Caregiver Compensation - Illinois
Angelica P. Herrera-Venson, DrPH
This article will focus on the various programs in the state of Illinois that help with the costs of aging at home, home care services, and related types of support, including adult day care and respite care.
Some of these services allow the care recipient to pay a family member to act as an in-home caregiver, often on a part-time basis. Such programs can reduce the financial burden of caregiving, while also providing more senior care support.
Other services don’t pay for family caregivers directly but may reduce costs in other ways. Such support services are still helpful for decreasing your financial burden and providing more resources for other needs.
Illinois Caregiver Compensation Programs
Medicaid Programs, Including Medicaid Waivers
Medicaid programs are a common source of financial support, as Medicaid caters to low-income older adults, plus people with disabilities. The program has expanded to support many types of in-home care, with the goal of helping seniors to remain independent at home for longer.
Medicaid-funded programs often have a consumer-directed aspect. This allows seniors to play an active role in their own care, including choosing who acts as their caregiver and which services they receive. Self-directed programs are one of the best ways for family members to get paid as caregivers and can be powerful.
Illinois has two main programs in this area, both of which may pay family members to provide some of the covered services.
HealthChoice Illinois is a Medicaid-managed care program and is available to Medicaid recipients across Illinois, along with people who are enrolled in Medicare and Medicaid (known as dual-eligible individuals).
It is the main program for supporting seniors and people with disabilities, to the extent that enrollment is mandatory for eligible seniors unless they’re part of the Medicare-Medicaid Alignment Initiative.
Most recipients need to choose a primary care provider and a health plan when they enroll. Doing so is important, as the older adult then receives care from doctors and other providers who operate within that health plan network.
Health plans can be changed once per year, during the open enrollment period
The program provides support for a variety of services, including doctor and hospital services, personal care assistance, prescription medicine, adult day care, home health care, transportation, and more.
Medicaid eligibility is the main requirement for HealthChoice Illinois. Seniors living alone must receive less than $18,755 per year before taxes to be eligible, while those living with a partner must receive less than $25,268 per year.
Other requirements need to be met as well, including being a resident in the state of Illinois, being a US citizen, a permanent resident, or a legal alien, needing health insurance assistance, and falling below the asset requirements.
If the senior’s income is too high, a professional Medicaid planner may be able to help them achieve eligibility.
The HealthChoice Illinois site provides all the information and links for seniors to sign up, including an online Client Enrollment Broker and a toll-free number to call.
Medicare-Medicaid Alignment Initiative
The Medicare-Medicaid Alignment Initiative (MMAI) is designed for dual-eligible seniors and disabled individuals. It helps to make Medicare and Medicaid easier to navigate, giving them access to all the provided services within a single program.
The program was initially available just in Central Illinois and the Greater Chicago area, but has since expanded across the state, providing services to many more individuals.
The services are similar to those offered through HealthChoice Illinois, including assistance with the activities of daily living (ADLs) and instrumental activities of daily living (IADLs), home health care, dental care, behavioral health services, care coordination, and more.
However, because MMAI encompasses both Medicaid and Medicare, it includes a more comprehensive set of services.
The program also provides users with a single health plan, care coordination team, personalized care plan, and number to call, rather than having their Medicaid and Medicare plans managed separately.
Seniors must meet Medicaid requirements for this program as well. They also need to be eligible for Medicare Part A and enrolled in Medicare Part B and Part D.
Some people are excluded from the program, including those who are eligible for Medicaid via spend-down, those with comprehensive third-party insurance and those who are in the Illinois Medicaid Breast and Cervical Cancer Program.
More details and materials for MMAI can be found on the HealthChoice Illinois website. You can also call 1-877-565-8576, which is a toll-free number that steps you through the enrollment process.
The Community Care Program
Medicaid also offers Medicaid waiver programs. These provide states with more flexibility in the services they provide and additional support for home-based support.
The Community Care Program (CCP) is the most relevant of these for seniors and family caregivers. The CCP supports those with a nursing home level of needs and is provided under the Illinois HCBS Waiver for Persons Who are Elderly.
The main services include an automated medication dispenser, an adult day service (which helps provide respite for family caregivers), an emergency home response service, and some in-home assistance.
The in-home services focus on household tasks, like cleaning, and personal care tasks, including bathing and dressing.
For this program, seniors need to be at least 60 years of age, be residents of Illinois, be either a US citizen or fall within one of the eligible non-citizen categories, have non-exempt assets that total no more than $17,500 and be assessed as having long-term care needs.
The senior’s home and main vehicle are exempt assets and are not counted within the total. Other exempt assets include personal clothing, furnishings, and a prepaid burial plan.
Income does not influence eligibility for this program. However, fees are based on income level, so seniors with a higher income are likely to pay more than those with little money.
Note: Illinois had a state-funded program called the Illinois Family Caregiver Support Program at one point; however, this no longer appears to be operational. The program’s page at illinois.gov now provides basic information for caregivers and links to resources.
Government programs aren’t the only source of caregiver funding. Long-term care insurance is another option.
This type of insurance is designed to pay for long-term care needs as a senior age. Some policies have a self-directed component, where the senior can designate a family caregiver to provide support.
A long-term care rider can also be purchased for regular life insurance. This allows some of the life insurance benefits to be used while the senior is still alive to support long-term care.
In both situations, what you can do is influenced by the specifics of the policy. Some policies will allow family members to be paid as caregivers, while others may only cover professional caregivers or institutional care. It’s important to check this out first, so there aren’t any surprises when care is needed.
Veterans, and sometimes their surviving spouses, have access to additional options through Veterans Affairs (VA).
The main option here is the Veteran Directed Care (VDC) program. This provides veterans with a monthly care budget they can help direct. Through this program, seniors can hire family members rather than professional caregivers.
The VA determines the hourly rate, which is often somewhere between $8 and $21. This rate is influenced by the senior’s level of need and the type of services the caregiver provides.
There are also pension benefits, including the Veteran Aid & Attendance Pension Benefit and the Housebound Pension Benefit. The Aid & Attendance version provides as much as $3,261 each month to support seniors with aging at home, which can include paying for family caregivers.
The housebound benefit is for VA pension recipients with a permanent disability who must spend most of their time at home. It provides up to $1,882 per month and can’t be used at the same time as the Aid & Attendance benefit.
However, spouses cannot get paid to provide care under either of the pension-related programs, as spouse income influences the pension amount a senior receives.
Therefore, only non-spousal family members can get paid through these programs.
Other Illinois Financial Assistance Programs
Some support programs don’t directly pay family caregivers to provide in-home care but provide other forms of compensation and assistance. These can still be helpful, as they decrease costs for families and free up financial resources.
Seniors looking for more support can also turn to the AARP’s Guide to Public Benefits.
This excellent resource compiles information about public assistance programs for financial support, social connection, legal advocacy, and food security. They even include details about both federal and state-funded programs.
Supportive Living Program
The Supportive Living Program (SLP) is a Medicaid waiver program that supports seniors who wish to live in a managed care environment, including assisted living.
Eligible seniors can receive services like housekeeping, personal care, meals, and intermittent nursing services through the program.
Because SLP focuses on managed care environments, it won’t normally pay family caregivers to provide care. However, it is relevant for situations where the older adult needs more care than the family member can provide or where home care is becoming too expensive.
Application for Benefits Eligibility
The Application for Benefits Eligibility (ABE) program in Illinois allows users to apply for and manage various types of healthcare, cash assistance, and healthcare benefits from a single location.
This service makes application and management easier for seniors and their loved ones, which can mean less time is spent trying to access benefits. This is particularly important for full-time caregivers, who often have very limited time and energy.
The service may also help seniors to access services that they were unaware of previously and are easily missed.
The Senior Farmer’s Market Nutrition Program
The Illinois Department of Human Services offers the familiar Supplemental Nutrition Assistance Program (SNAP), which can be applied for through ABE. Another option is the Senior Farmer’s Market Nutrition Program (SFMNP), which seniors can sign up for through their local Area Agency on Aging.
The SFMNP program operates in 37 counties and is facilitated through local agencies on aging. It specifically focuses on people aged 60 and older who meet nutritional and income requirements.
Members are provided with important health and nutrition information, plus checks that can be used to purchase fresh fruits and vegetables from local farmers’ markets.
Senior Health Insurance Program
Illinois also houses the Senior Health Insurance Program (SHIP). This service doesn’t provide any direct home care services. Instead, it provides objective advice to help seniors and their caregivers navigate Medicare.
This can be helpful, as Medicare can be confusing and overwhelming.
Understanding Medicare and making good choices about plans can help seniors to save money and stay healthy for longer.
Senior Care Costs in Illinois
As of 2021, in-home elder care services in Illinois averaged $4,854 per month, based on an estimated 40 hours of care each week. These costs are based on homemaker and home health aide services, so maybe higher for seniors who need greater caregiver support or a skilled nursing aide.
These costs are too high for many seniors, which is why loved ones often choose to act as family caregivers. However, hiring someone for even a few hours a week is valuable as a form of respite care, giving family caregivers the chance to rest and recover.
Some of the programs discussed in this article may provide funding for such support, even if they do not directly pay family members to act as caregivers.
Costs for community-based services and other types of care aren’t consistent across the state of Illinois. Instead, they tend to be most expensive in urban areas and decrease in price in more rural settings.