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Its becoming overwhelming trying to work full time and care for him and my home. Help.

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If your fiancé is Skilled Nursing Facility qualified, physically or mentally then you can get paid if your state supports a Medicaid Waiver Program or Chore grant.
Qualifications, medical and financial for your fiancé differ from state to state, because it is a full Medicaid program for the patient to remain in his home or yours with you as the main caregiver.
Medicaid waiver patients qualify for Medicare and Full Medicaid, Extra help for Prescription Drugs and can also buy extra health insurance if needed.
The patient has all the rights and benefits of a full time Skilled Nursing Facility.
Medicaid waiver is designed for Skilled Nursing qualified patients that want to remain in their home and usually they will get better care at home and be happier.

1. A Medicad Waiver program pays the caregiver no more than 40 hours per week, pay rates differ from state to state and are near minimum wage.
States want patients to remain in their homes because it cost Medicaid $100’s thousands less per year than a Nursing home.

2. Some states also have what is called a Chore grant that pay the caregiver a lot less.

Any way there are options.

if your fiancé doesn’t quality for Medicaid Waiver or a Chore grant to pay yourself, because he has to much money or assets to qualify, and your not satisfied with the pay rate, then use an Elder Law Attorney to set up a plan to pay you and be sure to fulfill all your IRS tax obligations.

I have been a Skilled Nursing Facility Family Council President volunteer 10 years and a caregiver for family members for 57 years, up to 4 loved ones for 35 years simultaneously, 12 to 16 hours a day, on 24/7/365 for decades.

Be careful, don’t get run down the pace and work can be very difficult.
Stay safe.

By the way, in the state of Michigan, a Medicaid Waiver caregiver individual, known as a “Direct Care Worker”, (DCW), not working for an agency, the pay rate for 38.5 hours per week, 52 weeks per year , starting February 22, 2025, will, be approximately $15.85 per hour and that is $32,000.00 per year, Federal and State taxes are taken out. You can qualify if you are not giving care for one reason or another for Unemployment benefits if you are not the patients spouse or parent of a minor child.

BTW I am also an accountant that studied probate law.

Good luck, stay safe, don’t get exhausted, take care of yourself as well as your fiancé .
Best wishes.
Helpful Answer (1)
Reply to Caregiver57yrs
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More than likely you would have to be hired on with a home health company and he would be one of your patients. Medicare will send home health to folks in the home with a doctor who writes the order - weekly nurse visit, physical/occupational therapy, and possibly some personal tasks like showering. Keep in mind you won't be able to make this a full or part time job if he's your only patient through a home health. Medicare doesn't pay for caregiving as in several hours a day - more like a scheduled arrival, do the showering/dressing and move on to the next patient.

Of course, he could be paying you for the hours you spend with him. Check out the financials and see what the two of you could work out.
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Reply to my2cents
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If he is medically discharged, then his care is considered custodial care to someone who is keeping him safe. Medicare has discharged its obligations.
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Reply to MACinCT
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Make an appointment with a lawyer that specializes in family law or elder law. Follow the lawyer's advise. It might be easier to get paid if you have a contract to cover your services that is similar to one for home health.
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Reply to Taarna
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Medicare isn't going to pay you to work as an LPN for your boyfriend.

For starters for Medicare to even consider paying for a nurse a couple hours a week (if that), a doctor would have to declare it medically necessary and it would have to be through a licensed homecare agency, hospital, or some other medical entity. For you to work independently and bill Medicare, you would need a homecare license from the state and a license to bill Medicare.

Medicare doesn't have paid family caregiver programs. Some state Medicaid programs do, but not Medicare. If your boyfriend has Medicaid you could become his paid caregiver if they state you live in has this program. They will not pay you nurse's wages though.
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Reply to BurntCaregiver
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NurseJackie: Edit - You cannot bill *his* Medicare.
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Reply to Llamalover47
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Nursejackie: You cannot bill your Medicare for your services as an LPN.
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Reply to Llamalover47
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I'm sorry to hear that that fiancee has his health condition. He should be placed in a facility to care for him. Do not quit your job.
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Reply to Patathome01
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Medicaid will never pay you what you earn as an LPN. They may not provide 8 hrs a day 5 days a week. You could see if BF qualifies and let Medicaid provide an side and you continue working. Do not quit ur job.
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Reply to JoAnn29
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Medicare is set up to pay health care vendors (hospital, clinics, rehab facilities, licensed therapists & health care providers) who are participating in the program and have vendor contracts with them. Thats not what you are.

You might be able to have him go onto Community based Medicaid program and if he’s assessed to be eligible for IHHS in home health services and the company with the State contract were to hire you to be a provider suitable for his care plan, they would pay you. And pay at whatever hourly rate their contract has set for the # of hours he is assessed at. Having this happen is pretty far fetched.
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Reply to igloo572
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You cannot get paid as an LVN to care for your Fiancé unless you are aware of some programs I am not.
As an LVN you can easily work your way to RN, as I did, and I sure recommend you do that.

What disability your fiancé has, and what in terms of disability payments and governmental programs to help him are there will be greatly helped by your working your job as an LVN, and even better if you work up to an RN, a job in which you can work anywhere any time, and if you do certain things such as traveling nurse you can often be at home to help your guy.

I wish you the best, but you will not be paid as a medical personnel caregiver for your guy, imho. If I am wrong and you find a way, do let us know.
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Reply to AlvaDeer
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Medicare does not pay for longterm in home care. If they did, to even be able to bill them is a long process. Do not quit your job. Might be time to place him.
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Reply to JoAnn29
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You can't. If your fiancé is on Medicaid they will pay for a few hours of care each week, or if he is a veteran the VA offers some aid and assistance, but neither is very much.
If his care is getting to be too much for you, he may have to placed in the appropriate facility where he will receive the care he requires and you can get back to just being his fiancé and advocate and not his overwhelmed caregiver.
Helpful Answer (6)
Reply to funkygrandma59
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