Getting Paid as a Family Caregiver Through Medicaid

Caring for an ailing family member is difficult work, but it doesn’t necessarily have to be unpaid work.

There are programs available that allow Medicaid recipients to hire family members as caregivers. Medicaid’s program in Wisconsin it is called “IRIS” (Include, Respect, I Self-Direct). The first step is to apply for Medicaid. In Wisconsin the home-based Medicaid program is called “family care.” Medicaid is available only to low-income seniors and individuals with disabilities who meet financial eligibility requirements. Medicaid application and approval can take weeks.

The state Medicaid agency usually conducts an assessment to determine the recipient’s care needs—e.g., how much help the Medicaid recipient needs with activities of daily living such as bathing, dressing, eating, and moving. Once the assessment is complete, the state draws up a budget, and the recipient can use the allotted funds to pay for goods or services related to care, including paying a caregiver. Recipients can choose to pay a family member as a caregiver.

In addition to Medicaid programs, some states have non-Medicaid programs that also allow for self-directed care. These programs may have different eligibility requirements than Medicaid and are different in each state. Family caregivers can also be paid using a “caregiver contract,” increasingly used as part of Medicaid planning. It is important to have a written care agreement that specifies the services being provided and the amount to that will be paid. Wisconsin requires that the services directly benefit your family member, that the compensation be reasonable.

Veterans who need long-term care also have the option to pay family caregivers. In Wisconsin, veterans who receive the standard medical benefits package from the Veterans Administration and require nursing home-level care may apply for Veteran-Directed Care. The program provides veterans with a flexible budget for at-home services that can be managed by the veteran or the family caregiver. In addition, if a veteran or surviving spouse of a veteran qualifies for Aid & Attendance benefits, they can receive a supplement to their pension to help pay for a caregiver, who can be a family member.

For more information about these programs and other ways to be paid as a family caregiver, contact us.