How to Get Paid as a Family Caregiver in Massachusetts

Family caregivers provide vital support for adults with chronic, disabling, or serious health conditions. In the United States, 38 million people take on this role (AARP 2021), offering crucial physical and emotional care to spouses, parents, and even friends or neighbors. Despite their invaluable contributions, many family caregivers face significant financial challenges, spending about $7,200 annually out of pocket for caregiving expenses, while trying to manage their time and energy. Fortunately, various programs are available that may offer financial relief and support. This guide will explore specific options in Massachusetts to help you navigate potential pathways for support and compensation.

Get Paid Through Massachusetts Medicaid

Medicaid is a joint federal and state program that provides health coverage to eligible low-income individuals. This includes families, seniors, and people with disabilities.

Many states offer extra services through Medicaid waiver programs, which allow them to expand support to specific groups in the community, like those needing long-term care. In Massachusetts, there are several waivers that can help family caregivers get paid for taking care of their loved ones.

Acquired Brain Injury Non-Residential Habilitation (ABI – N) Waiver: Offers a wide range of services including home health aide, personal care, and respite to individuals with brain injuries aged 22 or older who require a hospital or nursing facility level of care.
Acquired Brain Injury with Residential Habilitation (ABI – RH) Waiver: Provides residential habilitation, supported employment, and assistive technology to individuals with brain injuries aged 22 or older who meet a hospital or nursing facility level of care.
Adult Supports Waiver: Supports individuals with intellectual disabilities aged 22 or older with services like group supported employment, respite, and assistive technology, requiring an ICF/IID level of care.
Children's Autism Spectrum Disorder Waiver: Tailored for children with autism aged 0-9 years, this waiver includes community integration, respite, and behavioral supports for those meeting an ICF/IID level of care.
Community Living Waiver: Offers individualized home supports, respite, and transportation for individuals with intellectual disabilities aged 22 or older who meet an ICF/IID level of care.
Frail Elder Waiver: Provides services such as home health aide, personal care, and Alzheimer’s/Dementia coaching to individuals with physical disabilities aged 60-64 and those aged 65 or older who meet a nursing facility level of care.
Intensive Supports Waiver: Supports individuals with intellectual disabilities aged 22 or older with services like residential habilitation, live-in caregiver, and behavioral supports, requiring an ICF/IID level of care.
MFP Community Living (MFP – CL) Waiver: Offers services like personal care, supported employment, and home delivered meals to individuals aged 65 or older, those with physical disabilities aged 18-64, and individuals with mental illness aged 18 or older who meet a hospital or nursing facility level of care.
MFP Residential Supports (MFP – RS) Waiver: Provides residential habilitation, supported employment, and assistive technology to individuals aged 65 or older, and those with mental illness or physical disabilities aged 18-64 who meet a hospital or nursing facility level of care.
Traumatic Brain Injury (TBI) Waiver: Offers services such as residential habilitation, supported employment, and transitional assistance to individuals with brain injuries aged 18 or older who require a hospital or nursing facility level of care.

Medicaid waiver programs can change over time. Please visit the official Massachusetts Medicaid website or contact the Massachusetts Department of Health and Human Services directly to verify the most current details around waiver eligibility, caregiver compensation, and application requirements.

Process to Get Paid

Getting paid as a caregiver in Massachusetts generally follows this process:

Check Eligibility: The care recipient must be eligible for Medicaid and meet the requirements for one of the Medicaid waiver programs.
Apply for Medicaid: The care recipient should complete the Medicaid application process through MassHealth.
Assessment: MassHealth will conduct a functional assessment to determine the level of care needed.
Enroll in a Waiver Program: Once eligibility is confirmed, enroll in the appropriate waiver program (e.g., ABI – N Waiver, ABI – RH Waiver).
Select and Train Caregivers: The care recipient or their representative can select and train family caregivers

Pay Rates

The average pay rate for caregivers in Massachusetts is generally around $19.17 per hour.

Veteran’s Benefits

Veterans and their families have access to several programs through the U.S. Department of Veterans Affairs (VA), intended to support caregivers. If you're caring for a veteran, these benefits can provide crucial financial assistance and resources.

The Program of Comprehensive Assistance for Family Caregiver

This program offers a monthly stipend directly to caregivers of veterans who sustained or aggravated a serious injury or illness during military service. To qualify, the veteran must have a VA disability rating of 70% or higher and need personal care services for at least six months. The stipend ranges from $1,750 to $3,000, reimbursed directly to the caregiver and depends on the locality and level of support the veteran needs. To find out more on how to enroll, visit caregiver.va.gov or call the VA Caregiver Support Line at 1-855-260-3274.

Veteran Aid & Attendance and Housebound Allowance Benefit

Veterans and surviving spouses receiving a VA Pension may qualify for additional financial support through Aid and Attendance or Housebound benefits. These benefits are provided on top of the monthly pension and can be used to pay for in-home care, assisted living, or nursing home costs.

Aid and Attendance (A&A) increases the monthly pay rate for those needing help with daily activities like bathing, dressing, and feeding.
Housebound Allowance increases the pay rate for those who are substantially confined to their homes due to a permanent disability.
The pay ranges based on you and your spouse’s veteran status and if you have dependents (Learn more here). You cannot receive both benefits at the same time. For more information on enrollment, visit here.

Veteran-Directed Home & Community Based Care

This program provides veterans of all ages with a flexible budget to access home and community-based services. Veterans, or their family caregivers, can manage these funds to create a personalized care plan, allowing them to live independently at home or in their communities. For more information, visit: acl.gov.

Other Ways to Get Paid

Tax Credits

The Child Tax Credit allows you to claim up to $2,000 per child off your taxes owed if you have any qualifying children who lived in your home for at least half of the year, are your dependents, and are under the age of 17 by the end of the year.
The Credit for Other Dependents allows you to claim up to $500 for any dependents under your care (including parents and other relatives) if they live with you and rely on you for financial support.
The Child and Dependent Care Credit can be claimed if you pay someone to care for a child under 13 or a dependent of any age who is incapable of self-care. The purpose of the care must be to allow you (and your spouse, if filing jointly) to work or look for work. The amount of the credit is a percentage of your expenses, determined by your income.

Long-term Care Insurance

Some long-term care insurance policies offer the option to compensate family members as caregivers, providing a potential source of financial support. However, coverage can vary significantly between policies. It's important to carefully review the terms to understand whether in-home care and payments to informal caregivers, like family members, are included.

Employer-Sponsored Leave

Some employers may have sponsored leave for those leaving work to take care of their relatives. Check with your HR Department to see if this benefit is offered to you. Additionally, employees can take unpaid leave with job protection through The Family and Medical Leave Act, which allows employees to take up to 12 weeks of unpaid leave per year to care for a family member with a serious health condition.

Resources

Here are some useful resources for caregivers in Massachusetts:

Massachusetts Executive Office of Health and Human Services: Provides information for long-term care programs and resources.
Massachusetts Medicaid Waiver Programs: Offers information on Medicaid waivers available in Massachusetts.
Area Agency on Aging Massachusetts: Provides contact information for the local Area Agencies on Aging in Massachusetts.