Who Qualifies As A Caregiver Under Medicare Rules In Connecticut?

October 18, 2023

A caregiver is a helping hand for someone in need, offering assistance with daily household tasks that, due to factors such as aging, illness, disability, or special requirements, the one cared for has difficulty completing by themselves. Caregivers provide home care services that range from personal grooming, assistance with mobility around the home, light housekeeping, laundry, meal preparation, and, in certain cases, medical care.

Caregiving work is performed by people from different backgrounds, including some medical practitioners such as nurses and therapists, when specific expertise is required. However, many everyday individuals become informal caregivers for their family members, dedicating themselves to unpaid care work out of love and responsibility. Even in these situations, there are ways for family caregivers to receive recognition, compensation, and support for their efforts.

Being a family caregiver is a substantial responsibility, offering numerous benefits to those receiving care, and it deserves compensation. If you or a loved one relies on Medicare or Medicaid, it is possible to secure government assistance to cover the costs of an in-home caregiver, provided specific eligibility criteria are met. This support may extend to using your benefits to hire family members as caregivers. In this article, we will delve into how these processes operate and outline the options available within the state of Connecticut.

How Do You Qualify For A Medicare Caregiver In Connecticut?

The regulations and prerequisites for government assistance can differ significantly between states. This article will focus on home care options available in Connecticut through Medicare or Medicaid.

Difference Between Medicare and Medicaid in Connecticut

In most cases, Medicare plans typically require caregivers to be employed by certified facilities like nursing homes or home care agencies that maintain an established partnership with Medicare. Services covered by Medicare encompass specific tasks necessitating the expertise of skilled medical professionals, such as:

  • Intermittent nursing care.
  • Occupational and physical therapy.
  • Speech therapy.
  • Administering injections.

It’s important to note that Medicare does not directly compensate family members who act as caregivers for their loved ones.

Medicaid, designed to aid low-income families, offers greater flexibility. Certain Medicaid programs are structured to allow beneficiaries to decide how their allowances are allocated, potentially extending to employing family caregivers.

Connecticut’s Medicaid system, known as HUSKY Health, offers several programs aimed at assisting seniors in accessing essential care and support while maintaining their independence at home. These programs include the Connecticut Home Care Program for Elders, Community First Choice, and the Money Follows the Person Program.

Home Care Waiver Programs in Connecticut:

  • Connecticut Home Care Program for Elders (CHCPE) – The CHCPE waiver is specifically tailored for seniors at risk of nursing home placement. It provides a range of services, both in-home and out-of-home, including homemaker services, case management, companion care, personal care, and assistive technology. Eligibility requires seniors to meet the state’s Medicaid waiver income limit of $2,523 per month. Applications can be downloaded online in both English and Spanish.
  • Community First Choice (CFC) – This waiver allows Medicaid-eligible seniors in Connecticut to access services such as meal preparation assistance, homemaker services, and personal care while residing in their own homes. Eligible seniors must have the capacity to self-direct their services and require a level of care equivalent to nursing care. Participants have the option to choose qualified home care attendants or family members as paid caregivers. Applications can be submitted by calling 2-1-1 or online.
  • Money Follows the Person Program – This program aids individuals currently residing in nursing care, hospitals, or other institutions in transitioning back to their communities. It offers in-home care, home health care services, hospital discharge planning, and accessible housing, as needed. To qualify for this program, seniors must have lived in a residential long-term care setting for at least three months and express a desire to reside in the community. Additionally, they must be eligible for Medicaid benefits. Applications can be submitted by calling 2-1-1 or online.

When Is Home Care Not Covered By Medicare In Connecticut?

Medicare does not cover all types of home care services. Specifically, Medicare will not provide coverage for a caregiver in situations where the recipient:

  • Requires continuous, round-the-clock care.
  • Is capable of leaving their home independently.
  • Is not in recovery from injury or illness.

Additionally, Medicare does not extend coverage to caregivers offering non-medical services. If the primary need for care revolves around assistance with everyday activities such as using the restroom, grocery shopping, getting dressed, or housekeeping, or if it relates to overall frailty, Medicare will not cover these services.

How Do I Apply To Be A Medicare Caregiver In Connecticut?

Even in the case of a Medicare plan that offers a degree of choice in selecting a caregiver, family members must adhere to the Medicare application process. Approval for the caregiving role hinges on several factors, including the nature and frequency of the care required, the recipient’s insurance coverage, and whether any specific medical supplies are necessary.

Get Help With Becoming A Caregiver In Connecticut

Medicare and HUSKY Health regulations can often be difficult to navigate, but if you reside in Connecticut and need guidance on becoming a family caregiver or hiring one, Nova Home Care is here to help.

Nova Home Care delivers professional, personalized in-home care services across the state of Connecticut. We help family members become caregivers by offering official employment through our agency, complete with benefits like insurance, 401K, training, paid time off, and more. Our services are covered by HUSKY Healthy , and we can aid eligible families in securing coverage for their home care through their benefits.

As a caregiver employed by Nova Home Care, you don’t need to possess any medical qualifications. However, a high school diploma (or GED) and reliable transportation are prerequisites. To check your eligibility as a caregiver, please refer to our careers page for additional details and submit your application through our website.For further information on how we can assist you in qualifying as a family caregiver in Connecticut, complete with Medicaid benefits for your family member, please don’t hesitate to contact us online or call us at 317-537-2490.

You May Be Eligible!