Financial Concerns

caregivinghope.org expert advice on caregivingIt is important to understand that, as an “employer” you may be responsible for filing forms and paying taxes at various times during the year. You are not responsible for withholding income tax, but you may be responsible for Social Security Contributions (FICA), Federal Unemployment Tax (FETA), State Unemployment Tax, and State Worker’s Compensation Contributions

If you are uncertain about your obligations, you will find some guidelines in IRS publications on business reporting, which you can order for free by calling 800.TAX.FORM. Information specific to your situation may be obtained from your local Social Security office or Worker’s Compensation office. In addition, as an employer you are responsible for verifying that your employee is eligible for employment in the United States. Your local office of the U.S. Citizenship and Immigration Service will supply you with form # I-9 to be completed and kept in your records for at least three years after the date of hire. Attach proof of eligibility to this form. The paperwork and extra expense involved in complying with these requirements may seem overwhelming, but getting advice from a lawyer or accountant can help.
 
Costs And Payment Sources
 
The salary begins at minimum wage. The amount you pay a home care worker depends primarily on the training and experience the person has and whether an agency is involved. Agency cost range is $18 - $30 an hour. This will vary by region. Twenty-four hour care is typically charged at a daily, rather than an hourly, rate.
 
Transportation Fees
 
These may be added to the hourly rate of pay. They might be calculated in zones, from the agency to the older person’s home, or reimbursed on an actual cost basis. When negotiating a salary with a home care worker, be sure to discuss transportation issues.
 
Medicare
 
Medicare: will pay for the services of a home health aide for a Medicare-eligible individual if the need for the service is medically related. In order to qualify, the person must be:
  • Confined to his/her home
  • Under the care of a doctor who must prepare a plan for care in the home
  • In need of part-time and intermittent skilled nursing care as provided by a registered nurse or licensed practical nurse, physical therapist, or speech therapist
  • Receiving services from a Medicare-certified agency
Medicare does not cover everything. Most people who require long-term help at home are not eligible for Medicare services. As of 1998, the Medicare Part A Basic Hospital Insurance benefit is limited to 100 visits following a three-day hospital stay. Visits not following a three-day hospital stay and visits in excess of 100 per benefit period will be paid out of a new Part B Voluntary Medical Insurance home health benefit. According to the federal government, the beneficiary will not be responsible for copayments and deductibles for home health care services paid under Part B. Every state has a program that is available to answer specific questions about Medicare and changes in Medicare coverage. In Illinois, call the Senior Health Insurance Program (SHIP) at 800.548.9034 or CJE SeniorLife Consumer Assistance at 773.508.1000.
 
Private Health Insurance and Health Maintenance Organizations
 
These companies frequently apply many of the same restrictions that Medicare does on home care coverage, although there has been some expansion in coverage during recent years. Long term care insurance policies offer more possibilities to those who can afford their premiums.
 
Other Elder Care Benefits
 
Some employers may offer a family care benefit, or you may be able to use pretax dollars through a flexible spending account to pay for care. Check with a benefits specialist where you work.
 
Financial Assistance
 
Support services, such as housekeeping, shopping, laundry, and assistance with activities of daily living, are not typically covered by Medicare and/or other private insurance. In most cases, the recipient of the service pays the full fee. The Illinois Department on Aging offers home care services to persons of limited income at no charge or on a sliding fee scale through the Community Care Program. Check with your local agency on aging or call the Eldercare Locator at 800.677.1116 to find out what assistance your state offers. Public Aid coverage of home care varies from state to state. You may find out about your community by calling your local Public Aid office and your state Department on Aging office.
 
The following sections may assist you in finding help for your loved ones: