Paid Caregiving: How You Can Become a Paid Family Caregiver

Paid caregiving is an option – even without Medicaid.


Paid caregiving in actionAs of 2015, 23 percent of American family caregivers devoted over 40 hours a week to their loved ones. To put that in perspective, there are over 40 million caregivers in the United States. So we’ve got almost 10 million people who spend the equivalent of a full-time job in caring for a loved one. The average, in case you’re wondering, is 24.4 hours – equal to a part-time job. No wonder paid caregiving is such a hot topic.

Despite all that time, though, many caregivers feel hesitant when it comes to getting paid for what they do. Some caregivers feel uncomfortable taking money for what is, quite literally, a labor of love. Others are okay with the idea, but think that without Medicaid they shouldn’t even bother.

So today we’re going to talk about both: why paid caregiving is a positive thing, as well as ways to swing it without Medicaid.

Paid caregiving benefits your loved one.

Unless you have enough discretionary income that you don’t need to work, you’re likely juggling a day job along with caring for your loved one. That’s incredible, admirable – and really, really difficult, both logistically and financially.

Logistically – because you need someone to either be with or on call for your loved one while you’re at work.

Financially – because you need to support your family as well as your loved one. And more often than not, there’s not enough to go around for both.

Here’s how getting paid for caregiving helps:

  • Resources. There are resources out there to help you care for your loved one while you’re at the office – but they’re going to cost you. Daytime nurses, “grannysitters,” and senior daycare centers don’t come cheap.
  • Respite. If you’re caring for your loved one at home, there will be times when either you or they will need a break. Many assisted living and skilled nursing facilities offer short-term respite care – but you need to pay for it somehow.
  • Extra expenses. When you have another person to care for, your expenses go up. Getting paid as a caregiver can help you cover the extra monthly expenses you’re incurring.

Okay, so paid caregiving is a good idea. Don’t you need Medicaid for that?

Good question. The answer is no, you don’t. There are other ways of becoming a paid caregiver. But before we go into it, a word of caution: These are ideas to explore. Don’t make any financial decisions – with or without Medicaid – before consulting a lawyer, a financial consultant or both.

Here we go.

Long Term Care Insurance

If your loved one has long-term care insurance, they can use the benefits from it to pay a caregiver. Some policies exclude family members, but that’s becoming more and more rare. Check your loved one’s policy for the fine print, though, not only because of the family-member issue but because many policies require that the caregiver be licensed. Don’t let that stop you, though; in most states, the licensing process is a simple one. You will, of course, need to report any payment you receive as a caregiver to the IRS when you do your taxes.

Paid Family Leave Laws

Another Medicaid workaround is to take advantage of your state’s Paid Family Leave laws, or PFL. PFL allows a working person to take paid time off from their job to take care of a family member. The time doesn’t have to be consecutive; you could take off, say, 1-2 days a week over a long period of time. You will continue to receive most, if not all, of your salary, and you cannot be fired for not showing up.

Using PFL is not a permanent solution, since the amount of time you can take off is limited. It’s a great short-term solution, though. And if you have siblings or other relatives in the same state, you can pool your time so that it really adds up.

State-Based Consumer Direction

States are interested in preventing elderly residents from being placed in Medicaid-sponsored nursing homes as much as possible. Consequently, most states have some sort of consumer direction program that provides assistance to the elderly for care services. Many states allow the recipient to choose his or her own caregiver, rather than go through the state.

So theoretically, Mom or Dad could designate you as the caregiver, and you would then be paid according to the average hourly going rate for home care in the area where you live.

You need to check your state’s laws, though, to see if this is an option for you. Some states don’t allow family members to qualify, and others don’t offer this option at all. But it’s worth looking into.

Private Employment

If your loved one has the resources, you can skip all of these Medicaid workarounds and draw up a legally binding, employer/employee contract between you and your loved one. In this scenario, you are literally working for your loved one as a second job, and you will be compensated for your time according to the contract you draw up.

You should definitely retain an elder care lawyer for this, though; there are way too many details and pitfalls to try it on your own or even using a good lawyer who isn’t well-versed in the issues surrounding elderly care.


If your loved one is a veteran, there are a number of ways their benefits can be used to pay a family caregiver. However, the process is too long and complex to go into here. Check your local VA office to see which options might work for you.

There are a lot of advantages to becoming a paid family caregiver, both for you and your loved one. It might seem daunting without Medicaid – but remember, it can be done.