This form is a sample of an agreement between an elderly or disabled client and a Caregiver who operates as an independent contractor and provides personnel to assist Client to live at home and to have as much control over the home environment and life as possible under the circumstances. Caregiver's personnel also assist Client with the activities of daily living, scheduling medication, assistance with mobility, accompanying Client on errands and appointments, and such other services as agreed between Client and Caregiver.
In this agreement, Client waives damages for simple negligence of Caregiver, but not gross negligence or misconduct that is intentional or criminal in nature. Courts generally will not enforce waivers of this type of misconduct since such a waiver would be deemed to be against public policy because it would encourage dangerous and illegal behavior.
Caregiver Form Application With Medicaid In Travis
Category:
State:
Multi-State
County:
Travis
Control #:
US-00458BG
Format:
Word;
Rich Text
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FAQ
Family caregiver benefit for adults This benefit provides financial assistance to caregivers providing care or support to a critically ill or injured adult 18 year of age or older. Caregivers can receive up to 15 weeks of this benefit.
A medical doctor or nurse practitioner must complete and sign a medical certificate attesting that the adult or child is critically ill or injured and requires the care or support of one or more family members. Only one medical certificate needs to be completed, even if 2 or more caregivers intend to claim benefits.
How soon will I know if I qualify for Texas Medicaid or CHIP? Texas Health and Human Services usually will let you know in 45 days or less. If you or your child has a disability that is included on the application, Texas Health and Human Services might take up to 90 days to get back to you with a decision.
Income & Asset Limits for Eligibility 2025 Texas Medicaid Long-Term Care Eligibility for Seniors Type of MedicaidSingleMarried (both spouses applying) Income Limit Asset Limit Institutional / Nursing Home Medicaid $2,901 / month $3,000 Medicaid Waivers / Home and Community Based Services $2,901 / month†$3,0001 more row •
Income & Asset Limits for Eligibility 2025 Texas Medicaid Long-Term Care Eligibility for Seniors Type of MedicaidSingleMarried (both spouses applying) Income Limit Asset Limit Institutional / Nursing Home Medicaid $2,901 / month $3,000 Medicaid Waivers / Home and Community Based Services $2,901 / month†$3,0001 more row •