elderly mother with her daughter who is a caregiver

Family Caregiver Pay: Can a Family Caregiver Get Paid?

Many unpaid family caregivers have questions about whether they can get paid for taking care of an elderly parent or family member. We frequently hear questions like can Medicare pay for a caregiver?  Is there any way of getting paid for taking care of an elderly parent? Is there social security caregiver pay? What states pay family caregivers? And, what is the average caregiver pay or a good family caregiver pay rate? We review these questions and much more about getting paid as a family caregiver.

Can you Get Paid for Taking Care of Elderly Parents, Grandparents or other Family?

The Unpaid Family Caregiver

The highly valued Caregiving in the U.S. 2020 report shows about 48 million Americans are unpaid caregivers. These caregivers provide care without pay to an adult family member (or friend) for an average of almost 24 hours per week. In addition to these caregivers not being paid,  a recent AARP study revealed that 78 percent of family caregivers incur out-of-pocket costs caring for their loved one, with the average amount spent over $7,200 annually.

Family caregivers do play a critical role in helping seniors and persons with special needs to maintain their health and natural well-being at home. The responsibilities of a caregiver vary depending on a person’s needs. Duties can include providing companionship, assisting with personal hygiene, medication reminders, transportation to medical appointments, and much more. For more information about caregiver duties and responsibilities, please read our blog post, Caregiver Duties and Responsibilities.

 

Does Medicare Pay for Family Caregivers?

In short, Medicare usually will not pay for in-home family caregivers. Medicare usually does not pay in-home caregivers for things like personal care or help with laundry and housekeeping if that is the only care needed.

Medicare will pay for shorter-term home health services like physical therapy, occupational therapy, or skilled nursing care. Specific requirements must be met. For example, the patient must be considered homebound, and a doctor’s order is required.

If skilled nursing or therapy services are provided, Medicare may provide part-time or intermittent home health aid services for a short time. A Medicare-certified agency must provide the care.  It is a good idea to talk with your doctor and prospective home health agency to review what services are covered and for how long.

 

Is There Social Security Caregiver Pay? 

Social security disability benefits do not pay caregivers directly, but if someone receives social security disability benefits they can use that money for costs related to your loved one’s care. For example, everyday living expenses, medical bills, and other costs. There are two different Social Security Disability Programs that can provide financial assistance to people with disabilities: The Social Security Disability Insurance (SSDI) and also the Supplemental Income (SSI) program.

The SSDI program will pay benefits to those with a qualifying disability and meet the work requirements such as working long enough and paying social security taxes. The SSI program is a need-based program and pays benefits for those with a qualifying disability and who have limited income and resources.

Caregivers can help someone apply for social security benefits. People may qualify for benefits under one program or both, depending on their circumstances.

 

Can a Family Member Get Paid to Be a Caregiver?

Most caregivers do not get paid for taking care of an elderly parent or loved one. However, there are some options available to allow those eligible to receive payment for the caregiving services they provide.

Below we explore the various options available in the U.S to pay family caregivers who take care of their loved ones.  These include:

  • Personal Care Agreements including median pay rates for home health aides in each state
  • State Medicaid Programs
  • Long term care insurance
  • Veteran Benefits and Programs

Even if you do not qualify to get paid as a caregiver, read further below for some resources that may help ease your financial burden and help you locate respite care. 

 

 

 

senior women sitting in white chair reviewing caregiver pay rates using modern pad

 

Ways To Get Paid as a Family Caregiver 

Personal Care Agreements – Caregiver Contracts

Caregiver contracts are also known as personal care agreements or older care contracts. This is a formal agreement signed by family members agreeing to compensate the person providing home care to their older adults, elderly parents, sick loved ones, or persons living with disabilities.

This is a good option if the care recipient or their family has funds to pay for a caregiver. Drafting a personal care agreement among family members helps clarify the family caregiver’s compensation and who takes care of what and when.

A Written Contract for Family Caregiver Pay

A written personal care agreement brings transparency to the situation. It outlines all the tasks to be performed by the appointed family caregiver. This helps identify the needs of the loved one. In addition, it is clear to the caregiver what tasks they will perform. Having a written agreement also makes it clear how often the family caregiver will work and how much they are getting paid.

A written caregiver contract may also help with outside agencies. For example, payment for these services may be covered under a Veterans Administration or Medicaid program or could be considered a valid spend down of income to qualify for need-based programs (like Medicaid).

You may want to consider consulting an elder law attorney in your area to help with a personal caregiver agreement. The attorney can review your situation and whether a written contract is right for you. In addition, the contract will be valid and include the appropriate language.

 For more information about home health care, including what it is and what to expect, please read our blog post: Understanding Home Health Care. 

 

 

 

hand with money paying caregiver pay rates asking what states if Medicare Medicaid social security pay caregivers

 

Family Caregiver Pay Rates

There are many considerations on how much a family caregiver should get paid. For example, what type of care they will provide, your location, and your budget. We frequently get asked what are the average family caregiver pay rates. To give you an idea, we looked at the Genworth Cost of Care Survey.

Genworth Cost of Care Survey 2020

The Genworth Cost of Care survey provides the hourly median cost of in-home care by a home health aide in each state. Genworth defines a home health aide as someone who helps with daily activities such as showering, toileting, housekeeping, dressing, shopping for groceries, transferring, and serving meals. If the home health aid is appropriately trained, they can check vital signs, including temperature, pulse, and respiration rate. Usually, a high school diploma is the educational requirement.

The Genworth survey found the median national 2020 hourly rate for a  home health aide to be $24.00. Below is the median rate found per state.

 

 

Median Pay Rate for Home Health Aides in Each State

Genworth Cost of Care Survey Results 2020

LOCATION
USA Home Health Aide
Alabama $18.00
Alaska $28.04
Arizona $26.00
Arkansas $20.00
California $29.00
Colorado $28.00
Connecticut $25.00
Delaware $25.00
District of Columbia $26.13
Florida $22.50
Georgia $21.50
Hawaii $30.00
Idaho $23.50
Illinois $25.50
Indiana $24.00
Iowa $26.00
Kansas $22.00
Kentucky $21.75
Louisiana $17.00
Maine $28.62
Maryland $25.00
Massachusetts $29.63
Michigan $25.00
Minnesota $33.00
Mississippi $18.50
Missouri $23.00
Montana $26.95
Nebraska $26.00
Nevada $25.00
New Hampshire $29.25
New Jersey $26.00
New Mexico $23.00
New York $26.00
North Carolina $21.00
North Dakota $29.00
Ohio $23.95
Oklahoma $23.95
Oregon $29.00
Pennsylvania $24.00
Rhode Island $31.00
South Carolina $22.00
South Dakota $29.00
Tennessee $21.00
Texas $22.00
Utah $26.00
Vermont $29.00
Virginia $23.00
Washington $31.63
West Virginia $18.50
Wisconsin $26.00
Wyoming $29.12

From the Genworth Cost of Care Survey, conducted by CareScout August 2020

 

 

 

paper with medicaid in text what states pay for family caregivers

 

What States Pay Family Caregivers?

Medicaid Programs Available to Medicaid Recipients

Medicaid state plans (Medicaid)  may provide an option for becoming a paid caregiver for an elderly parent or loved one. While every state has a Medicaid plan, the names vary depending on the state you reside. For example, in California, Medicaid is called Medi-Cal, but it is called MassHealth in Massachusetts. To find what your state name is for Medicaid, click here.

Regardless of the name of your state’s Medicaid program, all Medicaid plans are entitlement programs. This means those who meet the eligibility requirements can receive goods and services via their state’s Medicaid program.

States Offer Different Medicaid Programs – What States Pay Family Caregivers?

Many people ask what states pay family caregivers. Depending on the state’s eligibility and requirements, family or friends may be able to become paid caregivers through the state’s Medicaid plan. Depending on your state, one of the following options may be available for self-direction of long-term care assistance:

 

Personal care services are available through most state Medicaid plans, and states allow recipients to self-direct their care.

 

Medicaid State Self-Directed Services Programs

If your loved one is Medicaid eligible, family caregivers may be able to get paid through Self-Directed Medicaid Services.  All 50 states offer self-directed Medicaid services for long-term care. These programs allow states to grant waivers to allow eligible individuals to manage their long-term care services. In some states, this includes hiring a family member as a caregiver.

Eligibility, coverage, benefits, and rules vary from state to state. For example, some programs will not pay family caregivers if they live in the same house, and some states exclude spouses as eligible for paid caregiving. The names of each state program differ as well. For example, states may call their program Participant-Directed Services, Consumer-Directed Care, or Cash and Counseling.

These self-directed Medicaid programs provide people with disabilities, including seniors, the option to manage their budget and determine how to use the money to pay for services directly related to their care needs. When enrolled in one of these self-directed options, recipients may use their allotted budget to pay for caregivers.

 

Contact you State Medicaid Program – What States Pay Family Caregivers?

Contact your state Medicaid program to ask about its options, eligibility requirements, or start the sign-up process.

Enrolling in a self-directed care program usually involves the following steps:

  • There will be an assessment to confirm what assistance is needed.
  • Developing a plan outlining the daily assistance required. The plan will include things such as help with showering, personal hygiene, feeding, medication management, toileting, and more.
  • Provide a budget for goods and services provided.
  • Once the care plan is set, the care recipient can then choose a caregiver.

 

 

Long-Term Care Insurance

Each long-term insurance policy differs in what type of care is covered, how much is covered, and coverage exclusions. The insurance provider may refuse to pay if your loved one is in the wrong type of facility.

Many long-term care policies cover in-home care, including nursing care, durable medical equipment, or physical therapy. Some policies may even pay benefits that cover home modifications for disabilities or pay family caregivers.

If the care recipient has a long-term care insurance policy that pays for home care, it may possibly pay for a family member to be a caregiver.

It is a good idea to read the policy over carefully. In addition, you can call the insurer with questions regarding what is covered and whether a family member can be a paid caregiver.

 

 

 

 

veteran elderly man in uniform

 

 

Veteran Benefits 

The VA offers a variety of benefits to veterans and their families. A few different VA programs may compensate family caregivers or provide the veteran with additional compensation for hiring a caregiver.

VA Pension Benefits

VA pension benefits help low-income veterans with limited assets. There are three tiers of financial help, and each has specific eligibility requirements. Veterans can use these tax-free monetary payments as they see fit, including paying a family member for their care.

Veterans (and Survivors) eligible for the basic VA pension may qualify for additional monetary payments through either the Housebound Pension Program or the Aid and Attendance Pension.

Basic VA Pension: This is income for veterans with low income and limited assets. This needs-based benefit is for eligible veterans, with the intent to supplement the income of financially needy veterans.

Aid and Attendance (A&A) Pension: This pension is an increased monthly pension for veterans who qualify for the basic pension and require help with activities of daily living (ADLs) or meet other criteria such as being bedridden.

Housebound PensionThis pension is an increased monthly pension paid to a Veteran or surviving spouse substantially confined to home because of a permanent disability. The disability does not have to be service-related.

 

 

The VA Program of Comprehensive Assistance for Family Caregivers (PCAFC)

The PCAFC provides a variety of resources and supportive services to family caregivers of veterans. Eligible veterans can select one primary caregiver and up to two secondary caregivers who, if eligible, may receive benefits through the program.

Benefits can include caregiver training, mental health counseling, and more. The primary caregiver may also be entitled to health care benefits and monthly payments for caregiving services.

Find out if you are eligible and if so, how to apply for the Program of Comprehensive Assistance for Family Caregivers (PCAFC).

 

 

Veterans Benefits (VD-HCBS), or Cash and Counselling

The Veteran-Directed Home and Community-Based Services program offers veterans a flexible budget based on their assessed needs.  The veteran (or their representative) will receive help developing a spending plan and for hiring workers.

Hired workers can include a family member or friend who helps the veteran live independently. This help can consist of personal grooming, toileting, eating, grocery shopping, and more.

 

 

VA Caregiver Support Program

The VA has a national toll-free number for caregivers, family members, Veterans, and friends to contact for information related to caregiving and available benefits and support. There is a dedicated team available to provide information on caregiver support services, educational services, counseling, benefits, and referrals (electronic notification) to your local Caregiver Support Program (CSP) staff at VA medical centers (VAMC).

Call the national VA’s Caregiver Support Line at 1-855-260-3274 to learn about the support and benefits available to you. Or use the directory to find the Caregiver Support Team at your local VA Medical Center.

 

senior mother sitting with adult daughter standing behind her

 

 

Other Options if You Can’t Get Paid as a Family Caregiver

Even though you may not get paid as a family caregiver, other programs may help cover costs for things like in-home support, adult day care services, or programs to help ease other financial burdens.

For more information on how to find local resources that may help  you or your loved one, please read our blog post: Senior Resources – a Guide for Caregivers. 

Here are are a couple from our extensive list:

Resources for People Over 55 Years Old

The National Council on Aging can help determine if your family member is eligible for financial assistance for medication, health care, and housing costs. There are over 2500 programs to help those with a fixed income. Please enter your zip code and other information into their Benefits Checkup.

Your local Area Agency on Aging

Your local Area Agency on Aging may likely be able to provide information on paying family caregivers. This agency manages the federally funded National Family Caregiver Support Program. This program provides grants to states to fund caregiver support to help ease the financial burden of caregiving to a person over 60 years old or under 60 with a diagnosis of Alzheimer’s disease and related disorders.

The services offered may vary by state. The Program services may include:

  • Information and assistance to caregivers
  • Counseling and support groups
  • Respite care
  • Education and training
  • Limited supplemental services, for example, the purchase of consumable supplies, emergency response systems, and home modifications.

Locate your Area Agency on Aging by entering your city and state, or zip code, to find your local office. They are trained professionals who may help assess and locate resources available to you and your loved one.

 

 

income tax return with Tax Deductions for Caregivers and a calculator and money

 

 Tax Deductions for Caregivers

If you have been caring for your elderly parents or a relative, you may be able to benefit from some tax credit and deductions.

There are a few possible ways you could benefit from tax credits. For example, if your parent qualifies as your dependent for tax purposes or pays someone to care for your parent so you can work, you may qualify for a tax credit. The IRS has an interactive tool to help determine if your loved one qualifies you for a tax credit. You can visit the IRS website or call their helpline at 800-829-1040.

You may want to consider talking to your accountant or financial planner to see if you qualify for any tax breaks. Throughout the year, ensure you keep detailed records. Good practice includes saving receipts and having a written log of related expenses. This helps ensure you don’t miss allowable deductions (and can serve as documentation if you get audited).

 

More Resources

For more information on community resources, please read our blog post: Senior Resources – a Guide for Caregivers. 

 

For additional support, we have a Facebook support group where caregivers support each other! Please join our Family Caregiver Facebook Group!

 

 

 

Conclusion

Most family caregivers are unpaid. In addition, many caregivers spend their own money to help their loved ones pay for expenses. There are some ways a family caregiver can get paid.  A common question is what states pay family caregivers. Each state has a Medicaid program, and some will pay family caregivers of program recipients. Contacting your local area on aging is a good idea because there may be some federally funded programs that help family caregivers. The VA also offers some programs that may pay family caregivers. For those with a long-term care insurance policy, please review it carefully to see whether there is coverage for family caregivers. And finally, although not direct payment, some family caregivers may be able to claim a tax credit.

 

 

 


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