How to Get Paid to Be a Caregiver for Your Parents

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Family members can get paid to be caregivers for their elderly parents through Medicaid, VA benefits, long-term care insurance policies, and caregiver agreements. Family caregivers often face greater financial instability and stress than noncaregivers. This is because they typically struggle to balance work and assisting their parents with personal care, meal preparation, and cleaning. Many caregivers choose to reduce their hours, take a leave of absence, or quit working, resulting in lost wages and benefits. Unfortunately, most family caregivers are unpaid due to strict eligibility requirements and unique financial situations. However, getting paid could help prevent stress and burnout.

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Key Takeaways

  1. Family caregivers may be paid for the care they provide to offset any sacrifices they’ve had to make.
  2. Caregivers may get paid through Medicaid and VA programs, but eligibility can vary based on factors like program availability, financial status, and veteran service record.
  3. If your loved one doesn’t qualify for Medicaid or VA help, look to other options, like insurance policies, and personal care agreements.
  4. Individual states may offer unique programs that support family caregivers monetarily, but compensation varies based on local regulations, cost of living, financial need, and more.

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Medicaid

Medicaid has several programs that allow seniors to both select and compensate their in-home caregivers. They can designate an adult child or, in some states, their spouse to act as their paid caregiver. Medicaid is a federal program that’s managed at the state level. It offers coverage to people with limited resources, including low-income adults, older adults, and individuals with disabilities.

Under the Medicaid programs listed below, family caregivers must follow care plans developed by the Medicaid recipient’s health care team. The care plan takes into account the senior’s preferences and abilities, and it can be informed by the family caregiver. The team must also create an individualized backup plan to outline what steps will be taken if the selected caregiver can no longer perform their duties.

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Home and community based services waivers with consumer direction

Some states offer home and community based services (HCBS) waiver programs through Medicaid that pay family caregivers for providing in-home care. HCBS waivers intend to help seniors receive the care they need within their home or community rather than an institution like a skilled nursing facility.

To qualify for the HCBS waiver program, seniors typically need to meet certain financial requirements and sometimes an age or diagnosis requirement. Furthermore, these programs often have enrollment limits and waitlists, so it may not always be an option when needed.

Some HCBS waiver programs offer a consumer-directed care model, which allows a qualifying Medicaid recipient to choose their caregiver, including a family member. If a Medicaid recipient qualifies for the HCBS waiver program, then Medicaid funds can be used to pay the family caregiver.

Depending on state and program requirements, family caregivers may need to pass a background check and complete training to qualify for payment. Oftentimes, states require caregivers to register as a certified provider under the Medicaid program. States may also require the caregiver to submit timesheets before getting paid.

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State Medicaid plans with consumer direction

Some state Medicaid programs may offer consumer direction to help individuals have more control over who provides their care. These are most commonly known as personal assistance services (PAS) and community first choice (CFC). These programs are entitlement programs, meaning all eligible Medicaid enrollees have access to them.

Personal assistance services (PAS)

Self-directed personal assistance services empower seniors to hire their own caregivers, which typically include family members and close friends. In many states, getting paid to be a caregiver for your parent or spouse is due to self-directed PAS. The program allows enrolled participants to facilitate their own care and exercise autonomy through key actions like:

  • Hiring relatives
  • Managing cash payments
  • Purchasing or directing purchases of products that enhance senior safety or health, such as mobility ramps, pill dispensers, and grab bars

Community First Choice (CFC)

The Community First Choice (CFC) program also grants seniors the ability to manage their own care. This often involves appointing family and friends to take on caregiving responsibilities in a paid role. Established under the Affordable Care Act, the CFC option is currently only available in a few states.

Due to differences in Medicaid’s state guidelines, older adults may benefit from consulting an elder law attorney to help them navigate the planning and application processes. If an older adult qualifies for multiple self-directed Medicaid programs, an attorney can help determine which one is most beneficial for them and their family caregiver(s). In some states, certain programs may be able to be combined.

Whether you can become a paid caregiver for a family member depends on your state’s rules. While it’s more common to get paid as a caregiver for parents, several states also offer payment to caretaking spouses.

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Caregiver child exemption

Medicaid offers a caregiver child exemption that allows an adult child to inherit their parent’s home in exchange for caregiving services without affecting the parent’s Medicaid eligibility. Gifting a large asset — like a home — for less than fair market value usually triggers a penalty period of ineligibility for Medicaid.

To qualify, the child must live in the parent’s home and provide care for at least two years, delaying the parent’s move to a nursing home. Keep in mind, relying on this exemption can be risky. You won’t qualify if your parent moves to a nursing home or dies before the two-year mark, or if you can’t be a caregiver for the required two years.

The caregiver child exemption doesn’t pay directly for caregiving. It’s a delayed type of payment as it allows the child to receive their parent’s home as compensation for providing care.

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Find local Medicaid services

You can learn more about programs and eligibility that may help you get paid for being a family caregiver by browsing your state’s Medicaid website or contacting the agency directly.

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VA benefits

The U.S. Department of 

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 (VA) offers several VA benefits that can help compensate family caregivers of veterans.

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Veteran-Directed Care

The Veteran-Directed Care (VDC) program is offered to veterans enrolled in the VA health care system. It gives veterans a flexible budget to spend on services. These include help with activities of daily living (ADLs), companionship, or respite care services to support an overwhelmed caregiver. Through this consumer-directed program, a veteran can choose their personal care aides. These aides can be a family member of the veteran’s choice.

Availability of this program varies by location. Your loved one’s VA care team or a social worker can help them get started in this program. To find local VA medical centers (VAMCs) and Aging and Disability Network Agencies (ADNAs) that participate in the VDC program, search for programs in your state using this VDC program list.

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VA Program of Comprehensive Assistance for Family Caregivers

The VA’s Program of Comprehensive Assistance for Family Caregivers (PCAFC) is the most direct source of payment for primary caregivers of veterans. It pays a monthly stipend to qualifying primary caregivers. The stipend amount is calculated based on a veteran’s location and the VA’s evaluation of the veteran’s personal care needs. As a reference, in Dallas, the monthly stipend was $2,909.67.

For a veteran to qualify for PCAFC, they must be enrolled in VA health care and meet certain disability and care requirements. For a family caregiver to qualify, they must be at least 18 years old, be related to the veteran, or live with them full time.

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VA pension

The VA pension is a needs-based benefit paid to low-income veterans and their qualifying surviving spouses who meet certain financial, age, and disability criteria. This benefit is paid to the veteran or surviving spouse directly to use for anything that they see fit — including paying a family member for caregiving.

Veterans may also qualify for one of the following VA benefits, which can be added to a VA pension and increase their monthly payment:

  • The Aid and Attendance benefit can be paid to veterans who can’t perform activities of daily living on their own.
  • The Housebound benefit can be paid to veterans who spend most of their time at home due to a permanent disability.

Keep in mind that receiving a VA pension doesn’t guarantee that a veteran or their surviving spouse will agree to pay their family caregiver. To qualify, your loved one needs to meet the income and asset limits. Even once they receive their benefits, they may need or choose to spend their funds on necessities or other items.

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Get help with VA benefits

It’s normal to have questions about VA programs or pension benefits. Reach out to a local VA-accredited representative or veterans service organization (VSO) for help exploring benefits and programs and even assistance with the application process.

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Long-term care insurance and life insurance

Long-term care insurance (LTCI) and life insurance are proactive investments designed to benefit seniors in retirement and old age. Life insurance also benefits their surviving loved ones, respectively.

While long-term care insurance terms vary depending on the company and a senior’s individual policy, most policies pay for in-home care. However, not all LTCI policies pay family members for caregiving. Be sure to consult your parent’s insurance company and ask for a written confirmation of benefits to see what their policy covers.

Using life insurance to pay for care is another strategy seniors and their families often overlook. Some hybrid life insurance policies may have a long-term care component built into their coverage. In other cases, older adults can sell their policy or surrender it for a cash value, freeing up funds to support a paid caregiving arrangement. Consider exploring these options with your family member’s insurance agent.

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Personal care agreement

Creating a caregiver contract can help put caregiving ground rules and boundaries in legal writing. A caregiver contract, otherwise known as a personal care agreement or personal services contract, outlines the terms and responsibilities of a caregiver and the person they care for. It can include payment information, services provided, hours of care, and more. It can also serve as documentation for care provided and money paid if required when applying for VA pensions or Medicaid.

Because many families may not qualify for government programs initially, a caregiver contract can help a family caregiver get paid and legally spend down funds to eventually qualify for some Medicaid and VA programs.

If your loved one does agree to sign a personal care agreement, make sure they have the funds to pay the family caregiver. In some instances, family members — like siblings — who aren’t caregiving may agree to pitch in to help cover some caregiving costs. Pitching in may include directly paying for long-term care costs or giving the care recipient money to pay the family caregiver.

Starting a conversation about getting paid for caregiving can often feel uncomfortable, but caregivers shouldn’t be afraid to respectfully stand up for themselves.

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Other financial support options

Some parents may not qualify for the programs mentioned above, or they may not have the means to pay their family caregiver. In this case, families can turn to financial support options to save some money.

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Tax credits and deductions

There are several tax credits and deductions for family caregivers who qualify. Tax breaks won’t pay the family caregiver, but they can help them recoup some out-of-pocket caregiving expenses. If done properly, tax credits can significantly lower your tax payment or result in a substantial tax refund.

Consult a local accountant or tax attorney to find out if claiming a senior relative on your taxes might be financially beneficial.

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Paid family and medical leave

Some states and Washington, D.C., have made it mandatory for employers to provide paid family and medical leave (FMLA). This means employers must pay qualifying employees who take a leave of absence to care for a family member, including a parent.

However, paid FMLA is only a temporary solution for most family caregivers. It provides only partial wage replacement for a certain amount of time, which is usually up to 12 weeks a year. However, paid FMLA policies may vary across states.

To learn about your state’s FMLA program and requirements, be sure to contact your local department of labor. To help you get started, here’s program information for Washington, D.C., and the 13 states that have enacted paid FMLA:

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Non-Medicaid state programs with consumer direction

Some states may offer local programs to help seniors age in place. However, they may not be consumer-directed or they may prohibit paying family caregivers. If your options are limited, use the eldercare locator service to search for your local Area Agency on Aging and support services and programs near you.

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How much family caregivers can expect to get paid

In the U.S., the median cost of home care is $30 per hour, according to A Place for Mom’s 2024 report on the cost of long-term care. However, family caregivers rarely get paid the same hourly rate through consumer-directed programs. Medicaid, the VA, and local state programs typically pay family caregivers less due to the lack of formal training and lower living costs in certain areas.

For instance, in California, Medi-Cal rates for family caregivers typically fall between $12 and $15 per hour. This is about half the national median rate paid to professional in-home caregivers.

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Taking a break from family caregiving

Family caregivers tend to forget to care for themselves while caring for a loved one, often leading to burnout. To prevent caregiver burnout, it’s critical to take regular breaks. Many family caregivers struggle to prioritize self-care because there is no one else to care for their loved one. However, professional respite care can fill this gap.

Respite care can be provided at home, at an adult day care center, or through a short-term stay in a senior living community. It can offer similar services you provide at home and sometimes even more. Respite care in another location can provide social opportunities and help you and your loved one feel out potential senior living communities.

This article originally appeared on APlaceforMom.com and was syndicated by MediaFeed.org.

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