5 ways to get paid caring for a loved one in

North Carolina

Published on
July 29, 2022
Last updated
April 19, 2024
Reviewed by
Published on
July 29, 2022
Last updated
April 19, 2024
Reviewed by
Presented by Givers
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Medicaid pays family caregivers in North 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.

In North Carolina, the following Medicaid waivers are available with an option for caregiver pay:

  • CAP/DA Waiver: This program provides services to individuals ages 65 or older, and individuals with physical and or other disabilities ages 18-64 years who meet a nursing facility level of care. Start enrolling to see if you and your loved one meet all eligibility requirements.
  • Innovations Waiver: This program provides services to individuals with intellectual disabilities or developmental disabilities ages 0 or older who meet an ICF/IID level of care.
  • Community Alternatives Program for Children Waiver: This program provides services to individuals who are medically fragile ages 0-20 years who meet a hospital or nursing facility level of care.
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Who are you caring for?

Medicaid programs and waivers can change over time, so it's important to consult the official North Carolina Medicaid website or contact the North Carolina Department of Human Services for the most up-to-date information on available waivers and eligibility requirements.

How does a Medicaid waiver work to pay family caregivers?

In most cases, to get paid by Medicaid as a family caregiver, you will work through a program called self-direction (also known as Consumer Direction, Participant Direction, or other similar names). Medicaid self-direction programs give people who need long-term care services more control over their care. Typically, when someone receives Medicaid-funded care, the government decides who will provide it and how it will be given. With self-direction, the person receiving care has more say in how care is provided and by whom, sometimes including family members.

While enrolling in self-direction can be complicated, it is a viable opportunity for caregivers to get paid for their work. Enrollment typically involves the care recipient going through an evaluation to determine their need for in-home care and obtaining approval accordingly. Afterward, you may need to complete training, acquire credentials, and secure "employment" with an agency responsible for processing payments for your billable hours. Once enrolled and hired by the agency, you must follow specific procedures to document and verify your work to get paid.

How much do family members get paid by Medicaid for caregiving in North Carolina?

Pay rates for family caregivers vary based on:
  • Program Guidelines: Each waiver program may have specific rules and regulations regarding caregiver compensation. These guidelines often outline the maximum hourly rate allowed. 
  • Local Wage Rates: Hourly rates are determined at the local zip code level based on a variety of factors.
  • Qualifications and Experience: Your qualifications and experience as a caregiver can impact your hourly rate. If you have specialized training or certifications relevant to caregiving, it may justify a higher rate. Additionally, your years of experience in caregiving can also influence your compensation. 
  • Level of Care Required: The level of care needed by the individual you are caring for can impact your hourly rate. Higher levels of care, such as providing medical assistance or supporting individuals with complex needs, may justify a higher rate compared to basic caregiving tasks.
  • Time Commitment: The number of hours you dedicate to caregiving can influence your hourly rate. If you are providing care full-time or have a significant time commitment, it may justify a higher rate compared to part-time caregivers. 
  • Market Demand: The demand for caregivers in your area can also affect your hourly rate. If there is a shortage of caregivers or a high demand for specific types of care, it may drive up the hourly rates.
Key stats in your state
Source: AARP
Family caregivers:
1.3M
Hours spent per year:
1.19B
Annual unpaid care value:
$16.5B
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Can you get paid to care for your loved one?

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North Carolina's VA pays caregivers for veterans

Veterans, and the surviving spouses of veterans, have a few options to pay family caregivers.

Veteran Directed Home & Community Based Care in NC

The Veteran Directed Care (VDC) program allows veterans to choose how to direct their monthly care budget. This means that when hiring a caregiver, a veteran can choose to hire his/her family member. The caregiving family member will be paid the hourly rate determined by the VA, typically $8-$21 per hour. VDC is available to veterans of all ages enrolled in VA medical benefits and require skilled services and assistance with activities of daily living.

Veteran Aid & Attendance Pension Benefit in NC

If your veteran loved one requires professional long-term in-home, assisted living, or nursing home care, you may be eligible for Aid and Attendance (A&A). The A&A Pension can provide up to $3,261 per month to pay for care, including to caregiving family members. A&A is an add-on benefit that requires eligibility for the basic VA pension or survivor pension, as well as meeting a disability requirement.

Housebound Pension Benefit in NC

The Housebound Pension benefit provides funds to veterans who are mostly unable to leave their homes. Similar to the A&A benefit, the Housebound Pension can be used to pay family caregivers. The Housebound Pension can be worth up to $1,882 per month, and spouses are unable to be paid as the family caregiver under the Housebound benefit, as spouse income is included in the calculation of the benefit. To qualify for Housebound, a veteran must be limited to his/her house and be eligible for the basic VA pension. Veterans cannot get A&A and Housebound benefits at the same time.

Program of Comprehensive Assistance for Family Caregivers (PCAFC) in NC

The PCAFC is the VA's broadest program targeting family caregivers. The program provides family caregivers with a stipend of up to $2,750 per month, in addition to training, counseling, and respite care. To qualify, the veteran must have been critically hurt or had a serious illness in the line of duty, and require help with at least one activity of daily living.

Find your local VA in North Carolina...

How does the North Carolina Department of Health and Human Services support family caregivers?

Every state is mandated by the federal government to create support systems for family caregivers. They often reach local communities through Area Agencies on Aging (AAAs).

Area Agencies on Aging are crucial in supporting family caregivers caring for older adults. These agencies typically offer various services, resources, and programs to assist family caregivers in their caregiving responsibilities. Some of the most common ways in which state Agencies on Aging support family caregivers include:

  1. Information and referrals: AAAs provide guidance on local resources, support groups, caregiver training, and respite care options.
  2. Caregiver education and training: They organize programs on caregiving techniques, stress management, healthcare navigation, and legal/financial aspects.
  3. Respite care: They offer temporary relief for caregivers, enabling them to take breaks and attend to their well-being.
  4. Support groups: They facilitate caregiver support groups for sharing experiences, concerns, and learning from others.
  5. Caregiver assessments: AAAs evaluate caregivers' needs and provide tailored support and recommendations.
  6. Counseling and consultation: They offer professional guidance and emotional support for caregivers.
  7. Advocacy and policy development: They advocate for caregiver-friendly policies and programs.
  8. Access to benefits and services: They assist caregivers in accessing benefits and programs like Medicaid, home-based services, and transportation assistance.

How do I find my local AAA?

There are 18 AAAs in North Carolina. Click here find your local AAA in NC.


Click here to learn more...

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Who are you caring for?

North Carolina tax credit for caregiving

What is a tax credit?

Tax credits are a way for the government to incentivize and compensate taxpayers for positive activities. A variety of tax credits cover a wide range of expenses and situations such as education, green energy, and caregiving. A tax credit is a dollar-for-dollar reduction of the income tax you owe. For example, if you owe $4,000 in federal taxes but are eligible for a $3,000 tax credit, your tax bill is $1,000.

What tax credits are available for family caregivers?

The Child and Dependent Tax Credit (CDCTC) is a tax credit earned by caregivers for a percentage of care-related expenses. Eligible expenses must be for the care of a child or dependent in order to enable the taxpayer to work or look for work.

How much can I earn in tax credits for caregiving?

The total tax credit you can claim in North Carolina for caregiving is $1,100.

Additionally, North Carolina matches the federal tax credit up to , which can equate to an extra off your taxes.

In 2021 the North Carolina Legislature considered bill S901, to create a tax credit of $3,000 for caregivers of veterans and $1,500 for caregivers of non-veterans. The bill is currently under consideration. Read more...

The CDCTC provides a tax credit for a percentage of your eligible caregiving expenses. The maximum CDCTC at the federal level is $1,100.
To get the CDCTC, you must claim your loved one as your dependent on your tax forms. You loved one must qualify to be claimed as a dependent based on a number of criteria. After claiming your loved one as a dependent, you will need to fill out tax form 2441. The tax form requires a clear picture of your care-related expenses that allowed you to work or look for work.
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Other ways to get paid as a family caregiver in North Carolina

Other caregiver pay programs in NC

Here are a few caregiver payment programs in your state that you may want to explore:
     

Long term care insurance

If your loved one has a long term care insurance policy, that policy may allow for the direction of funds to a family caregiver. To learn if this is an option for you, contact your loved one's insurance company or agent and ask about caregiver benefits.

Employer-sponsored caregiving leave

A growing number of companies are offering to pay employees while they take a leave to take care of a loved one. To learn if this is an option for you, talk to the Human Resources department at your company.

Learn more here

Get paid by family

When your family measures all of the potential costs of care, including nursing homes, in-home nurses, and more, they may recognize that your support is a much more cost-effective option. If there are funds available, you should ask to be compensated for your time and efforts, especially when compared to the costs of the alternatives.

If your family does agree to pay you for your caregiving efforts, you should consult with an attorney to arrange a contract that details your work and wage. This step will create documentation that may be important in the future for reimbursement from Medicaid, health insurance, or assisted living in the future.

Understanding Caregiver Rights and Resources North Carolina

Legal rights and protections for caregivers are essential to ensure their recognition, support, and fair treatment, allowing them to fulfill their caregiving responsibilities while safeguarding their own well-being.


Laws and programs in North Carolina that provide support to family caregivers include the following:

     
  • North Carolina Caregivers' Support Program: This act, enacted in 2019, recognizes the valuable contributions of family caregivers and aims to provide them with support and resources. It requires the North Carolina Department of Health and Human Services to develop and maintain a Family Caregiver Support Program, offering services such as caregiver education, respite care, counseling, and caregiver training.
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  • Adult Care Home Resident's Bill of Rights: This legislation outlines the rights of individuals residing in adult care homes in North Carolina, and it includes provisions that protect the rights of family caregivers. It emphasizes the importance of open communication, access to information, and involvement of family caregivers in the care and decision-making process of their loved ones.
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  • North Carolina Respite Care Program: This program offers temporary relief and respite for family caregivers by providing trained caregivers who can take over caregiving responsibilities for a short period. It allows caregivers to have a break, attend to personal needs, or simply recharge while ensuring their loved ones receive proper care.
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