According to a report conducted by the AARP Public Policy Institute, approximately 41 million family caregivers provided 34 billion hours of unpaid care in 2019. Caregivers’ unpaid contributions had a staggering estimated economic value of $470 billion. Unfortunately, this care is commonly provided at a huge personal cost to caregivers, including lost wages and benefits. Many spend thousands of dollars out of pocket each year on their care recipients, often to the detriment of their own financial security and retirement savings.
“Can I get paid for caring for my parents?”
It should come as no surprise, that the number one question asked in the AgingCare.com Caregiver Forum is, “Can I get paid for caring for my parents?” Unfortunately, there is no definitive answer. The vast majority of family caregivers do not get paid to care for an elderly loved one. However, there are a few options available that may allow a family member to receive payment in exchange for the care they provide.
Personal Care Agreements
Not all care recipients will be amenable to this arrangement, but it is possible for aging parents to use their own funds to pay a family member (usually an adult child) for the care they provide. It is important to work with an elder law attorney to complete a formal personal care agreement or caregiving contract detailing this arrangement before it begins. The document should outline the services to be provided as well as the payment to be received. Keep in mind that a personal care agreement cannot be created for retroactive payment for past care.
To learn more about how personal care agreements work and how to draft one, read Personal Care Agreements: A Must for Caregiver Compensation and Medicaid Planning.
Sources of Government Assistance for Caregivers
Public programs and assistance vary widely by state and individual circumstances. The resources listed below may help caregivers receive compensation for their services or at least find some programs and assistance that can help offset the costs of providing care for an ill or aging loved one.
While there are many different benefits available to veterans and their family members, the veterans pension was specifically established to help low-income vets with limited assets. There are three tiers of financial assistance:
- Level 1: Basic pension for those with the lowest income and assets.
- Level 2: Housebound pension for disabled individuals with low income and limited assets who cannot leave their home without great difficulty or at all.
- Level 3: Aid and Attendance (A&A) pension for those with low income and limited assets who require the help of another person to perform activities of daily living (ADLs).
The tax-free pension amounts are based on each veteran’s income and assets, and the funds can be used however the veteran sees fit. The housebound and A&A pensions are more sizeable and meant to offset the cost of increased care that eligible veterans require. Keep in mind that surviving spouses of eligible veterans may also qualify for this monetary benefit.
Medicaid HCBS Waivers
Individuals with low income and few assets other than their home may be eligible for health care coverage through Medicaid. This includes hospital care, doctor’s visits, home health care, personal care services and long-term care. Medicaid recipients must meet many eligibility guidelines, including functional and financial requirements.
Seniors who would otherwise be in a nursing home or hospital in order to receive long-term care may be eligible for a Home and Community-Based Services Waiver. Also called 1915(c) waivers, states use this method to pay for the care seniors receive in their home and community.
Waiver programs work differently in each state, and many states have a waiting list for enrollment. Each state names its own waiver program, most of which are associated with their Cash and Counseling Programs.
Medicaid Cash and Counseling Programs
One particular program called “Cash and Counseling” provides Medicaid recipients with a set amount of money each month and the discretion to use these funds to pay approved care providers of their choice. This cash benefit can be used to pay for professional in-home caregivers, family members or even friends to provide care. Cash and Counseling is often referred to as consumer-directed care, in-home supportive services and several other state-specific names.
Medicaid is a joint federal- and state-run program. Each state has its own eligibility guidelines and coverage parameters. To learn more about Medicaid eligibility, HCBS Waivers and the Cash and Counseling Program, contact your state’s Medicaid office or visit Medicaid.gov.
Supplemental Security Income (SSI)
The Social Security Administration’s Supplemental Security Income (SSI) program pays benefits to low-income aged, blind and disabled adults. Unlike Social Security retirement benefits, SSI benefits are not based on a person’s prior work. In addition to increasing a person’s income, applying for and receiving SSI is useful because the eligibility guidelines are also the basis for many other programs, such as Medicaid, food stamps, etc.
To learn more about SSI and apply for benefits, visit the Social Security Administration website.
Help Planning to Pay for Senior Care
If none of the above options is a good fit for you and your elderly loved one, it may help to search for other available benefits and services. Even a single program that can minimize the financial strain on your household can be worthwhile.
Benefits for Seniors
BenefitsCheckUp is the nation’s most comprehensive database of benefits programs for seniors with limited income and resources. BenefitsCheckUp is a free service of the National Council on Aging. This online tool allows elders to see if they qualify for more than 2,500 federal, state and private benefit programs simply by answering a few questions.
Available resources include:
- Prescription drug savings
- Nutrition assistance (including Supplemental Nutrition Assistance/Food Stamps)
- Energy/utilities assistance
- Income assistance
- Legal aid services
- Housing services
- In-home services
- Transportation services
Area Agencies on Aging
There is a federally mandated Area Agency on Aging (AAA) in your region, county or city. Each AAA is staffed by elder care professionals who are knowledgeable about every assistance program and service that is available in your area.
Gather as much information as you can about you and your care recipient’s health and finances and make an appointment to meet with a counselor at your AAA. The staff there can advise you on prospective programs and eligibility requirements and even help prepare the necessary applications and documentation. Visit the Area Agency on Aging Directory to find your local AAA’s contact information and schedule an appointment.
Hire an Elder Law Attorney
Elder law attorneys help seniors engage in estate planning and plan legally and financially for their long-term care needs. For example, an attorney who specializes in elder law may assist a senior in achieving and maintaining eligibility for public benefits like Medicaid and provide assistance with benefit applications, the spend-down process and much more.
When looking for an attorney to help you and your loved one draw up legal documents and apply for benefits, make sure the lawyer you choose has elder law experience specific to the state where your loved one resides. In addition, attorneys can pursue membership of specialized national consortiums. Look for a professional who belongs to the National Academy of Elder Law Attorneys (NAELA) or has received the Certified Elder Law Attorney (CELA) designation.
To find an elder law attorney near you, search the AgingCare Elder Law Attorney Directory.
Sources: Valuing the Invaluable 2019 Update: Charting a Path Forward (https://www.aarp.org/ppi/info-2015/valuing-the-invaluable-2015-update.html)