Can Your Spouse Get Paid for Being Your Caregiver?


Joseph quit his full-time job to provide full-time care for his wife, Stephanie, who is suffering from early-onset dementia. He bathes and dresses her, prepares her meals, takes her blood pressure, gives her prescribed medications twice a day, and takes her to all of her medical appointments.

Joseph had to quit his job to fulfill his family obligations, giving up a good salary. Although he was not ready mentally to retire, and it was difficult giving up his large paycheck, his pension plan and Social Security benefits (which he had to take earlier than he planned to, thus resulting in him receiving a lower amount each month), provide them with just enough money to make ends meet each month. Joseph sees caring for his wife as a labor of love. And that’s the way most federal and state programs see caring for a spouse . . . as a labor of love, and as a spousal obligation.

The reality is that most spouses providing care are already retired and receiving Social Security and perhaps another form of pension income, and don’t need to be paid for for filling their spousal obligation.

But with spousal caregivers such as Joseph, who are saving insurance companies and government agencies billions of dollars by providing care, shouldn’t there be a way to get paid something?

Medicare does not pay spouses.

Please note that Medicare’s policy towards spousal pay is very clear. Medicare will never pay a spouse to provide personal care or assistance for the other spouse. And in any event, Medicare does not even cover personal (non-medical) care for any of its beneficiaries.

Medicaid does not pay spouses.

Medicaid’s policy towards spousal pay is also very clear. Medicaid will never pay a spouse to provide personal care or assistance for the other spouse. However, Medicaid will, under very specific circumstances and pursuant to very strict rules, allow a parent to pay a child or other family member for in-home personal care services.

The Veterans Administration does not pay spouses.

VA’s policy towards spousal pay is generally the same — VA will generally never pay for a spouse to provide personal care or assistance for the other spouse. However, the VA will allow a parent to pay a child or other family member for personal care services.

But there are a Few Programs to Compensate Spousal Caregivers

As you can see, there isn’t much support out there for spousal caregivers. However, there is some. As a spousal caregiver, you may qualify for financial assistance.

For programs that help replace some of the lost income and cover some of the increased costs of caregiving, eligibility depends on a number of factors. These can include state of residence, income and financial assets, types of insurance one has, and if either the caregiver or the spouse are veterans. Here is a rundown of some of the programs available to help pay family caregivers:

Government Programs to Pay Caregivers

• Administration on Aging & Department of Aging Services: Each state and county provides different services through its Agency on Aging. Some programs will provide stipends, reimburse caregivers for supplies, offer training, and provide respite care. Paying for Senior Care maintains a list of Area Agencies on Aging and Disability Resource Centers that’s searchable by state and county.

• The National Resource Center for Participant-Directed Services can help connect you to the state programs that allow the patient to decide how to spend their health care money – sometimes including the option to pay a spouse or other family member for care.

VA Caregiver Support

If you or your loved one is a veteran, this program, also referred to as the Program of Comprehensive Assistance for Family Caregivers, allows spouses to receive a monthly stipend to provide care for their veteran partners. However, it is less relevant to the elderly, as veterans must have been injured in the line of duty following Sept. 11, 2001.

It should be reiterated here that VA Pensions, such as Aid & Attendance, cannot be used to pay spouses.

Life Insurance Policies

Many traditional life insurance policies can be converted to cash throug what’s called a viatical settlement, and the cash can be used as a way to supplement the income given up by a spouse who quits his or her job early to provide care to his or her husband or wife.

Many other life insurance policies have a specific benefit or rider built into them that allow the death benefit to be accelerated/ withdrawn early to pay for personal care expenses for someone who is dying and/or in need of long-term care.

And yet other types of life insurance policies, often called “hybrid policies,” are structured specifically to be able to provide either long-term care benefits or death benefits, whichever is needed. This type of long-term care insurance coverage has been growing in popularity over the last decade and is now the long-term care coverage of choice for most people looking to purchase long-term care insurance.

Paid Family Leave Acts

Currently, four states offer paid family leave in order to care for a spouse. These are New Jersey, Rhode Island, New York, and California. All of these programs are intended to allow spouses to care for their partners for short periods of time, usually between 4 – 12 weeks.

Washington DC will also be offering spousal pay through the DC Universal Paid Leave Act. Read more about Paid Family Leave for Caregiving in this recent Forbes article.

Financial Planning for Caregivers

Caregivers are often so focused on managing their loved one’s health and financial needs that they don’t even think about their own future needs. Although your focus is on providing care for your loved one, it’s important to think about and prepare for your own future financial and caregiving needs. If you haven’t done so already, now is the time to start planning for own your retirement.

Whether you are a senior or a caregiver, if you should ever want expert guidance with your financial planning process, remember that qualified assistance is available right here at the Farr Law Firm. Our team looks forward to helping you – no matter where you’re at in your financial and/or long-term care journey. Call us to make an appointment.

Medicaid Planning for Seniors

How has caregiving impacted your own family? Were their costs that you did not anticipate? Are you now considering nursing home care? If you or your loved one is suffering from any sort of serious health condition, the best time to do Medicaid Asset Protection planning is now. Whether you or your loved one is years away from needing nursing home care, is already in a nursing facility, or is somewhere in between, the time to plan is now, not when you are about to run out of money. Please don’t hesitate to call us at any time to make an appointment for a no-cost initial consultation:

Fairfax Elder Law Attorney: 703-691-1888
Fredericksburg Elder Law Attorney: 540-479-1435
Rockville Elder Law Attorney: 301-519-8041
DC Elder Law Attorney: 202-587-2797

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