How do we start the process of payment for care?

What is your aunts source of income.? That will make a big difference in how to approach all this. & what happens if you cannot provide caregiving at home anymore? To me, those are the keys to figuring out what direction to take.

If she ends up needing a higher level of care & goes to a NH, She can apply for Medicaid but her Payments to you will be viewed as a transfer penalty & make her ineligible for Medicaid. This is why you need a legit caregiver agreement done.

If she is stage 4, she will likely qualify for hospice. Now if she is over 65 she can get hospice as a benefit of Medicare. How young is she? If under 65, I'd suggest calling hospice providers to see how payments are done if NOT billable to Medicare. Your state may have a hospice program for the non elderly.

If her cancer has an association - like leukemia has Leukemia & Lymphona assoc with chapters all over - I'd contact them to see what might be available in your state. Others have been down this path, so you can learn from them. Good luck and it's wonderful you can do this for auntie!

OOPs the forms are on NOLO press or just type "caregiver agreement template" on a google search. Some states also have templates.

nono press also has one called "elder care agreement"...

A written agreement with the help of a lawyer to avoid complications.

The only thing I would add to ba8alou's post is to her pay you by check, not cash. create a time record of some sort and give her a bill for services. Also keep track of how much you collect each year as it may be subject to income tax. This may sound over the top but you want to help her if her money runs out and she can qualify for Medicaid at some time and they look back five years to see if she may be giving cash assets away to qualify. Further, if she has relatives, you want proof of services if they, God for bid, accuse you of stealing her money. Sad, but it happens all the time and you need to protect both of you.

I'm no expert on this. But if your cousin in not elderly and if she is terminally ill, and if there is no thought that she will live long enough to need Medicaid assistance, you can have a caregiver agreement drawn up and she can use her funds to pay you. If you are asking if you can be compensated by, say, Medicaid, that his a different question. Give us some clarification, you will get more accurate information.