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Your parents can pay their own way and still be eligible for Medicaid. It doesn't have to be a "nominal" amount for that purpose. For this purpose a written agreement should be in place to be sure Medicaid does not treat the payments as gifts.

I don't know the tax implications of being paid in room-and-board. Your sister will need to pay taxes on her income. More income means more taxes, but also more ability to pay the taxes.

I suggest the family consult an Elder Law attorney for advice on the most advantageous way to set this up.
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I am asking if room and board plus a small would be adequate compensation for the achieved goal of keeping tax costs down caregiver and Parents being Medicaid eligible.
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nana24bears, I'm not sure what you're asking here. Are you asking if a caregiver agreement would help to prevent problems with Medicaid? Or are you asking if room and board plus a small fee would be adequate compensation?
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