be the one taking care of her so that means I have to take time off of work. Would I be a good candidate it get paid from family care?


15 days ago, said...

My mother is 81 y.o. and my father who was 100% disabled veteran passed 3 years ago. As time goes by my mother now needs me to be with her a lot of my time as her mobility is limited. I honestly cannot afford to be without an income due to being a single mother of a child that fully depends on me. Is there any help where I can apply to either get her someone to come and be with her during the hours I work or maybe supplement my income so I can be with her instead?


18 days ago, said...

Can I get help taking care of my cousin. She's 39 and permanently disabled


20 days ago, said...

My grandfather has a stroke and he requires alot of care as his wife cannot take care of him at all. I quit my job in order to keep them from going into a nursing home. They are very poor and my funds are running dry, so are their funds..We need help. They don't have a good income, less than 19,000 per year with lots of medical bills flying in!


21 days ago, said...

My brother is age 27 and permanently disabled and has been since birth. He is wheelchair bound and needs assistance with meal prep housekeeping, bathing, and transportation to and from drs appointments. My son age 26, is going to be his caregiver but has to cut back on his work hours to do so. He received SSI and medicaid, will he be able to receive benefits to pay for his caregiver.


23 days ago, said...

Hello I am permanently disabled my fiance has been caring for me for the past 4 years and our kids and my illness has recently gotten worse that I have to have him here at all times to help me I am on ssi and was wondering if he could get paid for taking care of me


about 1 month ago, said...

Hello I have been taken care of my uncle with everyday things like cooking,cleaning,grocery shopping, doctors appointments and picking up his meds. He is o2 depend it and he does have Medicaid and we live in nh just wondering how can I get paid to take care of him?


3 months ago, said...

My dad has United Healthcare as his supplemental and they cover home health care but I have to go through a certified home care agency problem I run across is all that Ive contacted says he needs to be on medicaid also well supposedly he doesnt qualify for medicaid but If United Healthcare will pay why wont the homecare agencies atleast call and verify his insureance . Im loosing everything but All my dad has is me!!!


3 months ago, said...

I need immediate help. I currently take care of my mom full time. Her SSI is pending and im trying to get help through Elder Options. The friend that was helping us get by wont be able to help anymore and financially I dont know what to do. I appreciate any feed back. A lot of these things ive tried and they lead to dead ends, I appreciate any feed back.


3 months ago, said...

I have recently had to let my job go. Due to my husband health issues, she needs help around the house and he falls a lot. So I can't leave him alone. Can I become a paid caregiver to help balance out my monthly expences.


4 months ago, said...

Hello,i am a 38 years old mom who unfortunately get a disable boy age of 3 .Since he is born I stopped working and did everything to take care him.I did learn from doctors and nurse how to manage my son.Now he finish early intervention and start preschool with a nurse but I see that the way I can manage my son nobody can.Is that anyway in this world a mom who doesn't have a social sn and a working permit,just have an tax identification number ,I am an immigrant and tried with USCIS but get denied because I pass the I 94 date,and not authorized to stay in the USA.This is a double case but I just want to work for my son and get paid because the money is truely needed and the real problem ,the nurse is getting paid when you are doing the work and they add stress on you because for anything your son will be send home and living with this you can be concentrate in any job.I am desperate really with the system.