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The type of Medicaid will determine what is paid for.
If it’s LTC MEdicaid in a NH, Medicaid pays the NH directly a daily room&board fee and pays medical vendors (MDs, PT, Speech Therapist, etc) directly according to an already negotiated rate. The Medicaid recipient does NOT get $ from Medicaid.

For community based (they continue to live in their own Home) Medicaid for elderly, it’s going to depend on the evaluation & care plan as to what health services are needed & that Medicaid will pay for.

If your state does an in-home caregiver program that actually pays a family member (like CAs IHHS), they usually have to do a brief training program and then get paid by the state for whatever hours determined needed by the care plan. Some caregivers have posted on this site, and the average # of hrs is around 18-20 hrs a week with pay slightly above your states minimum wage per hr rate. Like $10 hr & taxable reported income. It will never be over 33 hrs as anyone needing that much direct care needs to be in a facility.

 !!!  Medicaid will not ever pay a family caregiver a salary that you could make working a full time job or what your old salary was .....

Right now the trend for states is to have elders living at home go into a PACE program. Rather than a 1-on- 1 type of payment program. The PACE center has transportation that gets them 2-4 days a week and they spent the day at the center with meals, health care oversight (including medication management), etc at the PACE center. But the elder or their family is expected to provide care or assistance for all the non pace time.

Most programs need for them to be “ duals”, so on both Medicare & Medicaid.
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