Get paid through Medicaid in North Carolina
Medicaid is a joint federal and state program that provides health coverage to eligible low-income individuals, including families, seniors, and people with disabilities. Medicaid waivers allow states to offer additional services and benefits not typically covered under Medicaid by "waiving" certain federal requirements to provide more tailored support to specific populations, such as those needing long-term care.
In North Carolina, the following Medicaid waivers are available with an option for caregiver pay:
- Community Alternatives Program for Disabled Adults (CAP/DA): This program provides services to individuals ages 65 or older, and individuals with physical and or other disabilities ages 18-64 years who meet a nursing facility level of care. Start enrolling to see if you and your loved one meet all eligibility requirements.
- Community Alternatives Program for Children (CAP/C): This program provides services to individuals who are medically fragile ages 0-20 years who meet a hospital or nursing facility level of care.
- Innovations Waiver: This program provides services to individuals with intellectual disabilities or developmental disabilities ages 0 or older who meet an ICF/IID level of care.
Note: Under the CAP/DA and CAP/C waivers, the Structured Family Caregiving program pays family members (including spouses) a tax-free daily stipend for the care they provide. See if you might be eligible >>
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Medicaid programs and waivers can change over time, so it's important to consult the official North Carolina Medicaid website or contact the North Carolina Department of Human Services for the most up-to-date information on available waivers and eligibility requirements.
How does a Medicaid waiver work to pay family caregivers?
Medicaid waivers allow family caregivers to get paid through self-direction programs (also known as consumer direction, participant direction, or other similar names), giving care recipients more control over their care by enabling them to choose who provides it, including family members. To get paid, the care recipient must be evaluated and approved for in-home care, after which the caregiver may need to complete training, acquire credentials, and be "employed" by an agency that processes payments. Once enrolled and hired, caregivers must document and verify their work according to the program's procedures.
How much do family members get paid by Medicaid for caregiving in North Carolina?
Pay rates for family caregivers vary based on:
- Program guidelines: Each waiver program may have specific rules and regulations regarding caregiver compensation. These guidelines often outline the maximum hourly rate allowed.
- Local wage rates: Hourly rates are determined at the local zip code level based on a variety of factors.
- Qualifications and experience: Your qualifications and experience as a caregiver can impact your hourly rate. If you have specialized training or certifications relevant to caregiving, it may justify a higher rate. Additionally, your years of experience in caregiving can also influence your compensation.
- Level of care required: The level of care needed by the individual you are caring for can impact your hourly rate. Higher levels of care, such as providing medical assistance or supporting individuals with complex needs, may justify a higher rate compared to basic caregiving tasks.
- Time commitment: The number of hours you dedicate to caregiving can influence your hourly rate. If you are providing care full-time or have a significant time commitment, it may justify a higher rate compared to part-time caregivers.
- Market demand: The demand for caregivers in your area can also affect your hourly rate. If there is a shortage of caregivers or a high demand for specific types of care, it may drive up the hourly rates.
Annual unpaid care value:
$16.5B
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Can you get paid to care for your loved one?
Get paid through VA in North Carolina
Veterans, and the surviving spouses of veterans, have a few options to pay family caregivers.
Veteran Directed Home & Community Based Care in NC
The Veteran Directed Care (VDC) program allows veterans to choose how to direct their monthly care budget. This means that when hiring a caregiver, a veteran can choose to hire his/her family member. The caregiving family member will be paid the hourly rate determined by the VA, typically $8-$21 per hour. VDC is available to veterans of all ages enrolled in VA medical benefits and require skilled services and assistance with activities of daily living.
Veteran Aid & Attendance Pension Benefit in NC
If your veteran loved one requires professional long-term in-home, assisted living, or nursing home care, you may be eligible for Aid and Attendance (A&A). The A&A Pension can provide up to $3,261 per month to pay for care, including to caregiving family members. A&A is an add-on benefit that requires eligibility for the basic VA pension or survivor pension, as well as meeting a disability requirement.
Housebound Pension Benefit in NC
The Housebound Pension benefit provides funds to veterans who are mostly unable to leave their homes. Similar to the A&A benefit, the Housebound Pension can be used to pay family caregivers. The Housebound Pension can be worth up to $1,882 per month, and spouses are unable to be paid as the family caregiver under the Housebound benefit, as spouse income is included in the calculation of the benefit. To qualify for Housebound, a veteran must be limited to his/her house and be eligible for the basic VA pension. Veterans cannot get A&A and Housebound benefits at the same time.
Program of Comprehensive Assistance for Family Caregivers (PCAFC) in NC
The PCAFC is the VA's broadest program targeting family caregivers. The program provides family caregivers with a stipend of up to $2,750 per month, in addition to training, counseling, and respite care. To qualify, the veteran must have been critically hurt or had a serious illness in the line of duty, and require help with at least one activity of daily living.
Find support through the North Carolina Department of Health and Human Services
Every state is mandated by the federal government to create support systems for family caregivers. They often reach local communities through Area Agencies on Aging (AAAs).
Area Agencies on Aging are crucial in supporting family caregivers caring for older adults. These agencies typically offer various services, resources, and programs to assist family caregivers in their caregiving responsibilities. Some of the most common ways in which state Agencies on Aging support family caregivers include:
- Information and referrals: AAAs provide guidance on local resources, support groups, caregiver training, and respite care options.
- Caregiver education and training: They organize programs on caregiving techniques, stress management, healthcare navigation, and legal/financial aspects.
- Respite care: They offer temporary relief for caregivers, enabling them to take breaks and attend to their well-being.
- Support groups: They facilitate caregiver support groups for sharing experiences, concerns, and learning from others.
- Caregiver assessments: AAAs evaluate caregivers' needs and provide tailored support and recommendations.
- Counseling and consultation: They offer professional guidance and emotional support for caregivers.
- Advocacy and policy development: They advocate for caregiver-friendly policies and programs.
- Access to benefits and services: They assist caregivers in accessing benefits and programs like Medicaid, home-based services, and transportation assistance.
How do I find my local AAA?
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Get tax credit for caregiving in North Carolina
What is a tax credit?
Tax credits are a way for the government to incentivize and compensate taxpayers for positive activities. A variety of tax credits cover a wide range of expenses and situations such as education, green energy, and caregiving. A tax credit is a dollar-for-dollar reduction of the income tax you owe. For example, if you owe $4,000 in federal taxes but are eligible for a $3,000 tax credit, your tax bill is $1,000.
What tax credits are available for family caregivers?
The
Child and Dependent Tax Credit (CDCTC) is a tax credit earned by caregivers for a percentage of care-related expenses. Eligible expenses must be for the care of a child or dependent in order to enable the taxpayer to work or look for work.
How much can I earn in tax credits for caregiving?
The total tax credit you can claim in North Carolina for caregiving is $1,100.
Additionally, North Carolina matches the federal tax credit up to , which can equate to an extra off your taxes.
In 2021 the North Carolina Legislature considered bill S901, to create a tax credit of $3,000 for caregivers of veterans and $1,500 for caregivers of non-veterans. The bill is currently under consideration. Read more...
The CDCTC provides a tax credit for a percentage of your eligible caregiving expenses. The maximum CDCTC at the federal level is $1,100.
To get the CDCTC, you must claim your loved one as your dependent on your tax forms. You loved one must qualify to be claimed as a dependent based on a number of criteria. After claiming your loved one as a dependent, you will need to fill out
tax form 2441. The tax form requires a clear picture of your care-related expenses that allowed you to work or look for work.
Other ways to get paid as a family caregiver in North Carolina
Other caregiver pay programs in NC
Here are a few caregiver payment programs in your state that you may want to explore:
- NC In-Home Aide Services: This program provides support to older adults with the intention of enabling recipients to continue to live in their homes and avoid institutional placement. Program participants are permitted to have relatives work as their in-home aides.
Long term care insurance
If your loved one has a long term care insurance policy, that policy may allow for the direction of funds to a family caregiver. To learn if this is an option for you, contact your loved one's insurance company or agent and ask about caregiver benefits.
Employer-sponsored caregiving leave
A growing number of companies are offering to pay employees while they take a leave to take care of a loved one. To learn if this is an option for you, talk to the Human Resources department at your company.
Get paid by family
When your family measures all of the
potential costs of care, including nursing homes, in-home nurses, and more, they may recognize that your support is a much more cost-effective option. If there are funds available, you should ask to be compensated for your time and efforts, especially when compared to the costs of the alternatives.
Know your caregiver rights and resources in North Carolina
Legal rights and protections for caregivers are essential to ensure their recognition, support, and fair treatment, allowing them to fulfill their caregiving responsibilities while safeguarding their own well-being.
Laws and programs in North Carolina that provide support to family caregivers include the following:
- North Carolina Caregivers' Support Program: This act, enacted in 2019, recognizes the valuable contributions of family caregivers and aims to provide them with support and resources. It requires the North Carolina Department of Health and Human Services to develop and maintain a Family Caregiver Support Program, offering services such as caregiver education, respite care, counseling, and caregiver training.
- Adult Care Home Resident's Bill of Rights: This legislation outlines the rights of individuals residing in adult care homes in North Carolina, and it includes provisions that protect the rights of family caregivers. It emphasizes the importance of open communication, access to information, and involvement of family caregivers in the care and decision-making process of their loved ones.
- North Carolina Respite Care Program: This program offers temporary relief and respite for family caregivers by providing trained caregivers who can take over caregiving responsibilities for a short period. It allows caregivers to have a break, attend to personal needs, or simply recharge while ensuring their loved ones receive proper care.
