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Can I Get Paid to Be a Caregiver For a Family Member? Answer: In some cases and some places.

Your chances are best if you are caring for someone eligible for Medicaid and living in a state with a Medicaid care program or caring for a U.S. military veteran. But there are other possibilities.

Medicaid All 50 states and the District of Columbia offer Medicaid waiver self-directed long-term services and supports (LTSS) programs that allow qualified individuals to manage their own care — meaning that people can hire and fire their own caregivers. Some states permit the care recipient to hire a family member to provide care.

Eligibility, benefits, coverage and rules differ from state to state. Some programs pay family caregivers but exclude spouses and legal guardians. Others will pay care providers only if they do not live in the same house. Medicaid home care benefits also depend on the Medicaid program in which you are enrolled. Program names also vary. What is called Consumer Directed Care in one state is called Participant Directed Care in another. Among the many names: Self-Directed Care, In-Home Supportive Services, Cash and Counseling. To qualify for Medicaid the recipient must not exceed the program’s annual income and countable assets, not counting home value. Step by Step

Step 1: If your family member qualifies and is ready to join the more than 1 million people already participating in self-directed care plans, contact your state Medicaid office to begin the process.

Step 2: The applicant (with assistance, if desired or needed) is assessed for risks, need, strength, capacities and preferences as required by Centers for Medicare & Medicaid Services.

Step 3: Your family member and any chosen representatives create a written service plan detailing the daily living assistance required — including bathing, dressing, moving from bed to wheelchair, light housekeeping, meal preparation, feeding, laundry, supervision, shopping, transportation and medication compliance. There should be contingency plans for coverage when the care provider is off, and instructions on how fill-in caregivers should address risks.

If the assessment shows need, a budget for goods and services will be provided.

Step 4: When the care plan is set, the participant (or surrogate, if needed) chooses a caregiver.

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