Unpaid family caregivers provide the vast majority of healthcare services for seniors in the US, at an estimated value of $375 billion dollars a year. Caregivers often do this service out of love for a parent or other relative and do not consider the potential costs to themselves in time and treasure.
The Costs of Caregiving
While this is noble, it may be time to consider finding ways to get reimbursed for these costs. The first hidden cost is time itself. This is time you are not improving your own earning potential either because you have reduced hours at work, quit your job, or are simply not getting promoted because you are less available and focused on work.
Another cost to consider is your own personal expenses you use to help a loved one. This may come in the form of outright support like buying groceries and medical needs - to your own transportation or costs associated with caring for someone else. One major expense that can come with caregiving is increased healthcare costs since caregivers are at a higher risk for injuries and illness. Finally, if you have quit your job or are not working because you are caregiving, you are also not as likely to be contributing toward your own social security or retirement.
How to Get Paid as a Caregiver
There are four main ways to get reimbursement as a family caregiver.
Formalizing an Informal Care Situation
The simplest way is if the person has enough money to pay you directly. In this case, it is wise to do this for several reasons. First, if you get paid formally, you can show that you are using your loved one’s assets legitimately if or when the time comes for other family members to question funds or if or when there is a determination of assets to qualify for nursing home care. This is also good for you to show you have been formally employed so that you are viewed more favorably if or when you go to get another job and depending on the level of pay, it may help contribute to social security benefits.
Medicaid and Waiver Programs
In 43 states, there is some form of help for a person to pay for home care services – which can include family caregivers. The idea behind this is that a senior can have some independence in determining which services to buy within a set budget.
Some of these are run through the Medicaid system and some are not – but all are typically a state program and will require residency in that state. The programs operated through Medicaid are called “Cash and Counseling” programs.
The specifics of these programs vary from state to state, but are often set up to help a person stay at home longer rather than entering a nursing home situation. Most require a person to be disabled or over age 65 and will likely involve some kind of needs assessment to determine the type of need for caregiving. While many will require that a person be eligible for Medicaid, the financial eligibility requirements will vary - but typically do not consider life insurance, vehicle or home ownership when determining assets.
For a listing of these types of state services and to find ones in your state, check out the program finder at the National Resource Center for Participant-Directed Services or contact your local Area Agency on Aging.
Veterans Home Care Benefits
Similar to the Medicaid and waiver programs, if your loved one is a military veteran, he or she may qualify for the same kind of ability to pay a caregiver for home-based care. If so, a person cannot do both types of programs. These benefits are currently in 24 states and have similar structure to the Medicaid type programs. For a listing of these types of services in your area, go to this directory to contact your local veteran’s health facility for more information.
What if you are supporting your loved one financially? Even if he or she has their own assets and/or lives separately from you, in some cases, you can qualify to have a person listed as a dependent if you are contributing substantial funds or indirectly through other types of support. See your own tax professional or accountant to look into the possibility of offsetting some of your out-of-pocket expenses this way.
Some caregivers feel awkward broaching this subject and others may worry what other relatives will think. It is important to know your value and know that you are providing something worth compensating. It may be wise to talk to a counselor or your physician about your concerns and learn ways of communicating your needs to family members in a way that is comfortable for you.
While there are isolated cases of people taking advantage of a loved one by taking funds, getting paid professionally for your time and care and talents is a normal and legitimate activity and may help provide stability, credibility, and legitimacy to your caregiving situation. No matter how you get paid (through waivers, veteran’s benefits, or directly), we repeat that it is wise to get a written contract together just for the sake of clarity and making sure both parties are comfortable and understanding the arrangement.