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Getting Paid as a Family Caregiver Through Medicaid

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

Medicaid’s program began as “cash and counseling,” but is now often called “self-directed,” “consumer-directed,” or “participant-directed” care. In Indiana, it is referred to as “self-directed” care.

The first step is to apply for a Medicaid waiver.  The Area Agency on Aging that services the area in which the applicant resides, conducts an assessment to determine the recipient’s care needs—e.g., how much help the Medicaid recipient needs with activities of daily living 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. The assessment process can take weeks; so, the applicant should begin as soon as the need for services arises.

The next step is to apply for Medicaid benefits.  For individuals who have assets or income in excess of eligibility limits, a legal plan to preserve assets and overcome the income limit will need to be implemented prior to the application for benefits.  An elder law attorney can provide assistance in creating and implementing such a plan.

Recipients can choose to pay a family member as a caregiver, but not all family members are allowed. For example, the State of Indiana prevents caregivers from hiring a spouse.

Self-directed care is one of several ways a family member can receive compensation as caregiver.  With a Care Agreement that meets Medicaid criteria, the ailing family member can pay family caregivers with monthly income not otherwise used for other expenses.  Also, certain family caregivers can be further compensated for caring for the ailing family member through opportunities to give the family home or other real estate interests to the family caregiver without penalty under Medicaid transfer rules.  In some situations, a reverse mortgage can also provide additional financial support to pay for additional care in the home.

To review you or your loved one’s Medicaid home care options and other Medicaid covered long-term care alternatives to a nursing home, contact us today.

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