Who Qualifies As A Caregiver Under Medicare Rules In Minnesota?

October 18, 2023

A caregiver is someone who provides assistance with daily activities at home, helping individuals who have special needs due to factors like aging, illness, or disability. The range of home care services offered by caregivers can encompass personal grooming, meal preparation, mobility assistance, light housekeeping, laundry, and in certain cases, even skilled medical care.

Caregivers can come from various backgrounds, including professionals in the caregiving field or individuals with medical expertise, such as nurses or therapists. In many instances, everyday people become informal caregivers to their family members, taking on unpaid care responsibilities for their loved ones. However, there are ways for these family caregivers to receive monetary compensation and support for their efforts.The role of providing in-home care is an important one for society, as receiving in-home care has proven benefits for the people cared for over staying in a facility like a nursing home. We believe that caregivers should be fairly compensated for their services, even when they look after family. If you or a loved one relies on Medicare or Medicaid, it’s possible to secure funding for an in-home caregiver, provided specific criteria are met. This could even extend to hiring family members as caregivers through government assistance programs. In this article, we’ll delve into the details of how this process works and what options are available in the state of Minnesota.

How Do You Qualify For A Medicare Caregiver In Minnesota?

The eligibility criteria and regulations for government assistance programs can differ significantly from state to state. This article concentrates on the options available for paying for home care through Medicare or Medicaid in the state of Minnesota

Difference Between Medicare And Medicaid

In general, most Medicare plans only accept caregivers associated with certified facilities such as nursing homes or home care agencies with established partnerships with Medicare. Medicare-covered home care services typically require the involvement of skilled medical professionals. These services may include intermittent nursing care, occupational and physical therapy, speech therapy, and tasks demanding specialized medical skills like administering injections.

It’s important to note that Medicare does not directly compensate family members who act as caregivers for their loved ones. However, Medicaid, known in Minnesota as Medical Assistance, offers more flexibility. Available to lower-income Minnesota residents, certain Medicaid programs are structured to allow the beneficiary to allocate their home care budget as they see fit, including employing family members as caregivers.

Medical Assistance has several programs for Minnesotans in which the beneficiary has some discretion over how their benefits are spent and could let you employ a family member as a caregiver. These include:

  • The Elderly Waiver (EW):  A suite of support services tailored to seniors who require a nursing home level of care but prefer to continue living within their community. These services encompass adult day care, home modifications, personal care assistance, home-delivered meals, assisted living, and adult foster care. Participants in the waiver program have the option to exercise self-direction in their care, which includes the possibility of hiring specific family members, such as adult children, as caregivers.
  • The Community Access for Disability Inclusion (CADI) Waiver: It covers services to individuals under the age of 65 with disabilities. However, individuals enrolled in this program before reaching age 65 can remain under its coverage. CADI covers nursing services, home and vehicle modifications, homemaker services, and personal assistance. Similar to the Elderly Waiver, the CADI Waiver allows you to choose family members to be employed as service providers.
  • The Minnesota Personal Care Assistance (PCA): It offers eligible individuals the opportunity to self-direct their personal care services and select their preferred caregivers, including friends and family members. To be eligible for this program, individuals must be enrolled in the Minnesota Medicaid state plan or a state-managed care program, such as Minnesota Senior Health Options (MSHO), the Elderly Waiver, or the Minnesota Alternative Care program.
  • Managed Medicaid programs, such as the Minnesota Senior Health Options (MSHO) and Senior Care Plus (MSC+) offer both short-term and long-term care assistance. 

When Is Home Care Not Covered By Medicare In Minnesota?

It’s crucial to understand that not all types of home care services are covered by Medicare. For instance, Medicare will not provide caregiver coverage in the following scenarios:

  • When 24-hour care is necessary
  • If the individual can leave their home independently
  • If the person is not in a state of recovery from injury, surgery, or illness

Additionally, Medicare does not cover caregivers who primarily offer non-medical services. If the primary need revolves around assistance with daily activities like grocery shopping, dressing, housekeeping, or general frailty, Medicare will not provide coverage for such services.

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

Even in cases where a plan allows for discretion in selecting a caregiver, family members must still apply through Medicare, undergo assessment, and gain approval for the caregiving role. Approval depends on factors such as the type and frequency of care provided, the recipient’s insurance coverage, and whether any special medical supplies are necessary.

Get Help With Becoming A Caregiver In Minnesota

Understanding the intricate rules and regulations of Medicare and Medicaid can be challenging. , but if you live in Minnesota and are looking for help on how to become a family caregiver or employ a family caregiver, then Nova Home Care can help you. 

Nova Home Care offers professional and personalized in-home care services across the state of Minnesota. We support family caregivers by offering official employment through our agency. By working with Nova Home Care Minnesota, family caregivers gain benefits like insurance, 401K, training, paid time off, and more. Our services are covered by Medicaid, and we can assist eligible families in securing Medical Assistance benefits for their home care.

As a caregiver employed by Nova Home Care, you do not require any medical qualifications. However, you must have a high school diploma or GED as well as reliable transportation. If you would like to check your eligibility as a caregiver, check our careers page for more information and apply via our website.Contact us online or call 317-537-2490 to find out more about how we can help you become a paid family caregiver in Minnesota with any Medicare or Medicaid benefits your loved one may be eligible for.

You May Be Eligible!