When it comes to providing care for elderly family members, many family members or friends step in to offer their assistance. Some potential care providers may not know that there are opportunities for financial assistance and you can get paid as a caregiver.
In Florida, these rules intersect with state Medicaid and the complex regulations surrounding the state’s Medicaid home and community-based care programs. It is essential to navigate these legalities carefully, as improper handling can lead to significant penalties.
Medicaid Eligibility and Caregiver Compensation
Firstly, let’s talk about Medicaid, a joint federal and state program that helps people with limited income cover medical costs. It can sometimes be used to pay for long-term care services in nursing homes and sometimes even for home care services.
The Florida Statewide Medicaid Managed Care Long-Term Care (SMMC LTC) program offers an option to pay caregivers, even if they are related to the person needing care. The program is designed for individuals who need a nursing facility level of care but prefer to remain at home.
Qualifying for the SMMC LTC program depends on meeting several eligibility criteria related to income, assets, and the level of care needed. However, there are restrictions.
Parents cannot be paid to care for minor children, and spouses cannot get paid to care for each other. Also, the caregiver must meet specific requirements, such as being over 18, being legally able to work in the United States, and passing a background check.
Florida’s Statewide Medicaid Managed Care Long-Term Care Program
The Florida Statewide Medicaid Managed Care Long-Term Care (SMMC LTC) program is a critical resource for those looking to get paid for providing care to elderly family members. Eligibility for this program is based on specific criteria. Firstly, the care recipient must be a Florida resident, be 65 or older, or be 18 or older and qualify for Medicaid due to a disability. In addition, a comprehensive assessment of the individual’s health status must demonstrate a nursing facility’s level of care needs.
Financial eligibility includes certain income and asset limitations. In 2022, the individual income limit for an applicant was $2,523 per month. For couples, when both parties are applying, the joint income limit was $5,046 per month, and the asset limit was $2,000 and 3,000 for couples. However, these limits change annually. It’s also worth noting that there are certain exemptions to the asset rule; for instance, the individual’s primary residence may not count towards this limit if its equity value is under a specific threshold.
Under the SMMC LTC program, caregivers can provide a range of services, such as help with activities of daily living (ADLs), including eating, bathing, dressing, toileting, transferring, and continence. They can also assist with instrumental activities of daily living (IADLs), such as meal preparation, shopping, managing finances, and managing medications.
Additionally, personal care, adult day care, medication management, and chore services are benefits. SMMC LTC allows beneficiaries to choose their own provider for certain services. Given that many services are non-medical in nature (the service provider requires no special medical training to perform the service), friends and family members, like adult children, are qualified and can be hired to perform those services.
There are certain exceptions, of course. Not all services under SMMC LTC can be “self-directed”, but personal care and homemaker services are benefits that do allow the beneficiary to choose their providers. Family members hired as care providers must accept the Medicaid hourly compensation rate. In Florida, this is estimated to be between $9 – $13 per hour. Caregivers typically must pass a background check and be able to legally work in the United States.
Caregivers under this program are not permitted to perform tasks that require a professional license. These tasks include administering injections, wound care, physical therapy, or other skilled medical procedures. They must be done by a registered nurse or other licensed medical professional.
If you are a Veteran or the spouse of one, you may be eligible to receive benefits through the Veteran’s Affairs program that can support your role as a caregiver. You can apply for Aid and Attendance Pension if you served in active duty military service that was not dishonorable and met certain other requirements.
Aid and Attendance is a tax-free monthly benefit that supplements your income to help you financially while caring for a Veteran. Benefits are not just limited to Veterans; they can be passed on to their spouses as well.
Eligible caregivers may receive $1,244 and up to $2,295 per month. Another program available is the Veterans Pension which provides financial support for those who have limited income and are unable to work due to caring for a disabled veteran or surviving spouse. The amount of aid depends on the number of dependents and other factors, but it is usually $1,597 per month.
Additionally, caregivers who qualify may also be able to receive a stipend for providing care to Veterans through the VA’s Program of Comprehensive Assistance for Family Caregivers. The PCAFC provides support to family caregivers caring for eligible Veterans. Veterans can designate a primary family caregiver who can then receive a range of benefits, including monthly payment, counseling, and even reimbursement for traveling to the Veteran’s appointments.
Medicare and Family Member Payment
Medicare, a federal program, provides health coverage for people aged 65 and older or with certain disabilities. It’s less likely than Medicaid to pay for long-term care, but it can sometimes cover short-term or intermittent home health care prescribed by a doctor.
Unfortunately, Medicare does not typically pay family caregivers. Under specific circumstances, though, an elderly relative may qualify for a Medicare-approved home health care plan. In this case, a professional health agency must provide the services, so family members generally cannot be compensated under this program.
Necessity for Legal Advice
Navigating the complexities of being a paid caregiver for a family member can be challenging, and it’s crucial to get the details right to avoid running afoul of the law. For instance, payments to caregivers can sometimes be seen as “gifts” by Medicaid, affecting the care recipient’s eligibility for other benefits.
Getting legal advice is a smart step to ensure that all transactions comply with the rules. Our team at Friedman Elder Law Department specializes in these issues and can provide guidance based on your specific circumstances. We can help set up a personal care agreement, which is a legal document outlining the services provided and the compensation to be received.
Being a caregiver for an elderly relative can be a rewarding yet challenging responsibility. Understanding the legalities of caregiver compensation, especially in relation to Medicaid and Medicare, is crucial. Although Florida offers options for caregivers to be paid, understanding what care services are eligible and what is prohibited can help avoid potential legal issues.
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