Government Programs for Family Caregivers

Medicaid

If your loved one is a Medicaid recipient, they may be able to hire you as a paid caregiver. Most states offer Medicaid waiver self-directed long-term services and supports (LTSS) programs, which allows Medicaid participants to maintain decision-making authority over their own care and how their Medicaid funds are spent.

According to the most recently available data from the Centers for Medicare and Medicaid Services, combined federal and state spending on these programs totaled over $154 billion in 2016. There are several self-directed options states offer, including self-directed personal assistant services in which participants select and train their own provider and decide how much to pay them and waivers for those who prefer to get home and community-based care, which are referred to as Home & Community Based Services (HCBS). Some states also offer Structured Family Caregiving programs through a partnership with the organization Caregiver Homes. Family caregivers can be paid through this program if their loved one is a Medicaid recipient.

Benefits, coverage, eligibility and rules differ from state to state, according to AARP. Some programs pay family caregivers but exclude spouses and legal guardians. Others will pay care providers only if they do not live in the same house as the care recipient.

Medicaid, which targets low-income Americans, seniors, people with disabilities and a few select other groups, has certain income requirements. Determine the eligibility requirements first to find out if your loved one qualifies for Medicaid. If so, contact your state’s Medicaid office to get more information about self-directed services and whether you can become a paid family caregiver.

Administration on Aging & Department of Aging Services

Other government programs may be able to offset some of your caregiving costs. Each state has several local agencies that are part of the Administration on Aging (AAA), many of which provide resources like:

• Respite care (this is where you would hire a caregiver to take care of your loved one while you take some much-needed time for yourself).
• Meal plans.
• Mobility assistance programs.
• Housing.
• Caregiver training, and other supplemental services.

Visit Eldercare.gov to find contact information for your local AAA agency.

In addition, it may be worthwhile to contact your state’s department of welfare or health and human services to find out what cash or medical assistance programs or support programs may be available to help with some of your family’s caregiving costs and responsibilities.

Veterans programs for family caregivers

If your loved one is a veteran, they may qualify for the Veteran Directed Care Program.

This program is designed for veterans who need daily assistance and for caregivers who need extra help. Veterans or their family caregivers are given a budget to manage their care and help them age in place in their own home or community. With the budget, a veteran can hire a family member or another person to provide in-home care and buy the necessary items or services to help them manage their own care.

The U.S. Department of Veterans Affairs also provides what’s known as Aid & Attendance, which increases a veteran’s monthly pension if they are bedridden and need treatment, if they are a patient in a nursing home, are visually impaired or if they need a regular caregiver to help with their daily activities, which can be a family caregiver or another individual. The agency also offers benefits for veterans who are housebound. To apply for these benefits, contact your state’s pension management center and submit the A&A application form (VA Form 21-2680). (A doctor should fill out the exam information section of the form.) You can also include evidence that details your loved one’s physical or mental disability and information about your loved one’s ability to care for themselves during the day.

Additional options and resources for family caregivers

If you don’t qualify for government or veterans programs, there are still other resources available to help family caregivers. Long-term care insurance is usually the first and best option, and some of these policies may even pay for a family member to provide care. The American Association of Long-Term Care Insurance provides several helpful guides and information resources to help consumers learn more. You also can request a quote from association members, so use this to shop around for the best price and the most comprehensive benefits. Premiums for long-term care insurance also may be deductible, depending on your loved one’s adjusted gross income.

Personal care agreements are another option to get paid for providing care to a loved one. Under these agreements, an elderly relative would enter into a contract with a family member to provide care. Though this arrangement may seem odd or uncomfortable, it can ease some of the financial costs that come with caregiving. Just be sure to consult an elder law attorney to advise on how to draw up the contract to protect both parties and to outline any tax obligations.

Tax deductions also can help to offset caregiving costs. Make sure you keep records of all your caregiving expenses throughout the year, because you may be able to use this information to get the dependent care credit, which can equal up to 35% of your qualifying expenses, including medical treatments, transportation to and from a health care provider, and health insurance premiums, among other expenses.

To qualify for caregiving-related deductions, you must be responsible for more than 50% of the costs for your loved one’s support, your loved one must be a dependent, spouse or qualifying relative (i.e. an aging parent), and they must be below a certain gross income.

And if you’re juggling caregiving and a full-time job, your employer might offer an elder care program or benefit. For example, since 2016, Deloitte has offered 16 weeks of paid leave to full-time employees caring for a family member. The same year, Nike offered all full-time employees (those who work 30 hours or more per week) eight weeks paid family leave.

Is more help for family caregivers on the horizon?

Caregivers’ need for financial assistance is not going unnoticed. In 2017, Hawaii became the first U.S. state to provide this benefit through the Kupuna Caregivers Act, which can provide up to $70 per day to cover things such as healthcare and transportation. Other states may view Hawaii’s provision as a litmus test of sorts, as they consider similar moves.

The bipartisan RAISE (Recognize, Assist, Include, Support and Engage) Family Caregivers Act, signed into law in January 2018, requires the U.S. Department of Health and Human Services to outline a strategy to help caregivers through federal programs, workplace policy changes, and more.

Even if additional resources come to pass, the benefits received won’t amount to the average full-time salary. But caregivers know that every additional bit of financial support can help adjust to this life-altering situation.