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You can read about what Medicare pays for and what it does not pay for in the Medicare & You handbook that’s sent out by Medicare every year. Phone numbers are provided in the handbook that you can call to get further information.
MediCARE is health insurance; & as it’s an insurer it is run like other insurance companies so set up to pay those that are registered as vendors or businesses. & set to pay under whatever terms of contract that are in place as per that policy and it’s benefits. MediCARE as health insurance is really designed to be about limited term type of benefits payouts…. like the up to 100 days of rehab, the 6 month qualifying period for hospice, in home care following a procedure, etc. Unfortunately for a lot of us, we don’t see it like this….. we see it as $ that is taken from a paycheck via FICA since we started working ages ago or taken from SSI each month if we are getting SSA retirement income and using Medicare Part B coverage.
For those on Medicare, what it pays would be whatever are benefits for policy we are on if we stayed with Original / Traditional Medicare OR if we went with a Medicare Advantage Plan that is covered and at whatever copay level that is available for where we live. For either, neither realistically will allow for you or I as an individual to be paid directly as a caregiver. That flat is so not happening as we are not “vendors”. The only way it could - maybe just could happen- would be if you are a licensed and registered healthcare professional who is a vendor in the State or you do this as a “pass thru” or as an employee of a company who is a vendor.
IMPORTANT!: MediCARE covers home health IF MEDICALLY NECESSARY part-time or intermittent skilled nursing care, PT, OT Speech pathology AND a Medicare certified vendor provides for it. Also may include part time or intermittent social services, home health aide & DME. For either, assessed by a physician with orders. For In Home a State Medicare certified home health agency provides for it. & State likely will reassess. Home health tends to be limited to those truly “home bound” who cannot leave due to their condition. So if can get around using a cane, walker or can get specialized transpo to pick you up, not gonna qualify for In Home paid by Medicare.
But Community Medicaid programs, specifically IHHS (In Home Health Services) will pay for in home family caregiver. Elder assessed to be “at need” for a certain # of hours of caregiving and elder files for & is eligible for community Medicaid and your States program has it set up for either the State or a partner* to be the go btwn on paperwork / training for a family member to provide in their home caregiving which the State pays at slightly above minimum wage with elder maybe paying a small copay if monthly income is high (community only looks at income NOT assets). California has done IHHS for decades as a stand alone in its budget; wage set by State minimum wage + then ++ if HCOLA; seems to avg 24 hrs a week with CG living in the home; & all taxable income. Most States do not do this….. what they do is a waiver program that takes part of their % share of State $ from the required LTC Medicaid program (all States get dedicated funds from Federal Government for this program) that pays for custodial care in a NH and waives or shifts some of that $ into the waiver program….. because of this, it’s not secure funding. & because it’s not secure, it’s scattershot for States to do year in / year out. & imho why many States don’t bother with it as crazy to administer as so iffy (ditto why no LTC Medicaid for AL or MC as they too would be waiver $).
So once again, exactly what your State does - or perhaps better said does NOT do - is what matters as to just the availability of programs.
* partner tends to be a nonprofit, like a health care subdivision of Catholic Charities.
"For those on Medicare, what it pays would be whatever are benefits for policy we are on if we stayed with Original / Traditional Medicare OR if we went with a Medicare Advantage Plan that is covered and at whatever copay level that is available for where we live. For either, neither realistically will allow for you or I as an individual to be paid directly as a caregiver. That flat is so not happening as we are not “vendors”. The only way it could - maybe just could happen- would be if you are a licensed and registered healthcare professional who is a vendor in the State or you do this as a “pass thru” or as an employee of a company who is a vendor."
Medicaid pays family caregivers in South Carolina. What is a Medicaid Waiver? Medicaid Waivers are exceptions to Medicaid rules that allow states to offer programs that do not fit within the traditional boundaries of Medicaid. Every state has at least one waiver in place to allow the payment of family caregivers.
Disclaimer: Not my authoring.
https://www.medicaidlongtermcare.org/eligibility/south_carolina/
What you are looking for is a waiver program that allows a patient in need of NH-level care to remain at home.
Sometimes family members can be paid by these waiver programs. There are often waiting lists for waiver programs.
however, you’ll need a few backup aides for them to approve it
https://www.aidaly.com/states/how-to-get-paid-family-caregiver-south-carolina#:~:text=The%20state%20of%20South%20Carolina,get%20paid%20for%20their%20services.
https://aging.sc.gov/programs-initiatives/family-caregiver-support