EPISODE 9- Caregiving Options and Pay Sources

Caregiving can be overwhelming—especially when you're trying to figure out what services are available and how to pay for them. In this episode, Jamie Callahan breaks down the most common types of caregiving and the funding sources that can help cover the cost, including options specifically for veterans.

She covers:

• The real cost of agency caregiving today
• How caregiver registries offer a more affordable option
• Key differences between VA programs like HHA and Veteran Directed Care (VDC)
• Medicaid and long-term care insurance benefits
• Why some caregivers can qualify for health insurance through DHS

Whether you're caring for a loved one or planning ahead for yourself, this episode offers practical guidance and real-world insight into navigating care at home.

📞 Questions? Call Team Senior at (541) 295-8230.

Transcript

Hi, this is Jamie Callahan with the Team Senior Podcast. Our goal is to simplify aging. Society grooms us to plan for retirement—but what about life beyond retirement, where the rubber meets the road? Perhaps you've had a stroke or you've been diagnosed with cancer, or maybe you're forgetting things and now you have dementia.

That's our area of expertise, and we are here to share our insight. Welcome to the Team Senior Podcast.

Hi there, it's Jamie Callahan, and I am excited to talk to you today about caregiving options for both veterans and the general population, as well as pay sources.

Who pays for caregiving? That's a question that comes up all the time.

So first, I want to talk about the types of caregiving that are available, and then we’ll circle back to who pays for the caregiving that’s out there.

Private pay caregiving is probably the first thing that we should discuss. Most people pursue caregiving that is private pay through an agency. There are several agencies in Southern Oregon—of course, hundreds, maybe thousands across the United States.

Caregiving prior to COVID was like $25 to $35 an hour. That’s definitely not the landscape of caregiving anymore. We're looking at a minimum of $40 to $45 an hour with an agency, and depending on the acuity of care that someone requires, we’re looking at anywhere between $50 to maybe even $70 an hour.

As you can imagine, that gets very expensive very fast.

There are other ways that you can hire a caregiver. I've heard people talk about finding someone off Craigslist or something like that. We would never recommend doing anything like that.

It's so important for you to know that if you're bringing somebody into your home, you want them to be vetted in some capacity.

There is a way to hire private caregivers—essentially independent contractors—through a registry. In the state of Oregon, there are five registries statewide. There's one in Southern Oregon called The Caregiver Group, and they usually start caregiving rates around $20 to $25 an hour.

The registry is required to be licensed with the Department of Human Services, so they have the same standards that a caregiving agency would have. The caregivers they recommend are vetted, background-checked, and must have a certain number of hours—very similar to what an agency does, but less expensive.

There are pros and cons to both: registry versus agency.

If you're a veteran, there are two primary caregiving programs to know about:

• HHA (Homemaker/Home Health Aide)
• VDC (Veteran Directed Care)

Let’s talk about HHA first. This is for a service-connected veteran who needs caregiving in their home. They can get care that is paid for by the VA.

Here’s how it usually works: the person who needs care gets a referral to the HHA program, usually through their doctor. Then the VA sends the referral to agencies they work with to provide caregiving.

Caregiving through the HHA program is typically a “three-by-three” model—you get three hours of caregiving, three days a week. I’ve seen this go up to twelve hours, but that’s rare.

Again, this program exists for service-connected veterans, meaning the veteran has a disability directly related to their time in the military.

Now let’s talk about VDC, the Veteran Directed Care Program. You qualify in a similar way: your doctor substantiates that you need caregiving, the referral goes to the VA, and then the VA sends that to the organization that manages the VDC program.

But here’s the key difference—VDC does not require a service-connected disability. It can also provide substantially more hours than the HHA program.

That said, it does require that the veteran can direct their own care. That’s why it’s called “Veteran Directed Care.”

In this program, we’ve seen most veterans receive about $2,300 to $2,500 per month. I’ve even seen a veteran receive $16,000 a month through the program.

Again, the veteran doesn't have to be service-connected. For example, if you were a military officer who never had an injury but now, at 70 years old, you've had a stroke and need in-home help—this is where the VDC program is paramount.

You can use VDC to hire caregivers—but not through an agency. The VDC program won’t allow it because they want to keep the cost down. They generally don’t want you paying more than about $25 an hour.

You can use a registry, as long as the caregiver agrees to that rate—and I think that’s very likely. There are plenty of registry caregivers willing to work for $25 an hour.

That’s something we can help you navigate.

So the key differences:

• HHA provides limited hours (3 hours, 3 days a week) through an agency.
• VDC gives you more hours and flexibility—but you manage the caregiver directly.

And VDC funds don’t just have to go toward caregiving. Let’s say you’re receiving $3,000 a month and it’s working well, but it’s getting harder to get out of bed. If a lift chair would help you stay in your home, VDC can potentially fund that too.

Those dollars are truly meant to support you being at home as long as possible.

Another pay source is Medicaid. Medicaid will also pay for caregiving in your home. I’m not totally sure of the number of hours available, but the caregivers must be certified through the Department of Human Services.

They have to become what’s called a provider with DHS. That means background checks, some training, and once approved, they’re paid through DHS or Medicaid to provide care.

There are also great benefits for caregivers who become Medicaid providers. For example, if you have a neighbor who’s already helping you, they might become certified, and if they work enough hours, they may even qualify for health insurance through DHS.

There are lots of benefits to becoming a Medicaid caregiver.

And lastly—though there are other options—the last big one I’ll mention is long-term care insurance.

Long-term care insurance will pay for caregiving in your home—but it has to go through an agency. It cannot be paid to an independent caregiver or someone through a registry.

So again, we always come back to this:
 You don’t need to remember all of this. You only need to remember our phone number.

If you call us, we’ll take a deep dive into your specific situation. We'll talk through your options. We’ll probably share what we would pursue if we were in your shoes.

Then we’ll look at what you're going to be able to sustain the longest—

• What do you want?
• What do you need?
• What’s your diagnosis and prognosis?
• What can you afford?

And then, how do we stretch your resources to serve those needs?

I'm going to close here. I just want to say thank you again for listening.

And I’ll leave you with this: if you need anything, please give us a call. We’re not going to spend 30 or 45 minutes going through a bunch of hoops.

We’re going to get down and dirty and ask, “What’s going on? How can we help?”

And if what we recommend doesn’t work out, just call us back—we’ll help you again with whatever hurdles or challenges you face.

Thank you so much, and have a wonderful day.

Thank you for listening to the Team Senior Podcast. We're here every week sharing new and relevant information.

Remember, we’re just a phone call away. Team Senior can be reached at 541-295-8230. Again, 541-295-8230.

Until next time, this is Jamie Callahan.