More than 48 million Americans are providing unpaid care for their loved ones. Are you one of them?
Caregiving a relative can be challenging. You must navigate providing essential care for your aging parents or family members and balancing your own other duties and responsibilities. The big question arises: “Will Medicare pay you for being a caregiver?”
We will break down who qualifies as a caregiver under Medicare. We will also explore how you can receive compensation as a family caregiver.
The Need for Caregivers
The United States is witnessing an ever-increasing need for caregivers. According to one study, a significant percentage of seniors (approximately 77%) express a strong desire to age in place. This means they wish to continue living at home, not at a nursing home or other long-term care facility.
For seniors, aging in place improves their overall well-being and quality of life. It allows them to retain independence and control over their lives. It is more cost-effective than institutional care, making it a preferred option for many families.
However, to age in place, many seniors require a caregiver.
General Qualifications for Family Caregivers
Caregiving responsibilities can encompass a wide range of tasks, including:
- Homemaker services such as transportation and errands
- Personal care
- Pet sitting
- Assisting with bathing and grooming
- Grocery shopping and meal preparation
- Laundry and light housekeeping
- Snow shoveling or lawn care
- Giving medication or assisting with physical therapy.
Generally speaking, a caregiver must be over 18, be able to complete these tasks and have a valid driver’s license.
Will Medicare pay you for being a caregiver?
The short answer is no. Original Medicare will not pay for a caregiver.
Medicaid, however, often will provide coverage for caregivers. State Medicaid plans allow you to direct your benefits toward paying family caregivers. The amount you can direct to your caregiver can vary widely depending on the plan and how much care you require.
Medicaid’s in-home medical coverage covers intermittent skilled nursing, occupational and physical therapy, speech therapy, medical social services, and injectable medications.
Significantly, all fifty states permit self-directed Medicaid for long-term caregiving. Nevertheless, Medicare does not directly compensate family caregivers, and rules can vary considerably from one state to another. It’s essential to look at your state and your specific circumstances.
How Can I Get Paid as a Family Caregiver?
For most family caregivers, payment often comes through a Medicaid Self-Directed Care Program. This program allows beneficiaries to allocate their benefits to qualified caregivers.
In addition to Medicaid, some caregivers may also explore other avenues like Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI) for long-term care coverage. However, it’s important to note that SSI and SSDI are separate federal programs with their own eligibility requirements, and they are not part of Medicare or Medicaid. For more information on these options, you can contact your state’s local area agency on aging.
Home Health Services Under Original Medicare
Original Medicare covers essential home health services when you meet specific criteria. To qualify, you must:
- require part-time or intermittent skilled services, and
- be “homebound,” meaning it’s difficult to leave your home because of illness, injury, or medical guidance.
It’s important to note that these covered services are typically provided by certified health professionals rather than family caregivers. Covered services can include skilled nursing care, physical therapy, occupational therapy, speech therapy, medical social services, and part-time home health aide care when concurrently receiving skilled nursing care. Some injectable drugs, durable medical equipment, and medical supplies for home use are also included in the coverage. A home health agency will coordinate these services.
Long-Term Care Insurance and Life Insurance
Long-term care insurance and life insurance policies can be valuable resources when financing caregiving services. These insurance options may cover caregiver services depending on the policy terms and coverage. These policies often allow individuals to select from a range of care options for coverage when initially purchasing the policy.
Remember, your long-term care insurance policy doesn’t automatically include caregiver coverage. You must carefully review your specific policy documents to determine the extent of coverage, any limitations, and the claims process.
Support for Veterans: Veterans Programs
If you are assisting a veteran, you can access specialized programs. You and the veteran must meet specific requirements to qualify for these programs.
The caregiver must:
- Be an adult family member or live-in companion of the veteran requiring caregiving services.
The veteran must:
- have a VA disability rating, either individual or combined, of at least 70%
- be discharged from the U.S. military or have a date of medical discharge and
- require at least six months of continuous, in-person care services.
Training for Informal Caregivers
A new proposal by the CMS seeks to grant Medicare reimbursements to healthcare professionals who provide training to informal caregivers. Family caregivers will be able to receive training that will help them provide medical care and administer prescription drugs.
This comprehensive proposal encompasses individual and group training. The CMS is still seeking comments from the public before finalizing its proposal.
Caring for your family with The Medicare Family
Navigating the complexities of caregiver compensation under Medicare and Medicaid rules requires careful consideration and planning. If you have questions or need expert guidance, The Medicare Family is here to help. With over 40 years of experience as Medicare experts, we can provide invaluable insights and assistance. To learn more, schedule an appointment with The Medicare Family today!