Yes, a spouse can be paid as a caregiver in Georgia, primarily through Medicaid waiver programs that fund home care as an alternative to a nursing facility, and, for military families, through several U.S. Department of Veterans Affairs caregiver benefits. The Medicaid route pays a daily stipend to a spouse who lives with and cares for the recipient; the VA route pays the veteran or the caregiver directly, depending on the program.
How Medicaid Pays a Spouse Through Structured Family Caregiving
The main pathway runs through the Georgia Department of Community Health’s Elderly and Disabled Waiver Program (EDWP), which has two tracks: the Community Care Services Program (CCSP) and Service Options Using Resources in a Community Environment (SOURCE).1Georgia Health. The Elderly and Disabled Waiver Program (EDWP) Information Sheet Both offer a service called Structured Family Caregiving (SFC), which pays a family member living in the same home as the recipient, including a spouse, to provide hands-on daily care.
Under SFC, Medicaid pays a daily rate to an SFC provider agency. The agency then passes roughly 50 to 65 percent of that rate to the caregiver. The exact amount depends on how much care the recipient needs, as measured during the state’s clinical assessment.
A Separate Track for Younger Adults With Severe Disabilities
Adults aged 21 to 64 with severe physical disabilities or traumatic brain injuries may qualify instead through the Independent Care Waiver Program (ICWP), which has self-directed options that can compensate a spouse.2Georgia Division of Family and Children Services. 2139 Independent Care Waiver Program – Section: Requirements Participants approved before age 65 can keep their ICWP services after that birthday if they still meet all other eligibility rules.
Does Your Spouse Qualify?
Two tests apply: a clinical one and a financial one.
Clinically, the care recipient must need a nursing-home level of care, meaning physical help with at least two activities of daily living such as transferring, bathing, dressing, toileting, or eating. A registered nurse or care coordinator verifies this during an in-home visit. For consumer-directed arrangements, either the recipient or a designated representative must also have the mental capacity to direct the caregiver’s schedule and duties.
Financially, for 2026 the individual applicant’s gross monthly income cannot exceed roughly $2,901, and countable assets are capped at $2,000. The family home (within state equity limits), one vehicle, personal belongings, and certain other resources do not count. If income exceeds the cap, Georgia allows a Qualified Income Trust (a Miller Trust) to bring the applicant under the threshold; setting one up generally requires an attorney, and any funds left at death must be repaid to the state.
What the Non-Applicant Spouse Gets to Keep
Federal spousal impoverishment rules protect the community spouse (the one not receiving Medicaid care). For 2026, the community spouse can keep between $32,532 and $162,660 in countable assets, depending on the couple’s total resources. If the community spouse’s own monthly income falls below $2,643.75, they can receive a share of the applicant’s income up to a maximum monthly maintenance allowance of $4,066.50.3Centers for Medicare & Medicaid Services. 2026 SSI and Spousal Impoverishment Standards
Two Rules That Trip Up Spouse Caregivers
You Cannot Be Both Representative and Paid Caregiver
Federal Medicaid rules bar the same person from serving as the participant’s legal representative and their paid caregiver in self-directed programs.4eCFR. Subpart J Optional Self-Directed Personal Assistance Services Program If you hold power of attorney for your spouse or manage the care budget as their designated representative, you cannot also draw the caregiver stipend. Families usually solve this by naming an adult child or sibling as representative so the caregiving spouse can be paid.
Electronic Visit Verification
Under the 21st Century Cures Act, Georgia uses Electronic Visit Verification (EVV) for Medicaid-funded personal care services. The system electronically records six data points for each visit: service type, recipient, provider, date, location, and start and end times.5Centers for Medicare & Medicaid Services. Frequently Asked Questions – Section 12006 of the 21st Century Cures Act Electronic Visit Verification For in-home caregivers, check-in usually happens through a phone system or a mobile app, and missed or inaccurate logs can delay pay.
How to Apply
Start by calling the Georgia Area Agency on Aging at 866-552-4464 for an initial screening.6Georgia.gov. Apply for Elderly and Disabled Waiver Program Screening questions cover the applicant’s situation and the urgency of need, which affect placement on the waiting list. EDWP has historically maintained waiting lists, and how long you wait varies by regional office.
When your spouse’s name comes up, a nurse or care coordinator visits the home to confirm the medical picture, assess the environment, set the number of care hours, and verify that you can physically meet the care plan. Two documents matter most on the way in: the DMA-6 form, a physician’s certification that the recipient needs a nursing-facility level of care,7Department of Community Health, Georgia. DMA-6 Nursing Facility ICFIID Form and five years of bank statements and tax records for Georgia’s 60-month look-back on asset transfers.8Georgia Division of Aging Services. Medicaid Information for Long Term Care Gifts or below-market transfers inside that window can trigger a penalty period of ineligibility.
After approval, the family picks a Structured Family Caregiving agency or a Financial Management Service to handle payroll, tax reporting, and state paperwork. From first phone call to first payment, plan on 60 to 90 days, with waiting list placement potentially adding more time.
How the Payments Are Taxed
Money you receive as a spouse caregiver may be entirely excluded from federal gross income. Under IRS Notice 2014-7, Medicaid waiver payments are treated as “difficulty of care” payments under Section 131 of the Internal Revenue Code and are tax-free when the eligible individual lives in the caregiver’s home.9Internal Revenue Service. Notice 2014-7 – Treatment of Qualified Medicaid Waiver Payments Because you and your spouse share a home, the exclusion typically applies.
Social Security and Medicare taxes work in your favor too. When the care recipient is treated as the employer, which is standard in consumer-directed programs, wages paid to a spouse for domestic services are generally exempt from FICA regardless of the amount.10Internal Revenue Service. Certain Medicaid Waiver Payments May Be Excludable From Income Even outside that spousal exemption, no FICA applies if cash wages to a household employee stay under $3,000 in 2026.11Internal Revenue Service. 2026 Publication 926 The trade-off: those payments may not build Social Security credits, which can matter for your future retirement benefits.
VA Caregiver Programs for Georgia Veterans’ Spouses
If your spouse is a veteran, three federal programs sit outside Medicaid and follow their own rules. Some can pair with Medicaid waivers, depending on how each program counts other benefits.
Program of Comprehensive Assistance for Family Caregivers
PCAFC pays a monthly stipend directly to the spouse or other family caregiver of a veteran with a serious service-connected injury.12Veterans Affairs. Program of Comprehensive Assistance for Family Caregivers The veteran must have a VA disability rating of at least 70 percent and need in-person personal care services for at least six continuous months.13VA Caregiver Support Program. PCAFC Eligibility Criteria Factsheet
Stipends use the Office of Personnel Management’s GS-4, Step 1 rate for the veteran’s locality.14VA Caregiver Support Program. PCAFC Monthly Stipend Fact Sheet In the Atlanta locality area, that annual rate is $38,502 in 2026.15OPM.gov. Salary Table 2026-ATL The stipend comes at two levels:
- Level One pays 62.5 percent of the monthly GS-4 rate, about $2,005 per month in the Atlanta area.
- Level Two pays 100 percent of the monthly GS-4 rate, about $3,209 per month in the Atlanta area, and applies when the VA determines the veteran cannot sustain themselves in the community without assistance.
Locality changes the numbers, so veterans outside metro Atlanta will see different amounts.
Aid and Attendance
Aid and Attendance is an increased monthly pension for veterans who need help with daily activities, are bedridden, or live in a nursing home.16Veterans Affairs. VA Aid and Attendance Benefits and Housebound Allowance For 2026, the maximum annual rate is roughly $29,091 (about $2,424 per month) for a veteran with no dependents, or $34,486 (about $2,874 per month) with one dependent. The money goes to the veteran, who can use it to compensate a caregiving spouse, but the VA does not treat the spouse as a formal employee the way Medicaid does. The condition does not need to be service-connected, though income and net-worth limits apply and are different from Medicaid’s.
Veteran Directed Care
Veteran Directed Care gives enrolled veterans a flexible budget to hire their own caregivers, including a spouse.17VA.gov. Veteran-Directed Care A counselor helps the veteran build a spending plan and choose who provides daily care. Eligibility opens to enrolled veterans who meet clinical criteria and qualify for community care, though availability varies by location. It often fits veterans who need daily help at home but do not reach the 70-percent service-connected rating required for PCAFC.