Budgeting for PCAs

[Micaela MacDougall]

I know this is a difficult question, but I figured it wouldn’t hurt to ask.

I currently live with my parents, and they are my sole caregivers.  As they age, we are finally starting to plan for the future, both in terms of caregiving and finances.  I am starting by planning a budget for how much I need to live on.  Most of that is easy to calculate based on our current expenses, but I’ve realized I have no idea how much to budget for the cost of caregivers.

I was diagnosed as being between Type II and Type III – I need a caregiver around most of the time (I can only be on my own for a couple hours at a time), but I don’t need specialized nursing – my needs are constant, but not complex.  I live in Maryland, and Medicaid is my only insurance.  Obviously, I’ll take time to transition into using PCAs, but once I’m relying on them full time, does anyone have any idea how much that will cost, and how much Medicaid will pay for?

[DeAnn R]

Programs vary state by state. In my state I’m on a waiver program where pca hours are paid through Medicaid. Every year I get evaluated to qualify and determine what hours I’m eligible for. I would recommend contacting your public health department to see what’s available in your state. A lot of folks do what’s called I think Consumer Direct Services where they’re given a budget at pay for services through that. Hopefully more will chime in here as well. Good luck!

[Micaela MacDougall]

Thanks for the advice!  I know I’m going to have to contact them eventually, I was just wondering if anyone here had a ballpark number I could use for now before going through the actual application process.  But you’re right, there’s probably so much variation that it’s difficult to say.

[Alyssa Silva]

To go off of what DeAnn said, I receive consumer direct services which is covered by my Medicaid. The company I go through gives me a budget based on my needs and I do the hiring. The typical rate is $13.75/hr which is sadly not enough, but I have to stick to the budget of course.

[Yvette Haas]

I also have PCAs though Medicaid. In Connecticut it’s called the PCA Waiver Program, and the rate has gotten better in the past couple of years. I think it’s around $15.75/hr now.
You may want to think about starting the process now, since the waiting list is often a few years. Also… While it’s probably better to start getting used to hiring, training and working with new PCAs, there is a good chance that you can put one or both of your parents on the books for helping you.

[Micaela MacDougall]

Those answers are very helpful!  Yvette and Alyssa, do you have a limit on the number of hours you can hire PCAs for?

Yvette, unfortunately Maryland is one of the few states where parents can’t get compensation for caregiving.

[Alyssa Silva]

Yes, I’m capped off at 80 hours with a pay rate of $13.75/hr per week.

[Micaela MacDougall]

And if you don’t mind me asking, do you still have family helping you in addition to your PCAs through Medicaid?  If yes, do you know whether your hours cap would increase if you were relying solely on Medicaid PCAs and didn’t have family to help?

[Alyssa Silva]

Yes, I still live at home with my parents who are able to care for me. I’m not sure if my hours’ cap would increase, but I assume I’d be re-evaluated to prove that I need more hours. Not sure if I would actually get approved though.

[Yvette Haas]

My budget is currently for 67 hours, with some room for more if I drop weekly PT visits at home. (Technically, I did drop that last March, because I didn’t want her going into multiple homes every day and then coming to my home… But I didn’t request more hours because I don’t need them right now).

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