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Which Medicaid Program Allows the Sick and Elderly To Hire Family Members As Caregivers

Which Medicaid Program Allows the Sick and Elderly To Hire Family Members As Caregivers
November 8, 2022

When a loved one needs additional, low-cost care as they grow older, you want to ensure they're well cared for. Maybe your mother's health needs are specific, and you want to take full responsibility for her health. Your friends and family members suggest hiring a caregiver from a Medicaid agency. You trust the caregivers but don't think your mother would like a stranger aiding her.

You want to provide your mother with full-time care, and she trusts you to do it. However, you don't have the time or money to do so comfortably. You'd have to quit your job to give her the care she deserves.

Many people don't realize that, in Florida, under the Medicaid Waiver Program, also referred to as home- and community-based services, they can become their loved one’s caregiver and be paid for their services. If you’re looking to do so, you can achieve this through a personal services contract or Participant Directed Option (PDO).

Both options allow you to care for your loved one instead of using a caregiver you don't know. If you're interested in learning more about these programs, continue reading this guide. We'll explain how each option works and how they can benefit you and your loved ones.


Option #1: Personal Services Contract 

The first option is the personal services contract through the Florida Medicaid Waiver Program. This is a useful strategy for applicants with assets they need to get rid of to be eligible for Medicaid.

With this program, you can set up a personal services contract anytime before your loved one applies to Medicaid. The arrangement allows the applicant to hire a caregiver that they know. The only condition is that the caregiver cannot be their spouse. Instead, it can be anyone else, such as their child, cousin, sibling, or neighbor.

To move forward with this program, we would calculate the lifetime value from the time the contract is signed and moving forward of the services that you provide for the eventual Medicaid applicant. Once we calculate the fair market value of services, the contract's total value can be transferred from the Medicaid applicant to the caregiver in one lump sum - prior to submitting the Florida Medicaid Waiver Application.

This is an excellent option if your loved one has assets they need to get rid of before applying for Medicaid. Medicaid only allows applicants to have $2,000 to qualify for the waiver program. Another benefit of this program is that Medicaid doesn't view this transfer as a gift, and gifting isn't required to meet the $2,000 requirement.


Option #2 Participant Directed Option (PDO)

The second way to hire a family member as a Medicaid caregiver is through the Participant Directed Option (PDO). This option is applicable to applicants who've already taken steps to remove assets from their names.

Once your loved one is on Medicaid after they've met the financial requirements and gone through the waitlist, they have a choice: hire a homecare agency that contracts with the Medicaid Care Organization hired after our elder care attorneys have gotten Medicaid Waiver approval and enrollment - or hire a friend or family member to get paid, by Medicaid, for home care services provided.. 

PDO differs from the personal services contract because the applicant can hire their spouse to be their caregiver. They can also hire other people, such as adult children, other family members or close friends. The only condition is that the care person must be legally able to work in the United States and pass a level two background check.Once you pass your background check, you can enroll in a PDO program. You will be paid for the hours the managed care organization has approved. 

For example, if the organization approves you to work 20 hours weekly, you can submit up to 20 hours each week. The pay rate for this role is around $11 per hour or less. If you're already caring for them, you at least deserve to be paid for your hard work.


Elder Needs Law: Contact Experienced Florida Medicaid Planning Attorneys Today

If you want to learn more about how you can be hired as your loved one's caregiver, Elder Needs Law is here to help. Our law firm will assist clients anywhere in Florida. So give us a call to schedule your consultation. We look forward to aiding you and your loved one with all your elder law needs.

Jason Neufeld is the Founder and Managing Partner of Elder Needs Law, a Florida estate planning and elder law firm he created in 2017. With more than 15 years of experience practicing law, he represents clients in a wide range of legal matters, including Medicaid planning, estate planning, elder law, probate, Medicare, and life insurance.

Jason received his Juris Doctor from the University of Miami — School of Law and is a member of the Florida Bar and the Broward County Bar Association. He has received numerous accolades for his work, including being named a Rising Star and Super Lawyer by Super Lawyers and among the Florida Legal Elite by Florida Trend in 2024.

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