Medicaid Caregiver Program: Who’s Eligible and How to Apply

It’s common for family and friends to serve as informal caregivers to their loved ones. However, balancing giving your loved one adequate care with other parts of your life can be tiring. And many times, caregivers have to sacrifice one or the other.

The Medicaid Caregiver Program offers a solution to this problem by compensating caregivers for their time. However, as with most things related to Medicaid, navigating the program can prove a little tricky. 

Key Takeaways 

• Medicaid may pay family members to take care of their loved ones.
• Eligibility for the program varies per state.
• Typically, caregivers must be over 18 years old.
• Under the Medicaid self-directed option, beneficiaries can choose who delivers care to them.
• Some non-Medicaid programs also pay caregivers 

What Is the Medicaid Caregiver Program?

The Medicaid caregiver program allows you to receive payment for caring for your loved one. 

Medicaid is originally known for taking care of older citizens and covering their nursing home expenses. However, there are situations where the participants prefer to receive care from the comfort of their homes. In such situations, the participant can apply for home care coverage. 

Participants approved for homecare assistance can choose who delivers the homecare assistance. This means they can decide to use one of the many home care agencies that work with Medicaid, or they can choose a person who Medicaid will pay to take care of them.

Most states call this “Care Direction,” however some other states refer to this option as Participant Directed Services, Choice Programs, Self-Administered Services, or Cash and Counseling. 

Many seniors pick their family because they prefer the familiarity and comfort of having someone they know care for them. 

Who Is Eligible for the Medicaid Caregiver Program?

Medicaid is a federal and state program, which means eligibility criteria differ by state. 

To become a Medicaid caregiver, your loved one must first be eligible for a Medicaid program or waiver that allows Care Direction.

The eligibility requirements you must meet also differ from state to state. However, there are some points to note:

• Medicaid caregivers must be over 18 years of age
• They must reside in the same state as their loved one
• Some states require that the caregiver has at least a high school diploma/GED or a year of comparable experience
• Some states require the caregiver to formally register as one 

How to Apply for Medicaid Caregiver Program

The Medicaid application process varies depending on the state and the specific program your loved one is enrolled under. discover registration details by contacting your loved one’s primary Medicaid contact. Depending on your state of residence, the steps below may differ slightly. 

1. Determine if Your Loved One is Eligible For Medicaid Homecare: Not all Medicaid programs cover home care assistance. Most of the Medicaid programs with an allowance for Medicaid homecare are waivers. You can determine this by contacting your state’s Medicaid office or consulting an elder care lawyer.
2. Choose the Self-Directed Care Option: As stated earlier, most programs that offer home care also allow beneficiaries to choose who they receive care from. This is only available under the Self-Directed Care option.
3. Get Assessed: The Centers for Medicare and Medicaid Services will request that your loved one undergo an assessment to determine the kind of assistance your loved one needs. 
4. Planning: After the assessment, your loved one and the necessary representative will draw up a service plan that details all the areas they will need help. This includes activities like bathing, shopping, light housekeeping, cooking, etc. Sometimes they may draw up a budget to take care of certain goods and services. 
5. Select a Caregiver: The last step is for the care recipient or beneficiary to select a caregiver. 

What Medicaid Programs Pay Caregivers?

Several Medicaid programs pay caregivers for their time. However, different states have different plans. Be sure to consult your local Medicaid office or reach out to an elder care attorney for more information on the programs your state offers.

Self-Directed Personal Assistance Services

Self-Directed Personal Assistance Services (PAS) allows program participants autonomy over some key aspects of their program. Under this service, participants can decide how they spend their Medicaid allowance including managing cash payments and purchasing health products.

More importantly, your loved ones can choose, manage, and train whomever they’d like to be in charge of their care. 

Note that this is not a program in itself; it’s an option some states attach to their Medicaid program. It’s also an entitlement since it falls under regular Medicaid. Hence, eligible participants have access to it without a waiting list. 

It’s sometimes called the 1915(j) Authority. 

Adult Foster Care

In some states, adult foster care is available to caregivers who live with the care recipient. Medicaid offers financial assistance to caregivers in exchange for 24-hour supervision. 

This arrangement is more popular between aging parent(s) and adult children. However, some states sometimes pay spouses too. 

Please note that Medicaid will not pay for room and board. They will, however, handle the participants’ medical care and compensate the caregiver. 

In some states, Medicaid also provides the adult child (caregiver) with training and respite care. 

Medicaid Caregiver Exemption 

The Medicaid Caregiver Exemption, sometimes called Caregiver Child Exemption or Caretaker Child Exception. is not a program on its own. Rather, it’s a Medicaid exemption that allows adult children of beneficiaries to inherit their parents’ home as a form of payment for taking care of their loved one. 

To be eligible for this exemption,  you must have lived with your parent(s) for at least two years before they moved into a nursing home. You must also have medical documentation to prove that your caregiving played a vital role in delaying their transfer to a nursing home. 

Home and Community-Based Services (HCBS) Waivers

HCBS waivers or 1915 (c ) Waivers are common in most states and are available to seniors who prefer in-home assistance to living in a nursing facility. Medicaid uses the money allocated to care for your loved one in a nursing home to provide in-home care. This includes assistance with activities of daily living, light housekeeping, grocery shopping, etc. 

Most waivers, HCBS included, allow participants to hire the personal assistant of their choice. 

You should note that waivers are not entitlement programs, meaning eligibility doesn’t always guarantee a spot. Most states have a predetermined number of participants they can take in and a selected region they accept applicants from. As a result, they always have long waiting lists.

Other Options that Pay Caregivers

Here are some non-Medicaid options that pay caregivers:

• VA Aid & Attendance: Veterans Aid and Attendance Housebound pension is available to wartime veterans and their spouses. Usually, the amount paid to the veteran or spouse depends on their present income. 
• VA Family Caregiver Program: The VA’s Program of Comprehensive Assistance for Family Caregivers (PCAFC) provides a stipend, health insurance and other benefits to family members who are taking care of eligible veterans.
• VA Home & Community Based Services: The Veterans Directed Home and Community-Based Services,  also called VD-HCBS or Veterans Directed Care is open to veterans currently enrolled in the VA health system. Under this program, veterans who require nursing home-level care can decide to receive care from home. They also get to receive care from a caregiver of their choice. 
• State-Based Non-Medicaid Programs: Most states offer nursing home diversion programs. These programs assist seniors who do not necessarily need to be in nursing homes. Sometimes these programs also allow seniors to choose who they receive care from. 

When you’re trying to figure out how to pay a family member for their caregiving services, it’s always a good idea to look into as many of these programs as possible.

FAQs

How Much Does Medicaid Pay Caregivers?

The amount Medicaid pays caregivers largely depends on several factors. Generally,  the amount a caregiver is paid hourly depends on the state. However, the monthly and yearly rates are determined by the nature of credit the beneficiary needs and the amount of money available to spend via consumer-directed care. 

Can Caregivers Benefit from Tax Credits and Reimbursements?

Yes, as a caregiver, you can deduct your loved ones’ care expenses. This includes nursing services, the cost of long-term care, transportation to appointments,  prescription drugs, etc. 

What Are My Responsibilities As a Medicaid Caregiver?

As a Medicaid caregiver, your responsibilities include:

• Preparing meals
• Light housekeeping and cleaning 
• Assistance with activities of daily living
• Transportation of your loved one to medical appointments 
• Assisting them with taking their medication 
• Companionship 

Relief Recap

Getting paid as a caregiver for taking care of your loved one can compensate for the time and energy it takes to care for your loved one.  Several Medicaid and non-Medicaid options pay caregivers. However, not all programs are available in all states.