Being a caregiver for a family member is a labor of love, and too often, that love costs. A June 2021 AARP study found that 78% of family caregivers regularly incur out-of-pocket costs while caring for a loved one, averaging $7,200 per year. Twenty-eight percent reported that they had stopped saving money, and 23% had taken on more debt.
Family caregivers need support to make ends meet while caring for their loved ones at home. In this article, we investigate some programs and resources in which family caregivers can participate to earn money for caregiving.
Medicaid recipients
All 50 states and the District of Columbia offer self-directed Medicaid services for long-term care, which let individuals manage their own long-term home care services. In some states, this can include hiring a family member to provide care.
It is essential to investigate the rules and requirements for your state’s Medicaid program. The names of the programs often vary from state to state. Some programs will pay family members but exclude spouses and legal guardians, while others won’t. Your local Area Agency on Aging can provide more information on your state’s Medicaid program and supply helpful resources and financial support for family caregivers.
Maxim Healthcare Services participates in several state Medicaid family caregiving programs where caregivers are trained and certified as Licensed Health Aides or Certified Nursing Assistants. Caregivers become Maxim employees while taking care of their family members, allowing them to get paid for their services and alleviating some financial burden. These services are only available in some states, so contact your local Maxim office for more information.
Direct pay
If your loved one is mentally sound, you might decide on a direct pay situation where they compensate you directly for your services. Follow these tips from AARP to help overcome awkwardness about establishing an employee-employer payment situation and avoid legal issues:
Discuss what you both need
- Talk about wages, paydays, scheduling, respite care, and sick days. Speak plainly and directly during this conversation so you and your loved one are on the same page.
Create a personal care agreement
- Your personal care agreement should detail wages, when and where care will be provided, the length of the agreement and other pertinent information that came up in your discussion. If other family members are close to the situation, consider including them in conversations about the agreement so that everyone is on the same page.
Consult a lawyer
- Take your agreement to an elder care lawyer to ensure that it meets tax requirements and deals with inheritances. Other interested family members should also take part in this process.
Be aware of emotional pitfalls
- If family members disagree with the plan, consider meeting with a neutral party, such as a mediator or family therapist specializing in elder care. They will be able to help you navigate difficult discussions and come to mutually beneficial agreements.
Keep professional records
- Keep a record of services performed, dates the services were provided, and the amount you were paid. These records will come in handy if your loved one decides to apply for Medicaid in the future, and a caseworker needs to examine records.
Report income
- Caregivers are legally required to report wages as taxable income. If your loved one applies for Medicaid, but your taxes have not been paid, Medicaid will consider your wages a gift – not an expense. This could prevent your loved one from qualifying for Medicaid.
Family members aren’t the only ones who may pay you directly. Some disease-specific organizations, such as CancerCare, offer grants and financial assistance programs to people with the disease and their family caregivers.
Military veterans
According to AARP, there are four programs that military veterans may apply for to compensate their family caregivers.
Veteran-directed care
Like Medicare’s self-directed care programs, veteran-directed care allows qualified former service members to manage their own long-term care. The program is available in 42 states, the District of Columbia and Puerto Rico to veterans who need nursing facility-level care but would prefer to receive care at home.
“A flexible monthly budget, based on a VA assessment of the veteran’s needs, enable participants to choose the goods and services they find most useful, including a caregiver to assist with activities of daily living.” Veterans may choose any physically capable family member.
Aid and Attendance benefits
This program supplements military pensions to help cover the cost of a caregiver. Eligible veterans must qualify for VA pensions and have at least one of the following: requires help with everyday personal functions, is confined to bed because of disability, is in a nursing home because of physical or mental incapacity, or very limited eyesight. Veterans’ spouses may also qualify for this benefit.
Housebound benefits
Vets who receive a military pension and are substantially confined to their home or immediate premises due to a disability can apply for a monthly pension supplement similar to aid and attendance benefits.
Program of Comprehensive Assistance for Family
This program provides a monthly stipend to family caregivers of vets who need assistance because of serious illness or injury sustained in the line of duty on or before May 7, 1875, to after September 11, 2001.
The veteran must be enrolled in VA health services, have an individual or combined disability rating of 70% or higher and need personal care related to everyday activities. Their caregiver must be 18+ and a child, spouse, stepfamily member, extended family member or full-time housemate of the veteran.
Contact the U.S. Department of Veterans Affairs for more information on these and other programs.
Long-term care insurance
Some long-term insurance policies cover home health and personal care costs. It’s important to note that not all policies approve paying spouses or family members living in the home with the individual who needs care. Contact your loved one’s insurance company or agent for specifics.
Family caregivers often benefit from Maxim’s respite care services, which allow you to take a much-needed break from caregiving while your loved one is in great hands. Respite services are only provided at some Maxim locations, so reach out to your local office for more information.