How You can get Paid as a Family Caregiver Through Medicaid

Caring for an ailing family member is difficult, but it doesn’t have to be unpaid work. There are programs available that allow Medicaid recipients to hire family members as caregivers.

All 50 states have programs that provide pay to family caregivers. The programs vary by state, but are generally available to Medicaid recipients, there are even some non-Medicaid-related programs.

Medicaid's program began as "cash and counseling," but is now often called "self-directed," "consumer-directed," or "participant-directed" care. The first step is to apply for Medicaid through a home-based Medicaid program. Medicaid is available only to low-income seniors, and each state has different eligibility requirements. The Medicaid application approval can take months, and there may be a waiting list to receive benefits under the program.

The state Medicaid agency usually conducts an assessment to determine the recipient's care needs—to determine how much help the Medicaid recipient will need with daily activities such as bathing, dressing, eating, and moving. Once the assessment is complete, the state draws up a budget, and the recipient can use the allotted funds to pay for goods or services related to care, including paying a caregiver.

Recipients can choose to pay a family member as a caregiver, but there may be some restrictions on which family members are allowed. Most programs allow ex-spouses, in-laws, children, and grandchildren to serve as paid caregivers, but typically family caregivers are paid less than the market rate in order to prevent fraud.

In addition to Medicaid programs, some states have non-Medicaid programs that also allow for self-directed care. These programs may have different eligibility requirements than Medicaid and are different in each state. Family caregivers can also be paid using a "caregiver contract," increasingly used as part of Medicaid planning.

In some states, veterans who need long-term care also have the option to pay family caregivers. In 37 states, veterans who receive the standard medical benefits package from the Veterans Administration and require nursing home-level care may apply for Veteran-Directed Care. The program provides veterans with a flexible budget for at-home services that can be managed by the veteran or the family caregiver. In addition, if a veteran or surviving spouse of a veteran qualifies for Aid & Attendance benefits, they can receive a supplement to their pension to help pay for a caregiver, who can be a family member.

To find out more about these programs, and to see if you qualify, contact Tacoma Elder Care for a consultation. Or attend one of our FREE workshops.