Yes, a spouse can be paid as a caregiver in Georgia. The two main routes are Georgia’s Medicaid waiver programs, which pay a daily stipend to a husband or wife who lives with and cares for a qualifying adult at home, and federal VA caregiver programs for the spouses of eligible veterans. Each route has its own eligibility rules, and in some cases the two can work alongside each other.
Getting Paid Through Georgia Medicaid Waivers
The Georgia Department of Community Health runs the Elderly and Disabled Waiver Program, 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 model called Structured Family Caregiving (SFC), under which a family member who lives in the same home as the care recipient receives a daily stipend for providing hands-on help. A spouse qualifies as a family caregiver under this model.
The stipend amount depends on how much care the recipient needs. Medicaid pays a daily rate to an SFC provider agency, and the agency passes along roughly 50 to 65 percent of that payment to the caregiver. Adults between 21 and 64 with severe physical disabilities or traumatic brain injuries have a separate option: the Independent Care Waiver Program (ICWP), which includes self-directed care.2Georgia Division of Family and Children Services. 2139 Independent Care Waiver Program – Section: Requirements Participants approved before age 65 can continue in ICWP past that birthday if they still meet the other requirements.
All of these programs are built to keep people out of nursing homes. The money that would have gone to institutional care follows the person back to the family home instead, where the spouse becomes the paid caregiver.
Who Has to Qualify, and for What
Important: it is the care recipient who has to qualify, not the caregiving spouse. Eligibility runs on two tracks, financial and medical.
Income and Assets
For 2026, the applicant’s gross monthly income cannot exceed about $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 toward the asset limit. These figures adjust annually with federal benefit changes.
When income runs over the cap, Georgia allows a Qualified Income Trust, sometimes called a Miller Trust. Monthly income above the limit is deposited into the trust so the applicant stays technically under the Medicaid threshold. Setting one up generally requires an attorney, and anything left in the trust at death must be repaid to the state.
Protections for the Healthy Spouse
Federal spousal impoverishment rules keep the non-applicant spouse (the “community spouse”) from being stripped of household income and savings. For 2026, the community spouse can retain between $32,532 and $162,660 in countable assets, depending on the couple’s total resources. If the community spouse’s own income falls below $2,643.75 per month, part of the applicant’s income can be shifted to bring them up to that floor, with a 2026 ceiling of $4,066.50.3Centers for Medicare & Medicaid Services. 2026 SSI and Spousal Impoverishment Standards
Nursing-Home Level of Care
The care recipient also has to 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 clinical assessment confirms this. In consumer-directed arrangements, either the recipient or a designated representative must be able to direct the caregiver’s schedule and duties.
The Rule That Trips Spouses Up
Federal Medicaid rules bar the same person from serving as both the participant’s legal representative and their paid caregiver in a self-directed program.4eCFR. Subpart J Optional Self-Directed Personal Assistance Services Program If you hold your spouse’s power of attorney or act as the designated representative who manages the care budget, you cannot also draw a paycheck as the caregiver. The usual fix is to assign the representative role to an adult child, a sibling, or another trusted person so you can be paid without a conflict of interest.
How to Enroll
Start by calling Georgia’s Area Agency on Aging at 866-552-4464 for an initial screening.5Georgia.gov. Apply for Elderly and Disabled Waiver Program A staff member asks about the applicant’s situation to gauge both eligibility and urgency, which affects placement on the waiting list. EDWP has historically carried waiting lists, and the gap between screening and in-home assessment varies by region.
When your spouse’s name reaches the top, a registered nurse or care coordinator comes to the home. They verify the application, evaluate the home environment, assess the recipient’s condition, and determine the number of care hours needed. They also confirm you are physically able to carry out the care plan. From that visit, the nurse or coordinator builds the formal care plan.5Georgia.gov. Apply for Elderly and Disabled Waiver Program
After approval, the family picks a Structured Family Caregiving agency or a Financial Management Service to run payroll, handle any tax reporting, and register you as the caregiver. From the first phone call to the first payment, plan on 60 to 90 days, longer if there is a waiting list.
Two things to have ready: a signed DMA-6 form from the recipient’s physician confirming nursing-facility level of care,6Department of Community Health, Georgia. DMA-6 Nursing Facility ICFIID Form and five years of bank statements and tax records. Georgia enforces a 60-month look-back on asset transfers, and gifts or below-market sales inside that window can trigger a penalty period of ineligibility.7Georgia Division of Aging Services. Medicaid Information for Long Term Care
How the Payments Are Taxed
Medicaid waiver payments to a spouse caregiver who lives in the same home as the care recipient can be fully excluded from federal gross income. IRS Notice 2014-7 treats these as “difficulty of care” payments under Section 131 of the Internal Revenue Code, which makes them tax-free so long as the eligible individual lives in the caregiver’s home.8Internal Revenue Service. Notice 2014-7 – Treatment of Qualified Medicaid Waiver Payments The exclusion covers payments made on or after January 3, 2014, and applies whether or not the caregiver is related to the recipient.
Social Security and Medicare taxes (FICA) also get favorable treatment. In consumer-directed programs where the care recipient is the employer, wages paid to a spouse for domestic services are generally exempt from FICA regardless of amount.9Internal Revenue Service. Certain Medicaid Waiver Payments May Be Excludable From Income Even outside the spousal exemption, no FICA applies if cash wages to a household employee stay under $3,000 for 2026.10Internal Revenue Service. 2026 Publication 926 Most spouse caregivers under Georgia’s waivers keep the full stipend. One trade-off: because the payments are not treated as taxable wages, they may not build Social Security credits that count toward your own retirement benefits.
If Your Spouse Is a Veteran
Veterans living in Georgia have federal caregiver programs that run separately from Medicaid, with their own eligibility rules. Depending on how each program counts other benefits as income, some combinations with Medicaid are possible.
Program of Comprehensive Assistance for Family Caregivers
The 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.11Veterans Affairs. Program of Comprehensive Assistance for Family Caregivers The veteran must have a VA disability rating of at least 70 percent (individual or combined) and need in-person personal care services for at least six continuous months.12VA Caregiver Support Program. PCAFC Eligibility Criteria Factsheet
The stipend uses the federal GS-4, Step 1 pay rate for the veteran’s geographic area.13VA Caregiver Support Program. PCAFC Monthly Stipend Fact Sheet In the Atlanta locality area, the 2026 GS-4 Step 1 annual rate is $38,502.14OPM.gov. Salary Table 2026-ATL Payment comes at one of two levels:
- Level One pays 62.5 percent of the monthly GS-4 rate, about $2,005 a month in the Atlanta area.
- Level Two pays 100 percent of that rate, about $3,209 a month in the Atlanta area, and applies when the VA finds the veteran cannot sustain themselves in the community without assistance.
Rates vary by locality, so veterans outside metro Atlanta will see different numbers based on their local pay table.
Aid and Attendance
Aid and Attendance is an increased monthly pension for veterans who need help with daily activities like bathing, feeding, and dressing, or who are bedridden or in a nursing home.15Veterans Affairs. VA Aid and Attendance Benefits and Housebound Allowance For 2026, the maximum annual pension rate with Aid and Attendance is about $29,091 (roughly $2,424 per month) for a veteran without dependents, or about $34,486 (roughly $2,874 per month) with one dependent. The money goes directly to the veteran, who can then use it to compensate a spouse. The VA does not formally designate the spouse as an employee under this benefit.
Unlike PCAFC, Aid and Attendance is pension-based and does not require a service-connected condition. It has its own income and net-worth limits, which differ from Medicaid’s.
Veteran Directed Care
Veteran Directed Care gives an enrolled veteran a flexible budget to hire caregivers of their choosing, including a spouse.16VA.gov. Veteran-Directed Care A counselor helps the veteran build a spending plan and manage daily care. Any enrolled veteran who meets the clinical criteria and qualifies for community care can participate, though availability varies by location. This option is often the right fit for veterans who do not meet the 70 percent service-connected rating required for PCAFC but still need daily hands-on help at home.