Acting as a family caregiver for a frail senior can be an extremely challenging job. Often, family or friends expend huge personal and financial efforts to help a loved senior stay at home while receiving the care they need. Now, thanks to the Massachusetts Caregiver Homes Program, family members who act as caregivers can be reimbursed for their services by MassHealth while allowing the senior to remain at home instead of having to enter a nursing facility.
Overview of the Massachusetts Caregiver Homes Program
The Massachusetts Caregiver Homes Program is a relatively new type of MassHealth (Medicaid) program that provides economic support and care to the elderly or disabled who are living in a caregiver’s home or where a caregiver has moved into their home. Often, caregivers are friends or family members of the care recipient, though this is not a requirement. The caregivers are paid for the 24-hr personal care they provide by MassHealth. Caregivers typically offer assistance with the activities of daily living like bathing, toileting, grooming and other personal hygiene as well as the instrumental activities of daily living such as meal preparation, housekeeping and laundry, thus allowing the senior to remain in the community.
The Caregiver Homes Program does not reimburse caregivers for the room and board of the senior; however, care recipients may pay $400 to $500 per month to their caregivers for those costs. This is not a requirement of the program but does offer one way in which a senior can pass assets to a family caregiver. In addition, caregivers receive payment from MassHealth of between $8,000 and $18,000 annually. They also can receive two weeks of respite care per year.
Eligible family members that can be paid as caregivers include siblings, the adult children and other relatives but not spouses, parents of minors or other legal guardians.
Qualifications for the Massachusetts Caregiver Homes Program
To qualify for the Caregiver Homes program, Massachusetts residents must be elderly or disabled and require assistance with their activities of daily living. They must require 24 hour care, however their care requirements cannot be so severe that they must reside in a nursing home.
In addition to the medical requirements, program participants must be financially eligible for MassHealth. Qualifying for MassHealth is a complicated process involving a review of a family’s income, assets and asset transfers as far back as 5 years. Rules change frequently and there are many exemptions, but typically “countable asset” limits, excluding the car and home, cannot exceed $2,000.
Not qualifying can be devastating to the comfort of a senior, their family’s finances and even their health. For these reasons, an elder law attorney should be consulted to ensure families have the best chance of acceptance into the MassHealth program.
Personal Care Contracts
Another option for reimbursing caregivers is the personal care contract. This option is primarily for those who do not yet qualify for MassHealth, but who want to plan ahead for MassHealth eligibility. Without a personal care contract in place, MassHealth may consider any payments made by a senior to a family caregiver as a disqualifying transfer. By establishing an employer/employee relationship through a personal care contract, a senior can pay a family caregiver for their efforts without disqualifying the senior from MassHealth eligibility. Personal care contract must observe strict formalities in order to be considered legitimate, so contacting an elder law attorney to assist you is highly recommended.
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