Can I get paid to be Dad's caregiver if I am on Social Security Disability and Medicaid?

Eddy0 asked...

I live with my dad and I am collecting Social Security Disability because of accumulated injuries. I can't work. I had cancer last year and I still am suffering effects from the cancer treatment.

My dad, in the past year, has almost died three times in front of me. He had a stroke last March. In November, he went into seizures and almost died and on February 6th he went into seizures and had a heart attack.

He's being discharged Monday from the rehab/nursing home to me. He needs more care than I can provide. I need answers on a few items.

What money of his can I touch without losing my Medicaid? Are there any benefits for a disabled person who has to take care of someone? I can't live if I lose my Medicaid so how do I pay his bills because he can't do it? Am I going to get in trouble with Medicare or Social Security for him being here?

Expert Answer

You've got a tough and complicated situation that involves several different government programs, so let's take them one at a time. First, let's look at who's going to help pay for your father's care at home. Medicare will only pay for short-term home care while he's recovering, and only if he meets certain qualifications. (If Medicare pays for some home care, the help he receives will not affect your Medicaid coverage or your Social Security disability benefits.) If Medicare doesn't cover his home care, or when Medicare home care coverage ends, he'll either have to pay for home care himself, or look to Medicaid to cover some of his home care needs , assuming his income and assets are low enough for him to qualify for Medicaid.

As far as your father's Medicare coverage and Social Security benefits are concerned, living with you will not affect them at all. He is eligible for those benefits regardless of where he is living or who is taking care of him.

Then there are the questions about how your taking care of your father at home, and having access to his money, might affect your Social Security disability benefits and your own Medicaid coverage. As you probably know, your Social Security disability benefits are based on your inability to work because of your disabling injuries. Social Security regularly checks to see whether you're making any income, as a way to check whether you continue to be unable to work. As long as your income is less than $1,000 per month, Social Security continues to consider you -- based on income alone -- still disabled. So, as long as your father is not paying you more than that amount to help take care of him, payments you receive from him should not affect your Social Security disability benefits. One way to make sure that there is no confusion about this is to keep very careful records of all of your father's money that you take or spend, to make sure that the money you spend just for him is not counted as income to you.

The same procedure is important to protect your own Medicaid benefits. You qualify for Medicaid only if your income remains lower than your state's income eligibility level. If Medicaid believes that you are receiving income from your father for taking care of him, it will count that income when deciding on your eligibility. So, you have to be very careful to keep good records showing that the amounts of your father's money that you take to spend for him -- on food, clothes, medicine, caregiving help -- is not "pay" to you. Depending on the rules of your state Medicaid program, you may be able to receive some payment from your father for taking care of him and still keep your Medicaid coverage, as long as the total amount of your disability benefits plus money you receive from your father don't put you over the state's eligibility limit.