According to a study by the Family Caregiver Alliance, about 43 million Americans provide care without pay to aging, ill, or injured family member. For many families, unpaid care leads to a severe financial burden and ongoing stress.

There are programs in the U.S. that can help families alleviate some of this stress.

In the United States, spouses, in general, can be paid as caregivers. As of June 2019, fifteen U.S. states have assistance programs that allow a spouse (and adult children) to get paid as caregivers for a family member. These programs allow the beneficiary to choose whomever they would like as a personal care provider. So, they can choose to hire their spouses as caregivers.

There are different funding resources and state programs that allow paying spouses and other family members as caregivers. It depends on several factors whether you will be eligible for such programs or not.

For example, your eligibility for spousal pay may be determined by factors such as your income and financial resources, your state of residence, the types of insurance you have, and if either you or your spouse are veterans.

What is Medicare Policy Regarding Spousal Pay?

Medicare does not pay for spousal care because Medicare doesn’t cover personal, non-medical care for its beneficiaries. So, you will not be able to obtain Medicare coverage for providing assistance or personal care with activities of daily living (personal hygiene, eating, dressing, maintaining continence, mobility) for your spouse.

However, there are often misconceptions about whether Medicare pays spouses to provide home care for their husbands or wives because a rare circumstance where a spouse is married to a practicing doctor (caregiver). In this case, Medicare may pay a doctor (spouse and caregiver) for home healthcare visits and providing medical care for his or her spouse, but not for personal care.

State Programs

While not all of the U.S. states have spousal pay programs, this benefit is still available to a fair percentage of the nation, as these programs are available in 15 U.S. states, which statistically represents 42 percent of the population.

There are several programs available that allow spouses to be paid as caregivers. These programs include Medicaid HCBC Waivers, a non-Medicaid state-funded assistance program, and Medicaid State Plan Personal Care programs.

How Paying Spouses Woks?

Each of the state programs for spousal pay allows the beneficiary or the user to decide from whom they will receive their home care services. This means that you can choose whoever you want as your caregiver, as long as this person meets certain requirements regarding physical ability, background check, etc.

If approved, the spouses are paid either by the state program or through an intermediary agency. Compensation rates vary from state to state, but you can expect to be paid between $10.75 – $20.75 per hour.