How To Get Paid To Take Care of a Family Member With a Disability

Are you taking care of a family member with a disability who’s struggling to manage their daily basic activities on their own? This can be an invaluable gift that enables them to remain in their home. However, when caring for loved ones without pay, many caregivers experience financial strain.

Caring for a loved one can require out-of-pocket expenses as well as reduced work hours, which can mean sacrificing income, career opportunities, and benefits.

If you’d like to continue caring for a disabled family member but need compensation to meet your financial needs, here are some programs that may be able to help. Learn how to become a caregiver who gets paid regularly.

What Programs Pay Caretakers?

Below, you’ll find various programs and other routes that can potentially help you get paid as a caregiver.

Medicaid Self-Directed Care

Medicaid covers various groups of people, including adults with intellectual, physical, and developmental disabilities, and elderly individuals who need additional services to help them live independently.  Beyond the normal coverage, it offers a Self-Directed Care program that allows disabled individuals to manage their care.

In other words, the disabled person (or their chosen representative) can manage a budget, choose who will provide them with personal care services, and decide how the services will be provided. If properly documented, the disabled person and their chosen caregiver (you) can be paid by the Medicaid program.

While it’s a federal program, to be eligible, the covered individual needs to meet the requirements set by their state. For example, in Idaho, they must:

• Live in Idaho.
• Be at least 65 years old or have a disability diagnosis under the Social Security Act.
• Meet the income guidelines.
• Be a U.S. citizen or a non-citizen who is eligible.

Additionally, states have several options for providing self-directed Medicaid services. Your state may offer any one of the following programs:

• The Home and Community-Based Services Waiver Program (1915 c): States can develop waivers for people who prefer to get long-term care services in their home or community rather than in an institution.
• Community First Choice Program (1915 k): Allows states to provide home and community attendant services and support to eligible Medicaid enrollees.
• The Home and Community-Based Services State Plan Option (1915 i): Enables states to define needs-based criteria for individuals to receive a combination of medical and long-term services in their home or community.
• Self-Directed Personal Assistance Services State Plan Option (1915 j): Enables personal care services that are provided under the Medicaid state plan or waivers that are in place.

To find out what options are available and which requirements apply to your situation, contact your local Medicaid office.

State Programs

Each state has its own programs that may help you get paid.

For example, California offers Paid Family Leave (PFL) for up to eight weeks. PFL is eligible to caregivers of ill family members who have paid into State Disability Insurance for the previous five to 18 months. If you qualify, you can receive about 60% to 70% of your normal wages every week.

While not a permanent solution, PFL could help you start getting compensated while you figure out a long-term solution.

The programs will vary from state to state, so contact your local Medicaid office and ask them about your specific caregiver payment programs and resources. Also, look for other authorities that may be able to help, such as Agencies on Aging, Aging and Disability Associations, and Departments of Health and Social Services.

Veteran Directed Care

Veteran Directed Care (VDC) is a program that gives qualifying veterans of all ages a budget for the personal care services they need. These services can include help with activities such as preparing meals, bathing, and getting dressed.

With the help of a counselor, a veteran or their representative can develop a spending plan and hire their own care providers, which can be family members. The goal is to help more veterans live at home and participate in their communities.

Aid and Attendance Benefits and Housebound Allowance (Veterans)

The Aid and Attendance Benefits and Housebound Allowance program is designed for veterans who are housebound or need help with daily activities. To be eligible, veterans need to receive a VA pension and meet one of the following conditions:

• They have limited eyesight.
• They need help with daily activities such as bathing, eating, and getting dressed.
• They have to stay in bed or spend most of their time in bed because of an illness.
• They are in a nursing home because of a disability that caused them to lose mental or physical abilities.
• They spend most of their time at home because of a permanent disability.

If a veteran qualifies, they’ll receive monthly payments on top of their monthly VA pension, which can help to cover the costs of a family member providing care.

Program of Comprehensive Assistance for Family Caregivers (PCAFC) (Veterans)

PCAFC enables veterans to appoint one primary family caregiver and up to two secondary family caregivers. Those designated individuals can receive a variety of benefits, including a monthly stipend along with caregiver training, mental health counseling, access to health care benefits, and more.

To qualify, the veteran must have a VA disability rating of at least 70% (individual or combined). Their disabilities must also have been caused or worsened during active duty on or before May 7, 1975, or on or after Sept. 11, 2001. Additionally, the veteran must have been discharged from the U.S. military or have a date of medical discharge and must need at least six months of ongoing, in-person personal care services.

Caregivers must be family members or individuals who live with the veteran full-time and who are at least 18 years old.

Long-Term Care Insurance

Long-term care (LTC) insurance helps cover the costs associated with long-term care that are often excluded from Medicare and health insurance plans. These can include personal care services for those who need help with basic daily activities.

If your family member has this coverage, it may help cover the costs to pay you to be their caregiver.

Private Caregiver Payment Contract

The going rate for a home health aide was $29,260 per year, or more than $14 per hour, in 2021, according to the U.S. Bureau of Labor Statistics.

So if your family member can pay you, it’s reasonable to request compensation for your role as a caregiver. To go this route, it’s best to create a formal contract between you and the family member, drafted by an attorney who specializes in elder care. It should outline your work and payment schedule.

Tax Credits and Deduction

Lastly, another route to get paid or reimbursed for the expenses you incur while taking care of a family member is on your taxes, especially if you file taxes together with the disabled individual.

The following credits and deductions may be available to you, depending on your situation:

• Medical Expenses Deduction: If the family member you care for is your spouse or dependent, you can deduct the qualifying medical expenses that exceed 7.5% of your income. This can include money spent to diagnose, cure, mitigate, treat, or prevent diseases, and can help to reduce the taxes you owe.
• Child and Dependent Care Credit: If you paid for the care of a qualifying family member while you were working or looking for work, you can get a credit equal to 50% of your expenses (up to $4,000 credit, or 50% of $8,000 in expenses, for an individual in 2021).
• Credit for the Elderly and Disabled: Qualifying taxpayers who are at least 65 years old or retired on permanent and total disability and who received taxable disability income can receive a tax credit from $3,750 to $7,500.

While these aren’t sources of regular income, they may help you recover some of your costs when you file your taxes each year.

How To Apply for Caretaker Pay

Now that you know many of the ways you can get paid, how do you apply?

Medicaid Self-Directed Care

To learn more about Medicaid Self-Directed Care and to apply, contact your local Medicaid office. The application process will vary by state.

State Programs

Contact your state agencies to find out about the available programs. You can start with your local Medicaid office as well as the department that handles health, aging, and/or social services in your state.

Veteran Directed Care

If the Veteran Directed Care (VDC) program sounds right for your situation, you and the veteran you care for should reach out to their VA social worker to find out if the program is available in your area. If it is, they can help with the next steps.

Aid and Attendance Benefits and Housebound Allowance (Veterans)

With the Aid and Attendance Benefits and Housebound Allowance program, the veteran can apply by completing VA Form 21-2680, which is the Examination for Housebound Status or Permanent Need for Regular Aid and Attendance. Their doctor will need to fill out the examination section.

They should also include evidence that shows they need the program’s services, like a doctor’s report, along with details about their daily activities, their disability, and how it impacts their life.

All of the paperwork will need to be mailed to the Pension Management Center (PMC) in your state or delivered to a VA regional office near you.

Program of Comprehensive Assistance for Family Caregivers (PCAFC) (Veterans)

To apply for PCAFC, both you and the veteran will apply together to determine your eligibility. You’ll fill out VA Form 10-10CG, which is a joint Application for the Program of Comprehensive Assistance for Family Caregivers.

You can submit it, along with any supporting documents, online, by mail, or in person at your local VA medical center.

Long-Term Care Insurance

Long-term care insurance is provided by private insurance companies that use medical underwriting. It’s best to research various companies, get multiple quotes, and compare them to find the best deal.

Private Caregiver Payment Contract

A private caregiver payment contract isn’t something for which you apply. Instead, it’s an option you should consider. In some cases, such as when the family member receiving care has sufficient financial resources, it may make sense. If a private caregiver payment contract seems like a good solution for you and your family member, speak with them, other family members involved, and an attorney.

Tax Credits and Deduction

If you’re interested in the possibility of getting tax credits and/or deductions, speak with a tax preparer or a tax attorney to find out if you qualify.

What Happens After You Become a Caregiver?

After you become a paid caregiver, you’ll receive regular compensation for the care you provide your family member. What happens next depends on the way you are getting paid.

For example, with the Medicare Self-Directed Programs and the Veteran Directed Care Program, the disabled family member is in charge of choosing who they want to provide their care services. So as long as they want you to be the person providing care and continue to qualify for the program, they can continue to keep you in the position of their paid primary caregiver.

Frequently Asked Questions (FAQs)