Recognizing the critical role that family caregivers play in assisting elders in maintaining their health and well-being at home, there is an expanding variety of alternatives for compensating a family member who cares for an aging loved one. Investigate various programs for elders and their carers, as well as extra financial aid alternatives for those caring for a parent at home.
The AARP Public Policy Institute said that about 41 million family carers supplied 34 billion hours of unpaid care in 2019. Unpaid caregiver contributions totaled an astounding $470 billion in economic value. Unfortunately, carers often offer this care at a high personal cost, including missed income and benefits. Many caregivers spend thousands of dollars a year on their care receivers, often at the expense of their financial stability and retirement plans.
It's unsurprising, therefore, that the most often requested question on the Caregiver Forum is "Can I get compensated for caring for my parents." Regrettably, the solution is complex. The overwhelming majority of family carers are unpaid. There are, however, a few alternatives that may enable a family member to get compensated for the care they give.
Although not all care receivers would agree to this arrangement, elderly parents may use their own money to compensate a family member (often an adult child) for the care they give. Before the arrangement can begin, it is critical to consult with an elder law attorney to draft a written personal care agreement or caregiving contract outlining the terms of the arrangement. The personal care agreement should spell out the services that will be performed and the compensation that will be received. A significant advantage of establishing a formal care agreement is that paying for in-home care services is a legitimate way to spend down assets or income to meet Medicaid eligibility criteria. Bear in mind, however, that a personal care agreement cannot be used to get reimbursement for previous treatment.
Read Personal Care Agreements: A Must for Caregiver Compensation and Medicaid Planning to learn more about how personal care agreements operate and how to create one.
Public aid and programs vary significantly by state and individual circumstances. The resources mentioned below may aid family carers in obtaining remuneration for their services or in locating programs and assistance that may help defray the expenses of caring for a sick or elderly loved one.
Veterans enrolled in VA health care have a variety of choices for managing a disability or chronic health condition from home. According to a Veteran's eligibility and program availability in his or her geographic region, the VA offers home-based primary care, homemaker/home health aide (HHA) services, and respite care for family caregivers. All veterans are eligible for home and community-based care; however, these services must be based on a proven clinical need.
Level 1: Subsidized pension for individuals with the fewest assets and income
Level 2: Housebound pension for handicapped people with little income and few assets who are unable or unwilling to leave their house.
Aid and Attendance (A&A) pension for people with a low income and little assets who need the assistance of another person to conduct daily life tasks (ADLs).
Housebound and A&A pensions are referred to as "enhanced" pension benefits; they are added to the monthly pension a qualified veteran receives and are intended to cover the expense of the additional care required by eligible veterans. Pension payments are tax-free and are determined by the veteran's income and asset levels. Because income levels are determined aftercare costs are deducted, the cost of personal care services may assist a veteran in meeting those income qualifying criteria. Thus, invoices filed for payment of personal care services provided by a family member or home care agency may be used to decrease income levels, and the resultant higher pension amount can be utilized to pay for ongoing personal care services. Survivors of qualified veterans may also be eligible for this financial benefit.
As an alternative to nursing home placement, VA Medical Centers that participate in VD-HCBS contract with home health providers to assist with personal care and activities of daily living. Any veteran registered in the VA health care system and needs nursing home-level care has the option of receiving care from anybody, including family members. If nursing facility care is necessary, a housebound veteran may employ an adult child or a home care service to offer personal care.
In appreciation of the critical role of family caregivers in ensuring veterans' health and well-being, a veteran and their primary caregiver may qualify for a variety of PCAFC benefits. If a veteran qualifies, any family member over the age of 18 may get the following benefits:
Education and training of caregivers
Counseling for mental health
Assistance with travel expenses to a VA Medical Center
30 consecutive days of respite care
The Civilian Health and Medical Program provides access to health care (CHAMPVA)
A stipend payable every month
For additional information about veterans pensions and other VA benefits, visit the website of the United States Department of Veterans Affairs or download a digital copy of our free Veterans Benefits Guide.
Individuals with a low income and little assets other than their house may qualify for Medicaid health coverage. Hospitalization, physician visits, home health care, personal care services, and long-term care are all included in this category. Medicaid users must adhere to a variety of eligibility standards, including functional and financial criteria.
Because Medicaid is jointly financed by states and the federal government, states differ in terms of the services they offer and the names of the programs that provide them. The good news is that all states now provide at least one program that pays for in-home care to assist seniors in delaying or avoiding nursing home placement. In certain jurisdictions, if a senior is qualified for Medicaid in-home care, family members may be compensated for providing the services. Numerous states ban spouses from being compensated. Medicaid users may, however, choose their adult children and/or ex-spouses as their care providers in states that allow self-directed care.
In addition to their state plan, states may provide services via waiver programs. Seniors who would otherwise need long-term care in a nursing home or hospital may be eligible for a Home and Community-Based Services Waiver (HCBS) to get support and assistance at home. Known as 1915(c) waivers, states utilize this approach to pay for care that enables seniors to stay securely and comfortably in their long-term communities.
Each state's waiver program operates differently, and many have waiting lists for participation. Each state has its waiver program, the majority of which are linked to its Cash and Counseling programs.
A program called "Cash and Counseling" offers Medicaid users a predetermined amount of money each month and the option of paying authorized care providers of their choosing with these monies. This financial benefit may be used to pay for in-home care provided by professional carers, family members, or even friends. Consumer-directed care, in-home supportive services, and a variety of other state-specific terms are often used to refer to Cash and Counseling.
Contact your state's Medicaid office or visit Medicaid.gov to learn more about Medicaid eligibility, HCBS waivers, and the Cash and Counseling Program.
If none of the following alternatives work for you and your senior loved one, it may be beneficial to look for additional financial advantages and services. Even a single program that alleviates financial pressure on your family may be beneficial.
Supplemental Security Income (SSI) is a program administered by the Social Security Administration that provides payments to low-income elderly, blind, and handicapped people. Unlike retirement payments from Social Security, SSI benefits are not dependent on a person's previous employment history. Along with boosting a person's income, applying for and getting SSI is beneficial since the eligibility criteria for many other programs, such as Medicaid, food stamps, and so on, are based on the SSI eligibility standards.
BenefitsCheckUp is the nation's most comprehensive database of benefits programs available to low-income and resource-constrained seniors. The National Council on Aging's BenefitsCheckUp is a no-cost program. Elders may use this online tool to determine their eligibility for over 2,500 federal, state, and private benefits programs simply by completing a few questions.
Among the resources available are the following:
Savings on prescription medications
Assistance with nutrition (includes Supplemental Nutrition Assistance Program/Food Stamps
Assistance with energy/utilities
Assistance with income
Services of legal assistance
Services relating to housing
Services provided in-home
Services of transportation
Each state designates an Area Agency on Aging (AAA) to handle the needs and concerns of all older people at the regional and local levels. All Area Agencies on Aging are funded by the federal government via the Older Americans Act, and the majority receive additional money from state and local governments.
Area Agencies on Aging (AAA) are designated to represent a geographical region, county, or city and are staffed by elder care experts who are informed about all available assistance programs and services in that area.
Collect as much information as possible about your own and your care recipient's health and finances, and schedule an appointment with a AAA counselor. The staff can advise you on potential programs and eligibility criteria, as well as assist you in preparing required applications and paperwork. Visit the Area Agency on Aging Directory to learn how to contact and book an appointment with your local AAA.
Elder law lawyers assist elders in estate planning and financially and legally preparing for their long-term care requirements. For instance, an elder law attorney may help a senior in obtaining and maintaining Medicaid eligibility, submitting applications, and much more.
When selecting an attorney to assist you and your loved one with drafting legal papers and applying for benefits, ensure that the attorney you pick has elder law expertise in the state where your loved one lives. Additionally, lawyers may join specialized national consortiums. Consider hiring an elder law attorney who is a member of the National Academy of Elder Law Attorneys (NAELA) or who has earned the Certified Elder Law Attorney (CELA) certification.