Medicaid wants its elderly clients to be safe, but prefers them to be safe in an economically efficient way. With that in mind, it benefits the government agency to keep older clients living at home rather than in a long-term care facility.
Genworth, a Virginia-based long-term care insurance provider, conducts an annual cost of care survey for retirees. The median price for a month in a private room in a nursing home in 2020 was $ 8,821. A semi-private room costs $ 7,756 a month.
To keep clients living at home longer, even if they need help, all 50 states and the District of Columbia offer some type of program through Medicaid that allows clients to choose a family caregiver who is paid with Medicaid funds. In many states, they can choose a friend or relative, often an adult child or spouse, to be their designated caregiver.
“The vast majority of older adults want to stay home as they age, and allowing them to pay a friend or family member to help them with their daily needs can make that possible,” said Susan Reinhard, senior vice president of Public Policy, AARP. . Institute. “The pandemic prompted states to expand this option, and we hope that many of them will make their policy changes permanent.
“Paying family caregivers is a solution that saves states money and meets the growing need for long-term care.”
How to become a paid caregiver for a family member
Clients must demonstrate that they need a certain level of care, and caregivers must demonstrate that they are capable of providing that care. If the client needs medical attention and the loved one is not trained, they cannot be appointed as a caregiver.
The amount of money paid to family caregivers varies by state Medicaid programs, the level of care the individual needs, and the average salary for a home health aide in each state. The programs that allow family caregivers to be paid also have different names and have different warnings and benefits in each state:
- Home and Community Based Services Waivers they are offered by most states. But many have a limited number of these exemptions, so there may be a waiting list. This exemption allows the Medicaid participant to hire a friend or family member as a personal care attendant. This is also known as Exemption C of 1915.
- The Self-Directed Personal Assistance Services State Plan Option allows a Medicaid participant to hire, train, and pay a personal care attendant of their choice. Based on the budget that Medicaid offers, the participant decides how much the attendant is paid. A unique part of this option is that the participant pays taxes on the attendee’s payroll. An intermediary helps with this financial aspect of the process.
- Community first choice, also called the 1915 state plan option, actually applies to Medicaid recipients who are in nursing homes but need personal care services. Rather than paying more for a staff member at the facility to provide that care, this option allows friends or family to help with bathing, grooming, housework, and transportation. According to the American Council on Aging, the following nine states offer this option: Alaska, California, Connecticut, Maryland, Montana, New York, Oregon, Texas, and Washington.
- With the Child caregiver exceptionMedicaid does not pay the adult child a salary for the care of his parents, but allows the parent’s home to be transferred to the adult child as a form of payment. This comes into play when an elderly Medicaid participant moves into a nursing home but would not qualify for Medicaid because they own their home.
Learn more about Medicaid
Eligibility for Medicaid in general, not just for these programs and waivers, is not consistent across the country. A general rule of thumb as of 2021 is that senior applicants cannot have more than $ 2,382 in income and $ 2,000 in assets.
State specific eligibility can be found here. If an older person is already enrolled in Medicaid, the next step is to contact their state Medicaid office.
The American Council on Aging strongly recommends finding a Medicaid planner to help you apply for caregiver positions and other benefits.
Katherine Snow Smith is a staff writer for The Penny Hoarder.