Some long-term care insurance policies allow family members to be paid as caregivers. Contact your insurance agent and ask them for one. Medicare Part B benefits help pay for home health care services, including those for caregivers. However, it doesn't cover 24-hour care, meal delivery, or personal attention when personal attention is all that's needed. Medicare doesn't offer refunds to family caregivers.
It also doesn't cover payment for long-term care services, such as home care or day services for adults. There are some Medicare Advantage plans that offer coverage for services such as food delivery or transportation to medical appointments, but they are limited. One possible way for your loved one to pay you for providing care is if they have long-term care insurance. Policies vary by company, but many long-term care policies allow payment for home care.
The insurance company can tell you if a family member can provide this care for you. Medicare (government health insurance for people age 65 and older) doesn't pay for long-term care services, such as home care and day services for adults, regardless of whether those services are provided by a direct caregiver or family member. If you don't have the proper documentation, all the money you get paid for care may have to be paid to Medicaid so that your loved one is considered eligible for future Medicaid benefits. Payments to family caregivers are generally allowed for the provision of personal care, which can be offered through several different types of Medicaid HCBS programs.
There are fewer states with other types of exemptions, and the percentage of those states that allow family caregivers to pay is also lower: 39 states for exemptions for adults over 65 or with physical disabilities, 17 states for people with traumatic brain or spinal cord injuries, and fewer states for other types of exemptions. This model often allows more people to take advantage of paid family leave, because those who work for smaller employers or who are self-employed can afford coverage. The COVID-19 pandemic compounded the workforce's existing problem for Medicaid home care, and states used new federal funding and flexibility to maintain service levels by increasing self-directed services and payments to family caregivers. I have established that few of us care for an elderly loved one with an LTCI policy that pays family caregivers.
States may be forced to reduce Medicaid spending by eliminating coverage for some people, covering fewer services, and (or) reducing rates of payment to providers and supports for family caregivers. Self-directed services and payments to family caregivers are one of the tools that states use to address the shortage of direct care workers, including those who work at home and in the community. In addition to paying for the provision of care, Medicaid supports family caregivers with services such as training, support groups, and temporary care (which is paid care) that allows family caregivers to take a break from their normal responsibilities.). Many LTCI policies only pay formal caregivers, and some even require that those caregivers be employed or hired by a professional home care agency.
If your loved one has an LTCI policy that pays informal caregivers, you may be eligible to be paid for the care you provide. If a person pays additional premiums to add an additional long-term care clause to their life insurance policy, they can use a portion of the death benefit to help pay for long-term care. This resource can help your loved one manage a budget and determine how to pay for the goods and services needed for their personal care needs.
