Understanding Why Medicaid Doesn’t Always Pay Spouse Caregivers
- Sanskriti Kumar
- 7 hours ago
- 3 min read
Millions of Americans rely on their family members for daily care and a lot of times; it is their spouse or partner. Caregiving responsibilities can sometimes affect their ability to commit to their work and affect them and the household financially. So, a common question is: Can a spouse be paid by Medicaid for caregiving?
A simple answer would be it depends on the criteria of the Medicaid program in the state you live in. In this article we will explore if your spouse can get paid to provide care for you and why if they cannot.
Getting Paid as a Family Caregiver
Caregiving for a family member can require attention and energy. The family member being taken care of can feel like a burden and hesitate to ask for more help even if they need it. Self-directed home care programs under Medicaid give them the freedom to get the care they need on their own terms. This allows them to hire family members or people they trust to care for them.
There is an application process that requires documentation, verifications, and sometimes training. Every state in the United States has a program with its own name and process. Consulting a professional will be helpful to keep track of what the requirements are.
Getting Paid as a Spouse Caregiver
Spouses are common caregivers who take care of their partners and do very important work. So, the question of whether the spouse can be paid comes up often. Compensation isn’t offered to spouses in many cases. The question and confusion usually come up because some states allow it while others don’t.
Who Is Considered a Spouse?
For the purpose of self-directed care programs, a spouse is generally defined as someone legally married to the person receiving care.
Even if you’ve been living together for many years or share financial responsibilities, most programs do not consider domestic partners or long-term partners as spouses unless you are legally married. If you are unsure how your relationship is classified, you can consult a professional to confirm your eligibility.
States That Do Not Pay Spouses as Caregivers
Your partner can be a caregiver, however compensation for that role depends on the specific Medicaid programs, state rules, and insurance. It is important to check eligibility criteria since programs have income and asset limits.
Even if you qualify for Medicaid and need care for basic and daily needs, you might not be able hire your spouse in the following states:
Alaska
Arkansas
Connecticut
Georgia
Idaho
Illinois
Iowa
Kansas
Maine
Massachusetts
Michigan
Mississippi
Missouri
Nebraska
Nevada
New York
Ohio
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Virginia
West Virginia
Wisconsin
Wyoming
Since the rules vary by state regarding training, background checks, qualifications, and allowable hours and rates, it is important to check your state specific guidelines. You can consult a professional to understand the application process and requirements.
Why the Medicaid Program Might Not Pay Spouse Caregivers
If you are in a state where spouses cannot be paid caregivers, the self-directed program in your state still allows you to hire some other family member or someone you trust to take care of you. Hiring someone else could still lighten the responsibilities of your caregiving partner.
The Medicaid programs often do not pay legally responsible family members or spouses to maintain program integrity and avoid conflict of interest.
Paying the Spouse Could Blur Lines of Familial and Professional Roles
Under the framework of marriage, the state often expects spouses to carry financial, emotional, and basic caregiving responsibilities towards each other.
Other than a legal obligation, the state can also consider this a moral and ethical responsibility. Introducing payment into spousal care can make it harder to separate marital roles from caregiving responsibilities.
Integrity of the Program and Its Funding
The state also wants to avoid fraud or misuse of the program. States may find it difficult to determine whether the care provided by a spouse exceeds what is normally expected within a marriage.
If My State Does Not Pay My Spouse, What Can I Do?
Excluding spouses from compensation can seem like an unfair burden, especially if and when caregiving responsibilities limit the spouse's ability to work outside the home. While spouses are excluded, adult children, siblings, or in-laws can qualify as paid caregivers.
You can consider hiring another family member and manage and direct your own care without hesitation.
Contact BURD Home Health today to get started to take control of your own care. Call us at (833) 447-3326 or find more information on our website.