Who Qualifies As A Caregiver Under Medicare Rules In Colorado?

October 18, 2023

A caregiver is an individual who assists someone in need with various daily tasks within their home environment. This assistance may be required due to factors like aging, illness, disability, or other unique needs. Caregivers offer a range of home care services, which can encompass personal grooming, meal preparation, mobility support, light housekeeping, laundry, and even skilled medical care in certain situations.

Depending on the specific care requirements, a caregiver can be a trained personal aide or a medical specialist, such as a nurse or therapist. In many instances, people assume the role of informal caregivers for their family members, providing unpaid care out of love or familial obligation. However, there are ways for these family caregivers to receive compensation and support for their work.

In-home care is a vital service for society, and caregivers deserve recognition and compensation. If you or a loved one benefits from Medicare or Medicaid, there may be opportunities to have these programs cover the costs of an in-home caregiver, provided certain conditions are met. In some cases, this might even enable you to hire a family member as a caregiver, paid for by government assistance. In this article, we will explore how this process works and what options are available in the state of Colorado.

How Do You Qualify For A Medicare Caregiver In Colorado?

Rules and conditions for government benefits can vary from state to state, and this article focuses on options for home care in Colorado via Medicare or Medicaid.

Difference Between Medicare and Medicaid

Most Medicare plans require caregivers to be employed by certified facilities, such as nursing homes or home care agencies with established partnerships with Medicare. Home care services covered by Medicare typically require tasks that must be carried out by skilled medical professionals, including:

  • Intermittent nursing care
  • Occupational therapy or physical therapy
  • Speech therapy
  • Services that need trained medical skills, such as administering injections

It’s important to note that Medicare in Colorado does not directly compensate family members for becoming caregivers to their loved ones. However, Medicaid, designed for low-income families, is more flexible in this regard. Some Medicaid programs are structured to grant beneficiaries the choice to decide how their allowances are utilized, potentially allowing them to employ family members as caregivers.

Colorado offers several avenues of financial support and benefits for family caregivers through Health First Colorado (Colorado’s Medicaid program). This includes:

  • Elderly, Blind, and Disabled Waiver (EBD)
  • Family Support Services Program (FSSP)
  • Health First Colorado Buy-In for Working Adults with Disabilities
  • Health Insurance Buy-In Program (HIBI)
  • Program For All-Inclusive Care For The Elderly (PACE)
  • Transition Services

You can also apply for these programs via Medicaid’s official website, either for yourself or on behalf of someone else. Navigating the state bureaucracy can be confusing, but Nova Home Care Colorado can help you secure the funds you need for a family caregiver through Medicaid.

When Is Home Care Not Covered By Medicare In Colorado?

It’s crucial to understand that not all forms of home care services are covered by Medicare. For example, Medicare will not provide compensation for a caregiver if the recipient:

  • In need of 24-hour care
  • Able to leave their home under their own power
  • Not in recovery

Furthermore, Medicare will not pay for a caregiver who provides services that are not strictly medically necessary. If the primary need revolves around assistance with daily activities (such as using the restroom, grocery shopping, dressing, housekeeping, etc.) or is related to general frailty, Medicare will not cover these services.

How Do I Apply To Be A Medicare Caregiver in Colorado?

Even if your plan offers some discretion in selecting your caregiver, family members must still undergo an application process via Medicare and gain approval for the role. Approval hinges on factors like the type and frequency of care required, the recipient’s insurance coverage, and whether any specialized medical supplies are necessary.

Get Help With Becoming A Caregiver In Colorado

Navigating the intricacies of Medicare and Medicaid regulations can be challenging. If you live in Colorado and need guidance on becoming a family caregiver or hiring one, Nova Home Care Colorado is here to help.

Nova Home Care offers professional, personalized in-home care services across the state of Colorado. We support family members in their caregiver roles by officially employing them through our agency. This arrangement comes with a range of benefits, including health insurance, 401K, training, paid time off, and more. Our services are Medicaid-approved, and we can help eligible families secure home care coverage through their benefits.

As a caregiver employed by Nova Home Care, you do not need medical qualifications. However, having a high school diploma (or GED) and reliable transportation is necessary. To determine your eligibility as a caregiver, please refer to our careers page for additional information and submit an application via our website.

Contact us online or call 317-537-2490 to find out more about how we can help you qualify as a family caregiver in Colorado with any Medicare or Medicaid benefits your loved one may be eligible for.

You May Be Eligible!