Serving as a caregiver for a family member is an enriching experience. You get to spend time with your loved ones, and you also have the opportunity to ensure they receive the best quality care possible. In addition, as the primary caregiver, you don't have to worry about outside help that may not be sympathetic or attentive in caring for your loved one.
Unfortunately, being a caregiver for a family member comes at a cost. Caregivers often have to significantly reduce their number of hours working outside the home or leave their jobs entirely to provide quality care for their loved ones. This means that caregivers are spending hours assisting loved ones with daily tasks, cooking meals, taking them to appointments, ensuring their safety and well-being, and providing companionship but are not being compensated for their time.
The Caregiving in the U.S. 2020 AARP Research Report highlighted that 1 in 5 caregivers report high financial strain due to caregiving. In addition, 3 in 10 have stopped saving, and 1 in 4 have taken on more debt.
Caregivers can lose a great deal of income as they care for their loved ones, yet they often have to pay for caregiving expenses out of their own pockets. According to the AARP report, family caregivers spend about 20% of their income on costs associated with caregiving.
Family caregivers need to know their options for financial assistance while caring for their loved ones. Here are a few steps you can take to be compensated for caregiving:
Determine your eligibility for Medicaid's Self-Directed Services
Opt into a home and community-based services program
Determine whether your loved one is eligible for Veterans Aid
Determine whether your loved one has a long-term care insurance policy that provides for caregiver compensation
Determine whether your company offers paid leave for caregivers
Determine whether your family is willing to pay you for your caregiving time
If you need to become a paid caregiver, look into the following possibilities for caregiver compensation.
Step 1: Determine Your Eligibility for Medicaid's Self-Directed Services Programs
If your loved one is eligible for Medicaid, you may be able to receive financial aid from the Self-Directed Medicaid Services programs. According to Medicaid.gov, states have several options for providing Medicaid enrollees with the opportunity to self-direct Medicaid services under the state plan and waiver programs. This option is available in some form in most states. It is important to note that the names of self-directed services programs vary from state to state. Self-directed services programs provide people with disabilities, including older adult citizens, the option to manage a budget and determine how to use their money to pay for goods and services directly relating to their personal care needs. For example, when enrolled in one of these waiver programs or other self-directed options, program participants may use their allotted budget to hire and pay for caregivers. Contact Modern Health Home Care to determine your family member's eligibility for self-directed services available in your state.
Step 2: Opt into a Home and Community-Based Services Program
Many older adults are eligible to opt into a home and community-based services program (HCBS). HCBS programs, such as services provided by Caregiver Homes, deliver ongoing support and care oversight to assist caregivers while providing them with a tax-free daily stipend to make the financial burden of caregiving easier to bear.
These programs are typically available to Medicaid beneficiaries who receive in-home care. They are often open to people with intellectual or developmental disabilities, physical disabilities,/or mental illnesses, and older adults. The guidance and financial assistance HCBS programs reduce the financial burden on caregivers and while enabling them to learn and improve at providing quality care.
Step 3: Determine Whether Your Loved One Is Eligible for Veterans Aid
In the United States, some veterans can enroll in a Veteran Directed Care Program (previously known as Veteran-Directed Home and Community Based Services programs). This program empowers veterans to manage their care, including hiring and paying for in-home caregivers. Another option for veterans who require in-home care is a benefit known as Aid and Attendance. This benefit may be used to cover assisted living, nursing home, and in-home care costs, including paying family caregivers.
In many cases, your loved one must need assistance with activities of daily living and fall in line with income and asset guidelines. If you need more help determining your loved one's eligibility for these veteran's benefits, contact your local Veterans Affairs office or your local veteran's service organization.
Step 4: Determine Whether Your Loved One Has a Long-Term Care Insurance Policy That Provides for Caregiver Compensation
According to the Family Caregiver Alliance, some long-term care insurance policies include provisions for paying a family member who provides care. If you can determine whether your loved one has such a policy, you need to determine if caregiver payment is among the benefits. If you need clarification about your loved one's long-term health insurance policy, contact the agent or the insurance company and ask about the caregiver payment benefit.
Step 5: Determine Whether Your Company Offers Paid Leave for Caregivers
As more families require at least one member to serve as caregivers for aging parents, companies realize the need to assist employees with paid leave. If you find yourself acting as a caregiver to a family member while you are employed, your company may offer an elder care program or benefit. In addition, companies like Intel and Sun Life are allowing up to 8-16 weeks of paid leave for caregiving employees. However, the Bureau of Labor Statistics found in 2018 that just 16% of private-industry employees had access to paid family leave through their employers, and 88% had access to unpaid family leave.
Step 6: Determine Whether Your Family is Willing to Pay You for Your Caregiving Time
Considering the amount of money, you are saving your loved one and the rest of the family by serving as the primary caregiver, you are well within your rights to ask your loved one or other family members if they will compensate you for your time. The family would be paying out of pocket for a home health aide, which the Genworth Cost of Care Survey reports carries a monthly median cost of $4,576 per month. To protect yourself and your family, meet with an attorney to explicitly draft a contract to state your work and payment schedule. This contract may be used later if your loved one needs to apply for Medicaid or enter an assisted living facility or nursing home.
You must know your loved one's eligibility for various government programs, insurance policy benefits, employee benefits, and family payment options if you hope to become a paid caregiver for a family member.
To help you navigate the available options, we've put together a step-by-step guide to help you obtain financial assistance for caregiving services.
Pennsylvania's OPTIONS Program is a non-Medicaid-funded program that assists older adults and family members in caring for aging loved ones at home. The OPTIONS program funds some assistance services through block grants (Aging Block Grants or ABG) provided through local Area Agencies on Aging. Recipients cannot also be receiving services through the Pennsylvania Department of Aging Medicaid Waiver. Still, those who are not eligible for Medicaid may be able to receive some free or low-priced services through other funding avenues. In addition, some services provided through the OPTIONS program may be self-directed, allowing participants to choose their service providers. However, family members are typically not eligible to be paid for providing services through this program.
Medicaid-funded programs in Pennsylvania include the Community HealthChoices Program (CHC) and Pennsylvania Services My Way. The CHC program began in January 2018 and rolled out in phases. Those previously enrolled in the Pennsylvania Aging Waiver (PDA) were automatically enrolled in CHC as it became available in their area. The Community HealthChoices Program is a Medicaid managed care program serving adults 21 years of age and older who are dual-eligible (eligible for both Medicare and Medicaid), or individuals who require skilled nursing care (and would otherwise qualify for nursing home placement).
CHC provides older adults and physically disabled individuals with medical benefits and long-term support services to promote independent living and prevent unnecessary nursing home placements. Benefits include personal care services, such as assistance with activities of daily living (ADLs) and instrumental activities of daily living (IADL), like bathing, meal preparation, and medication management. Enrollment in this program is mandatory for those who meet the eligibility requirements. Seniorlink offers a support program known as CarePlus, for family caregivers enrolled in the CHC program.
The Pennsylvania Services My Way (SMW) Program allows recipients to choose their care providers. While it's not technically a specific Medicaid waiver, it is a program that provides another way for waiver recipients to receive services. Through the SMW program, certain family members may receive compensation for providing services. Participants work with a state case manager to determine care needs and a budget, resulting in an Individual Services Plan – from there, participants can choose providers for obtaining the required goods and services. Adult children, neighbors, and other family members may be hired, although spouses and legal guardians are ineligible for compensation for providing services. An Employer Agent, a fiscal intermediary, handles payments to care, providers.
The Pennsylvania Domiciliary Care program, also known as Dom Care, is a state-funded program that offers an alternative to assisted living by allowing care recipients to receive care in a caregiver's home. Providers are screened by the PA Area Agencies on Aging and may care for up to three recipients in their homes, although most providers care for a single resident or married couple. Care recipients cannot move into a relative's home, but they may move into a friend's home, provided they're qualified to provide the required services and pass the background and safety screenings.
Pennsylvania's VDC program is offered through the Philadelphia, Pittsburgh, Coatesville, and Erie, PA VA Medical Centers.
Summary: How to obtain financial assistance for caregivers in Pennsylvania
Contact your local Area Agency on Aging for information on the OPTIONS program, availability, and eligibility requirements. Your local AAA can also assist you with the application process.
Determine eligibility for Medicaid and apply if eligible. You can apply online using COMPASS.
Call the PA Department of Aging Resources Long Term Care Helpline at 1-866-286-3636 for information on the Services My Way Program or to start the application process.
Click here to learn more about Community HealthChoices (CHC) and visit Care Coordination to get in touch with a care coordinator to assist you in obtaining services.
Get in touch with Seniorlink of Pennsylvania to learn more about the caregiver coaching and support program, eligibility criteria, and how to apply.
Contact your local Area Agency on Aging for information on other programs and services that may be available or your local county assistance office.
Veterans should contact the Pennsylvania Department of Military and Veterans Affairs for information on the VDC program.
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