Editor’s Note: This post has been updated for accuracy and comprehensiveness on July 25, 2014.
Caregiving for a family member or friend can be a very rewarding and loving experience. However, the time and energy spent can be draining emotionally and financially. You may have found yourself pinching pennies or cutting back your hours to help your loved ones, and you are not alone. More than 70 million people provide unpaid caregiving for family members. What most people don’t realize is it might be possible to receive payment for your caregiving.
Low income assistance for in-home care, Medicaid Cash and Counseling programs and long-term care insurance are often available to those who seek it out.
Low Income Assistance for In-Home Care
Candidates with few assets and a low income could be eligible for Medicaid healthcare coverage which includes in-home care, personal care and low-level healthcare monitoring and/or services. Similar to the care you give, low income assistance for in-home care can provide help with bathing, dressing, cooking, cleaning, eating and various daily activities. Typically Medicaid goes through a licensed home health care agency and pays them to schedule aides to come to the home. This might work well for some, but not for others due to the inconsistency of the agencies and their high worker turnover.
Medicaid Cash and Counseling Programs
In some states, Medicaid runs a program called Cash and Counseling that pays seniors directly for their in-home care. (These programs are called different names in different states so visit this program map for information and contact details.) This gives the senior the option to compensate the family member or anyone they choose for their care. They can also use the money to purchase items that might make life more comfortable such as a kitchen items, safety equipment, transportation, meal delivery or cleaning services. The amount depends on a Medicaid assessment of need and the pay rate for in-home care aides in that state.
Applying for Medicaid coverage is not as complicated as it seems. The process usually involves gathering bank and tax records to show income and assets. Medicaid will then determine if you are financially eligible. If eligible, program representatives will come to the residence to asses in-home care needs by discussing the current care as well as talking to the doctor. Once the assessment is completed and the number of hours needed have been determined, the senior decides who will provide the care and the rate they’ll pay from the program’s monthly payment (at least minimum wage). The program helps with the paperwork and taxes as well as the details of the plan.
Long-Term Care Insurance
Long-term care insurance is only carried by a small number of people, but it can be extremely beneficial to families. If the policy covers in-home care, you can file a claim for benefits based on the care needs of the elderly person. The senior may qualify for monthly in-home care benefits. In most cases, the payment would go directly to the senior to disperse to whom they choose. Some policies require the payment to be specifically made out to the state-certified in-home care aide. Low-cost certification classes are usually offered at community colleges.
Regardless of the various options, if you are going to receive payment from the person you are caring for it is a good idea to draw up a contract that sets out the terms of the care and payment. The personal care agreement will simply help communicate the expectations between both parties involved and prevent disagreements between you, the person you are caring for and other family members. If they should need to enter a nursing home at some point, the agreement will also help legitimatize these payments and assist in qualifying them for Medicaid.
If you are happy in your role as caregiver, but tired of scrambling to make ends meet due to the financial constraints, consider exploring these options to ease the burden. Sometimes a little bit can go a long way.
For additional resources and information, visit Caregiver Action Network.
Carrie Robertson
Research & Community Education