Can I Get Paid for Taking Care of My Spouse?
This information is current as of June 30, 2022.
Over 48 million individuals take care of their spouse or relative without financial support in the U.S. Caring for a loved one is admirable. Still, it can also be draining – both physically and financially. Instead of hiring someone to watch your partner, you may ask, “Can I get paid for taking care of my spouse?”
Almost every state offers some form of payment through Medicaid for individuals caring for their spouses. Veterans and military service members may qualify for one of four plans to help pay family caregivers. If you don’t qualify for Medicaid, a local or state agency may still be able to pay you.
Let’s learn more about these programs and how you can get paid for caring for your spouse.
Get Paid to Take Care of Your Spouse Through Medicaid
Medicaid is a public insurance program geared towards low-income individuals and families. To get paid by Medicaid to care for your spouse, you’ll need to do the following:
- Enroll in Medicaid
- Contact your state’s Medicaid self-directed services
- Go through an assessment process
- Get paid for your care
1. Enroll in Medicaid
If you don’t have health insurance and are low-income, you may qualify for free or low-cost Medicaid coverage. If you’re already covered by Medicaid or another type of health insurance, you can skip ahead to step #2.
Medicaid is funded through the federal government and your state. Still, you need to apply directly to your state’s Medicaid program. Each state has a different application procedure and list of requirements. You’ll need to:
- Meet the Modified Adjusted Gross Income (MAGI) limits
- You may be exempt if you’re eligible for Medicaid based on blindness, disability, or are 65 years or older
- Be a legal resident of your state
You may also qualify for Medicaid if you receive Supplemental Security Income (SSI), are part of your state’s medically needy program, or are pregnant.
After visiting your state’s Medicaid website or calling a Medicaid office to see if you’re eligible, you can apply for Medicaid online or in person at a local office. You will need to provide documents to prove your income and health status.
2. Contact Self-Directed Services
Once enrolled, you’ll reach out to your state’s Medicaid Self-Directed Services Department. Each state will have a different name for its self-directed services department. This department will oversee assessing your situation and paying you, if possible.
Self-directed services are when a Medicaid participant or their representative can decide on or be responsible for certain services, such as home care.
3. The Assessment Process
As of 2022, most states have some form of possible payment for spousal caregivers, especially for long-term care. However, the criteria are different depending on the state. Some allow for family caregivers, but not spouses. Others don’t pay anyone who lives in the same home as the participant.
If your state provides payment for spousal caregivers, you can request a waiver that allows you to manage your spouse’s long-term care services.
A Medicaid employee will assess your spouse and their situation for risks, strengths, need, capacities, and preferences. You will likely need to provide a written plan of all services your spouse requires. For example, bathing, preparing meals, shopping, transporting to doctor’s appointments, etc.
4. Get Paid
If the assessment shows that your spouse needs your care – and your state can pay a spouse through Medicaid – then you will be approved to care for them with compensation. How much you’re paid will entirely depend on your spouse’s needs and the Medicaid assessment.
Get Paid to Take Care of Your Military Spouse
Vets and military service members may also qualify for paid spousal care through Medicaid or the Program of Comprehensive Assistance for Family Caregivers (PCAFC).
The Aid & Attendance benefit for veterans will cover family care but not for a spouse.
Getting Paid Through Medicaid
The Department of Veterans Affairs (DVA) has a program under Medicaid that allows self-directed services for veterans. This is available in 42 states, D.C., and Puerto Rico.
Vets must be:
- Enrolled in the Veterans Health Administration health care system
- In need of nursing facility-level care
After the assessment period, a flexible monthly budget will be created. The veteran and their spouse can choose the things and services they find the most useful on the budget.
Call or visit your local DVA office to find out how to apply for these services.
Getting Paid Through the PCAFC
The PCAFC allows veterans to appoint one primary family caregiver and up to two secondary caregivers to help them day to day. The primary caregiver can be the spouse. They are paid a monthly stipend and receive caregiver education, mental health counseling, and travel compensation if they take the veteran to receive care elsewhere.
To apply, the veteran must:
- Have a disability rating of 70% or higher
- The disability must have been caused or made worse before 5/7/1975 or after 9/11/2001
- Have a date of medical discharge
- Need at least six months of continuous in-person care
The caregiving spouse must:
- Live full-time with the veteran
Apply and find out more information about this program here.
Getting Paid Through Aid & Attendance
The Aid & Attendance benefit is part of the veteran’s pension program. It can provide up to $2,000 per month for approved veterans and their spouses to cover the cost of caregivers.
Caregivers can include children but not spouses.
For more information, see here.
More Ways to Get Paid to Take Care of Your Spouse
If your spouse isn’t a veteran or doesn’t qualify for Medicaid, you may still have a way to get paid to take care of them. Some agencies can work with the state or federal government and pay a spouse to care for their partner.
First, you can check the Family Caregiver Alliance’s Services by State tool to find resources and organizations in your area. Reach out to those nearest you and ask about any programs they have or know of that pay spousal caregivers.
Second, you can contact your nearest Area Agency on Aging. This entity has a federally supported program that can help pay spouses who care for a partner 60 years or older or under 60 with a diagnosis of Alzheimer’s disease or another related disorder.
Third, you can check out the American Elder Care Research Organizations’ list of non-Medicaid programs with consumer direction.
Finally, you may be able to receive some financial support if you care for a spouse with a specific disease. For example, CancerCare provides financial assistance to spouses caring for a partner with cancer. This search tool can look for resources specific to your spouse’s illness.
FAQs
How Can I Get Paid to Care for My Spouse?
The most common way to get paid to care for a spouse is through Medicaid. The home-bound spouse must qualify for Medicaid through SSI, blindness, or a low annual income.
Veterans can also have a paid spousal caregiver through Medicaid or PCAFC.
Those who don’t qualify for Medicaid can contact local agencies or state organizations to see if other programs are available.
What Will My Payment Cover?
Caregiver spouses are usually paid between $11 and $20 per hour depending on the financing program, how many hours the spouse works, and the level of care their partner needs.
How Is My Pay Determined?
Pay is determined by your program. Most programs, including Medicaid, will have an assessment period. This is when the Medicaid worker will determine the level of care the home-bound spouse qualifies for.
After the assessment, there is generally a proposed budget. The couple will review it and determine what can and cannot be used. The final budget will determine the caregiving spouse’s pay.
Who Qualifies for Paid Spousal Care?
To qualify for spousal or any home care, most programs require the individual to have a particular disability rating. For example, veterans under Medicaid need a 70% disability rating or higher to receive paid spousal care.
You may still qualify for paid spousal care if you aren’t disabled but are extremely limited due to an ongoing or chronic illness.
In Summary
If you’ve sworn to love each other in sickness and health, it is admirable that you care for your spouse when they can’t care for themselves. Unfortunately, this can quickly become a full-time job, causing financial strain for many couples.
Luckily, there are some ways you can be paid to take care of your spouse. The most common way is through Medicaid self-directed services. Your spouse will need to qualify, apply for, and be approved for Medicaid before you can request an assessment for self-directed services. If approved, you could be paid to care for your spouse.
Dependent veterans can also receive paid spousal support through the DAV’s Medicaid program or the PCAFC.
Finally, suppose you don’t qualify for the programs above. In that case, you can search for local organizations and state agencies that may provide payment or grants for you to care for your spouse.
Thank you for all you do, and best of luck with your search and applications!
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