08/11/2026
Every day in Illinois, family members quit jobs, rearrange their lives, and provide hours of unpaid care to aging parents — with nothing in writing and no legal protection.
That arrangement, however loving, carries serious financial and legal risks. And there is a simple, powerful tool that fixes it: a Personal Care Agreement.
What a Personal Care Agreement actually is:
A Personal Care Agreement — also called a Family Caregiver Contract or Personal Services Contract — is a written agreement between a caregiver and care recipient that formally establishes a business relationship, specifies what care will be provided, and sets a fair rate of compensation. Most commonly, it is between an adult child and an aging parent.
Why it matters legally — especially for Medicaid:
To qualify for Medicaid long-term care in Illinois, a senior must have assets below $17,500. Medicaid's five-year look-back period reviews all asset transfers, and payments to a family caregiver without a written agreement can be misclassified as improper gifts, triggering a penalty period of ineligibility.
A properly drafted Personal Care Agreement provides documented proof that payments to a family caregiver are legitimate compensation for services rendered — not gifts — protecting future Medicaid eligibility.
What the agreement must include to be Medicaid-compliant:
The agreement must be in writing, specify payment for future services only — not for past or current care already provided — and establish a reasonable compensation rate that does not exceed what a professional caregiver would charge in the same market.
The national median cost for in-home care in 2026 is $34 per hour, which provides a clear benchmark for setting a defensible, compliant rate.
Beyond Medicaid — the family benefits:
Personal Care Agreements also reduce family conflict by clearly establishing who provides care and at what compensation — preventing resentment between siblings about unequal contributions and unanswered questions about money.
For the caregiver, the agreement provides financial security and recognition that they will not face undue financial consequences for the significant sacrifices they make.
Full guide to Personal Care Agreements and Medicaid:
https://www.caregiver.org/resource/personal-care-agreements/