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Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
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From my experience you pay out of pocket for in home care. You can use agencies to find a person(s) you pay the agency and they handle paying the employee etc. Hourly costs depends on what level of care you need, hours etc. It was cheaper for me to place mom in 24/7 care at asst living otherwise it would have cost up to +5k a month. Everyone's needs are different.
I own a homecare agency. We bill Medicare and Medicaid all the time. Long Term Care insurance policies too. All of them pay for homecare hours if it is ordered by a doctor. Live-in caregivers or round-the-clock 24-hour caregivers are not paid for by Medicare or Medicaid. Some Long Term Care policies do pay for live-in but it's only a percentage. There will be out-of-pocket cost.
If the person needing care has a Long Term Care insurance policy then you can hire an agency to help with care needs. The agency has the responsibility to pay the caregiver. Fortunately my parents have a LTC insurance policy and in our case we were able to engage an agency to provide a caregiver allowing my parents to stay in their own home. My dad had a caregiver 8-12 hours a day till he passed and now my mom has one for 8 hours a day. We pay the agency and then the LTC insurance reimburses us. It can cost anywhere between $8K-$10K a month. The only time Medicare was involved was in getting medical equipment for my dad and providing home health care visits with a doctor and nurse monthly as well as physical therapy. As for Medicare paying, we were told they step in when a person enters Hospice.
Curious to know if your parents had separate long term insurance for each or did one policy kick in for the other spouse. I would think to be able to have that amount of money reimbursed, they had money to afford a really good LTC plan. I understand today, LTC, is much more expensive, complicated and there is many pros and cons. You were very lucky with your parents care and their investment in LTC. I would say about 80% of the baby boomers have no such thing. Many people think Medicare will cover it and it won't.
LIVE-IN CAREGIVERS: I researched this for my friend-companion years ago. It is not as cut and dry as one might think.
Not only do I believe Medicare/Medicaid would need to know, I believe on a form(s) you must provide, they ask you who else lives in the house? You have to tell them. In addition, consider:
Be very careful about 'live-in' caregivers as they are considered an EMPLOYEE and you have to pay all their wages, report taxes, and likely provide workers' compensation, vacation, and break times, and specify hours. You have to track everything / keep accurate records.
There is no such agreement 'free rent for care services.'
This isn't a 'trade' situation. There are very clear 'rules and regulations' hiring employees, even when they live in your property.
In addition, there are times when you may want them to leave and THEY (may not) / do not want to leave ... which means you would need to call the sheriff to physically move them and/or cite them, too.
However you manage this, require a criminal check (fingerprinting) at their cost, copy of driver's license, car insurance, TB and Covid tests (if you want). And always ask for references.
If you do not follow clear tax employee-employer guidelines, they can also sue you. They can try to sue you anyway. Be very careful. I researched this at a law library years ago.
Have you actually ever been a caregiver live-in or otherwise? I did private-duty independent homecare for years before I went into business. I took out my own taxes and paid my own liability insurance.
The employer doesn't have to do this. If you're independent then it's your responsibility. I worked for a few families who did it for their caregiver employees, but not many.
I worked agency help also. Places in my state don't have to pay workman's comp to part-time employees. This is why most businesses keep the help under full-time hours. Part-timers are also not given vacation time or over-time pay. It finally got past that part-time employees do get some sick time now. That was only done last year though.
My company will not provide 'live-in' care for just the reasons you stated. Never allow caregivers to make your home their legal address. We'll do 24-shift but not live-in.
Live-in caregivers do not get paid hourly and often people get talked into paying them hourly which they should not do. Live-ins get salary and it is not based on minimum wage requirements. It is similar to waitstaff and hairdressers do not have to be paid minimum wage. Live-in caregivers do not have to be either. Even 'Sleep Duty' aides who are people that basically just go to sleep at a care client's house for the purpose of just having someone else in the house, don't get minimum wage either. They get a set amount per shift.
Free room and board is factored in as part of the wages for a live-in caregiver. It does not replace the actual wages though.
10,000 a month for my parent, through an agency. No other choice for us other than facility which isnt much less in that east coast area (8k-9k by my research). So 120k a year, all from cash. Lucky to have it for now but won't last forever....
That's way too expensive. You can hire two private caregivers that either split the week, work one week on one week off, or two on two off and save a lot every month.
I'm in CT which is a very expensive state to live in. Go to care.com and interview a few private-duty caregivers. You can save a lot this way.
To find out how much a live in caregiver costs in your area, you can: 1. Search Online: Look for local caregiving agencies in your area and check their websites for pricing information. Websites like Care.com and Home Instead can provide estimates. 2. Contact Agencies Directly: Call local home care agencies and ask for a quote. They can provide detailed information based on your specific needs. 3. Ask for Recommendations: Reach out to local senior centers, healthcare providers or community groups for recommendations and insights on costs. 4. Use Cost Estimaters: Websites like Genworth’s Cost of Care Survey offer tools to estimate the cost of in home care based on your location.
Regarding payment through Medicare or Medicaid: Medicare generally does not cover long term in home caregiving services. It may cover short term care if you meet specific conditions, such as needing skilled nursing care after a hospital stay. Medicaid may cover in home caregiving costs if you qualify under your state’s Medicaid program. Coverage and eligibility vary by state, so it’s best to check with your state’s Medicaid office.
For additional information, you can contact your local Area Agency on Aging, which can provide guidance on costs and financial assistance options.
My mom recently had a caregiver come in for 24 hour care. It took spelling out to my mom that she would be out of money in a very short time at a cost of over $300K a year for her to realize she didn't really need someone there to sit around with her 24 hours a day. We are in an expensive part of California where the going rate is $35 an hour for a caregiver who does not drive.
Live-in caregivers do not get paid hourly. Never let anyone talk you into paying them hourly.
In fact, their pay is salary and not even based on minimum wage requirements. Free room and board while it is not a replacement for actual wages, is part of the live-in caregiver's salary.
Hire privately. I was a private caregiver in northern California when I lived out there. You'll save money hiring privately.
Jimmy58, welcome to the forum. When you get a chance please fill out the Profile, that will help us to better understand. Example, are you the person who needs a live-in caregiver, or is it for someone else? Your home, or their home?
Here is something else you need to think about.... if you (or whomever) hires a live-in caregiver and that person is not from an Agency (where the Agency does the payroll), please note you would need to contact your (or whomever) homeowner's insurance carrier about Workman Comp Insurance. Workman Comp helps cover the employee should he/she gets hurt on the job.
Here's more info why Workman Comp is important: www.care.com/hp/nanny-workers-compensation-insurance This article also refers to "caregivers". (I tried to find an article that wasn't tied to a company or law firm but had zero luck).
Let’s do some basic math. How much per hour do you think someone should get paid for a job. Skilled caregiver with training. $40 per hr or more. That’s about 83k per year for 8 hr shifts. There are 3 8hr shifts per day. That’s 249k per year. That’s a good starting point. Now ask yourself are you willing to work 7 days a week 24 hrs a day? Perhaps you need a team.
Live-ins do not get paid hourly. They are salary. The free room and board is considered part of their wages.
If someone is willing to pay $40 an hour, why go with a homecare worker? You can hire an actual nurse for that. No homecare worker ever got $40 an hour. I own a homecare agency and even though homecare is expensive, no one is paying upwards of a quarter mil a year for it.
Without giving specific numbers because those can vary wildly depending on the area, I will say it has been my experience that paying for caregivers for 24-7 care in the home will significantly exceed the cost of placing someone in a facility. As others have mentioned, neither Medicare nor Medicaid will cover the cost of caregivers.
I worked with a lawyer who knew employment law for my state to draw up a contract. I already had a caregiver identified who was working with my mom who wanted to have the live-in arrangement. Her rent/utilities are covered and she receives a weekly salary. She had weekend time off that I had to find coverage for as well as vacation time that requires coverage. She is a W-2 employee so taxes are paid, but I’ve seen other arrangements where live-in caregivers are 1099.
Setting this contract up and payment was a lot of work. I’ve been managing this for over a year and it’s not easy, but has allowed my mom to remain in her home.
There is an option to post a job on one of the care sites for live-in.
This is all paid for with savings. I see the article that was linked by another member mentioned how insurance may pay for some portion, but that hasn’t been my experience.
There are a couple of articles on this site addressing your question like this one at https://www.agingcare.com/articles/24-hour-in-home-care-cost-477984.htm. There's no date on the article; but look for the Genworth Cost of Care Survey link in the references at the end to see the latest cost estimates for your area.
All of your answers vary tremendously by state and area. Live in caregivers are few, and will always need regular time off as well as coverage for their own emergencies and vacations. Medicare and Medicaid are state specific, call your state agencies for information on what programs are available for caregivers
Neither Medicare nor Medicaid pay for "custodial" care. They cover medical needs. This is why they both have "medi" in their names.
Some states have special or waiver programs where Medicaid pays for care in the home, but one has to qualify per their criteria, both medically and financially, and it is usually never full time and never more than minimum wage. Sometimes a family caregiver can get paid, but again, they have to apply and qualify, and then it is usually not enough to cover all the care needs.
You will need to research it for your home state, which you don't mention.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Not only do I believe Medicare/Medicaid would need to know, I believe on a form(s) you must provide, they ask you who else lives in the house? You have to tell them. In addition, consider:
Be very careful about 'live-in' caregivers as they are considered an EMPLOYEE and you have to pay all their wages, report taxes, and likely provide workers' compensation, vacation, and break times, and specify hours. You have to track everything / keep accurate records.
There is no such agreement 'free rent for care services.'
This isn't a 'trade' situation. There are very clear 'rules and regulations' hiring employees, even when they live in your property.
In addition, there are times when you may want them to leave and THEY (may not) / do not want to leave ... which means you would need to call the sheriff to physically move them and/or cite them, too.
However you manage this, require a criminal check (fingerprinting) at their cost, copy of driver's license, car insurance, TB and Covid tests (if you want). And always ask for references.
If you do not follow clear tax employee-employer guidelines, they can also sue you. They can try to sue you anyway. Be very careful. I researched this at a law library years ago.
Gena / Touch Matters
Have you actually ever been a caregiver live-in or otherwise? I did private-duty independent homecare for years before I went into business. I took out my own taxes and paid my own liability insurance.
The employer doesn't have to do this. If you're independent then it's your responsibility. I worked for a few families who did it for their caregiver employees, but not many.
I worked agency help also. Places in my state don't have to pay workman's comp to part-time employees. This is why most businesses keep the help under full-time hours. Part-timers are also not given vacation time or over-time pay. It finally got past that part-time employees do get some sick time now. That was only done last year though.
My company will not provide 'live-in' care for just the reasons you stated. Never allow caregivers to make your home their legal address. We'll do 24-shift but not live-in.
Live-in caregivers do not get paid hourly and often people get talked into paying them hourly which they should not do. Live-ins get salary and it is not based on minimum wage requirements. It is similar to waitstaff and hairdressers do not have to be paid minimum wage. Live-in caregivers do not have to be either. Even 'Sleep Duty' aides who are people that basically just go to sleep at a care client's house for the purpose of just having someone else in the house, don't get minimum wage either. They get a set amount per shift.
Free room and board is factored in as part of the wages for a live-in caregiver. It does not replace the actual wages though.
That's way too expensive. You can hire two private caregivers that either split the week, work one week on one week off, or two on two off and save a lot every month.
I'm in CT which is a very expensive state to live in. Go to care.com and interview a few private-duty caregivers. You can save a lot this way.
1. Search Online: Look for local caregiving agencies in your area and check their websites for pricing information. Websites like Care.com and Home Instead can provide estimates.
2. Contact Agencies Directly: Call local home care agencies and ask for a quote. They can provide detailed information based on your specific needs.
3. Ask for Recommendations: Reach out to local senior centers, healthcare providers or community groups for recommendations and insights on costs.
4. Use Cost Estimaters: Websites like Genworth’s Cost of Care Survey offer tools to estimate the cost of in home care based on your location.
Regarding payment through Medicare or Medicaid: Medicare generally does not cover long term in home caregiving services. It may cover short term care if you meet specific conditions, such as needing skilled nursing care after a hospital stay. Medicaid may cover in home caregiving costs if you qualify under your state’s Medicaid program. Coverage and eligibility vary by state, so it’s best to check with your state’s Medicaid office.
For additional information, you can contact your local Area Agency on Aging, which can provide guidance on costs and financial assistance options.
In fact, their pay is salary and not even based on minimum wage requirements.
Free room and board while it is not a replacement for actual wages, is part of the live-in caregiver's salary.
Hire privately. I was a private caregiver in northern California when I lived out there. You'll save money hiring privately.
Here is something else you need to think about.... if you (or whomever) hires a live-in caregiver and that person is not from an Agency (where the Agency does the payroll), please note you would need to contact your (or whomever) homeowner's insurance carrier about Workman Comp Insurance. Workman Comp helps cover the employee should he/she gets hurt on the job.
Here's more info why Workman Comp is important: www.care.com/hp/nanny-workers-compensation-insurance This article also refers to "caregivers". (I tried to find an article that wasn't tied to a company or law firm but had zero luck).
Live-ins do not get paid hourly. They are salary. The free room and board is considered part of their wages.
If someone is willing to pay $40 an hour, why go with a homecare worker? You can hire an actual nurse for that. No homecare worker ever got $40 an hour. I own a homecare agency and even though homecare is expensive, no one is paying upwards of a quarter mil a year for it.
Setting this contract up and payment was a lot of work. I’ve been managing this for over a year and it’s not easy, but has allowed my mom to remain in her home.
There is an option to post a job on one of the care sites for live-in.
This is all paid for with savings. I see the article that was linked by another member mentioned how insurance may pay for some portion, but that hasn’t been my experience.
at https://www.agingcare.com/articles/24-hour-in-home-care-cost-477984.htm.
There's no date on the article; but look for the Genworth Cost of Care Survey link in the references at the end to see the latest cost estimates for your area.
Some states have special or waiver programs where Medicaid pays for care in the home, but one has to qualify per their criteria, both medically and financially, and it is usually never full time and never more than minimum wage. Sometimes a family caregiver can get paid, but again, they have to apply and qualify, and then it is usually not enough to cover all the care needs.
You will need to research it for your home state, which you don't mention.