Ways to Become a Medicaid-Certified Caregiver for Your Family Member
May 31, 2023
6 min read
As we age, it's natural to want to remain in the comfort and familiarity of our own homes for as long as possible. However, as our physical and cognitive abilities change, it's getting difficult to manage daily tasks without assistance.
Seniors living in the United States can now receive care at home, even when they require additional support. Most states, like the District of Columbia, offer a Medicaid program that lets them select their preferred caregiver and have it funded through government assistance.
This innovative participant-driven approach ensures residents can stay connected with families, friends, and familiar surroundings for as long as possible without compromising on quality healthcare.
What Is Medicaid?
Medicaid is a federally funded, state-administered health insurance program that provides coverage to low-income individuals and families. Medicaid also offers a range of home and community-based services to help seniors and individuals with disabilities "age in place" and remain in their homes as long as possible. These services can include personal care assistance, homemaking, transportation, and more.
How Do I Become a Paid Caregiver for a Family Member?
Medicaid understands the value of family, offering payment for those supporting elderly relatives. Instead of relying on costly long-term care facilities which take individuals away from their homes, loved ones can receive financial assistance to provide aid and comfort in familiar surroundings.
Genworth, a Virginia-based provider of long-term care insurance, released its research on the prices associated with in-home services. To put it into perspective: one can expect to pay up to $61,776 per year for Home Health Aide coverage and an hourly rate ranging from $19-$36 depending upon location.
For those requiring a certain level of care, caregivers must undergo training to provide the assistance needed. On top of this, individuals providing such services can be eligible for financial compensation based on their state's Medicaid program.
These programs’ regulations may go by different names in each jurisdiction and local average wages for home health aides.
Medicaid State Plans
Most states offer an option to become a paid caregiver for a loved one via Medicaid, commonly referred to as State Plans. While the name of this program may vary between states, such as Medi-Cal in California or MassHealth in Massachusetts, all state plans constitute entitlement programs.
All individuals who meet the necessary criteria may access services provided by their State Plan.
Medicaid state plans provide the choice and flexibility for individuals to self-direct their personal care services. With this option, participants can customize their service provider selection by hiring and managing selected relatives or friends as paid caregivers.
No matter where you reside in the US, there are various Medicaid-backed options for self-directed long-term care assistance. Home and Community-Based Services (HCBS), Community First Choice Option (CFCO), Self-direct Personal Assistance Services State Plan Options, and more.
1. Self-Directed Personal Assistance Services State Plan Option
Self-Directed Personal Assistance Services State Plan Option, also known as the 1915 authority, allows Medicaid participants to select their own Personal Care Assistant and manage payments from a budget provided by Medicaid.
Additionally, employment taxes may be incurred that require assistance from an intermediary for financial processing—giving those receiving care more autonomy over their health decisions.
2. Home and Community-Based Services (HCBS) Waivers
Medicaid waivers provide a variety of home and community-based services, including 1915 (c) Waivers commonly referred to as HCBS Medicaid Waivers and 1115 Demonstration Waivers. These waivers contribute significantly to helping those with special needs receive the assistance they need within their homes or communities.
The majority of states offer Home and Community-Based Service (HCBS) waivers, which provide elderlies or those with physical disabilities access to Medicaid services.
However, the names vary from state to state. Iowa uses the HCBS Elderly Waiver, Indiana's Aged and Disabled Medicaid Waiver, and Washington DC has an Elderly and Persons with Physical Disabilities program.
4. Community First Choice Option
The Community First Choice option is a rewarding way for Medicaid recipients in nursing homes to access personal care services. The 1915 state plan allows friends and family members of the recipient an opportunity to contribute, with tasks such as bathing, grooming, light housekeeping, and transportation taken on by those closest to them.
Nine states across the U.S., including Alaska, California, Connecticut, Maryland, Montana, New York, Oregon, Texas, and Washington, support this program.
5. Caretaker Child Exception
Medicaid allows elderly participants facing nursing home admission to transfer their house as a form of payment for the care given. This method is applicable when these individuals would otherwise not qualify for Medicaid due to owning their own homes.
However, this transaction should be under legal parameters, or else it could cause jeopardize an individual's eligibility status under Medicaid’s look-back rule. Any child involved must have resided with the parent for at least two years before entering state-sponsored care services.
6. Adult Foster Care
Adult foster care is beneficial for seniors and individuals with dementia. Several states offer Medicaid coverage to assist financially, allowing them the supportive services they need, such as 24-hour supervision, transportation aid, housekeeping help, or support preparing meals.
Adult family homes provide an inviting home setting where these elderly citizens receive guidance from their caregivers on managing day-to-day necessities essential for well-being.
For individuals who wish to care for their loved ones in an informal setting, foster care homes may be the perfect solution. It is important to note that this service does not rely on a paid caregiver-based system—it involves members of one's family providing homecare services as part of an HCBS Medicaid waiver or regular state plan.
As such, relatives can provide these types of solutions across several states, including Connecticut, Indiana, Louisiana, Massachusetts, and others.
7. Home and Community-Based Services State Plan Option
Through the HCBS State Plan Option, states may offer home and community-based services as part of their Medicaid plans. Unlike HCBS waivers, it doesn't require a nursing home level of care for applicants. This option allows participants to create individualized care plans tailored to their specific needs and budget allocations that enable them to self-direct their care by hiring a relative or caregiver of choice.
What Are Medicaid Eligibility Requirements?
Medicaid programs that pay for personal care assistants evaluate an applicant’s ability to receive long-term care based on their financial situation and functional capacity.
Medicaid eligibility is subject to variation at both state and program levels. Generally speaking, seniors seeking an HCBS Waiver have access to more lenient requirements in 2022 than standard Medicaid plans—with income limited to $2,523 per month and assets capped at $2,000.
State Medicaid programs impose strict financial and care requirements on senior applicants. Depending on the particular program, eligible seniors can have a monthly income of up to $841 or $1,133 with assets not exceeding 2 thousand dollars.
In addition to these restrictions, some states may require a nursing home level of care while others demand assistance in activities related to daily living. Gain more insight into Medicaid eligibility by exploring the information available on their website. Uncover state-specific details to pinpoint which requirements you must meet to qualify.
Maximize Medicaid Benefits Today
It is crucial to understand the eligibility requirements, available services and how to access them, and the process for hiring and paying a caregiver. With careful planning and the right resources, you can help your loved one age in place with the support they need. Maximize Medicaid benefits today!
