Medicaid Funded Home Care Eligibility
The first step in obtaining Family Caregiver Pay is for the care recipient to qualify for home care services under a Medicaid waiver. The Georgia Elderly and Disabled Waiver Program (EDWP) is a Medicaid-funded program that provides home and community-based services to elderly and disabled individuals who are at risk of entering a nursing home. This program is designed to help those in need stay in their own homes and communities by providing the necessary support services needed to make this possible. The program offers a wide range of services, including personal care, homemaking, meal preparation, transportation, and more.
Get Started Now
If you or your family member meet the income requirements for EDWP and have not applied for Georgia Medicaid EDWP / home care services yet, we can assist you in getting started.
Financial Eligibility & Requirements
The financial eligibility and requirements referenced in this section refer to the income limits of the Care Recipient. The caregiver's income is not considered in the equation; however, if applying for Structured Family Caregiver, the designated primary caregiver is not allowed to be employed or self employed.
Income & Asset Limits
Click on a year to view the Financial Limits for that year.
Income cannot exceed $2,742 for all sources of income combined. Individuals with a higher income should contact an attorney regarding a Qualified Income Trust if interested in receiving EDWP services.
For individuals whose gross income is above the current SSI limits ($914/month), there may be a cost share for services. The estimated cost share can be calculated by subtracting $914 from the gross monthly income (example: SSA income is $1,114 per month; after subtracting $914, the estimated monthly cost share for EDWP services would be $200).
- Some adjustments may be made to reduce cost share, including “spousal diversion” for individuals who are married and only one of the couple is participating in a Medicaid program.
Assets/Resources are limited to $2,000 for an individual. This includes stocks, bonds, savings accounts, certificates of deposit, second homeplace, second automobile, property not connected to the primary homeplace, etc.
There is a five-year lookback period for transfer of assets. Individuals who have transferred assets or property to another individual in the last five years may be subject to a period of disqualification for Medicaid waiver programs. This period of disqualification is based upon the value of the transfer and the date upon which the transfer occurred. You may still be eligible for services even if you have recently transferred assets to someone else.
Program participants must meet a nursing home level of care. This does not mean that applicants must currently reside in a nursing home. It simply means that the applicant’s need for care must be consistent with those who are eligible to receive Medicaid care in a nursing home (typically 5+ hours or care needed daily).
IMPORTANT: Not meeting all of the criteria does not mean one is ineligible or cannot become eligible for Georgia Medicaid. Review the Medicaid Planning Strategies section for more information on how to qualify for Medicaid Long-Term Care.
Additional Resources
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Single |
Married (both spouses applying) |
Married (one spouse applying) |
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Type of Medicaid |
Income Limit |
Asset Limit |
Level of Care Required |
Income Limit |
Asset Limit |
Level of Care Required |
Income Limit |
Asset Limit |
Level of Care Required |
|
Institutional / Nursing Home Medicaid |
$2,829 / month* |
$2,000 |
$5,658 / month ($2,829 / month per spouse)* |
$3,000 |
$2,829 / month for applicant* |
$2,000 for applicant & $154,140 for non-applicant |
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Medicaid Waivers / Home and Community Based Services |
$2,829 / month† |
$2,000 |
$5,658 / month ($2,829 / month per spouse)† |
$3,000 |
$2,829 / month for applicant† |
$2,000 for applicant & $154,140 for non-applicant |
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|
Regular Medicaid / Aged Blind and Disabled |
$943 / month |
$2,000 |
$1,415 / month |
$3,000 |
$1,415 / month |
$3,000 |
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*All of a beneficiary’s monthly income, with the exception of a Personal Needs Allowance of $70 / month, Medicare premiums, and possibly a Needs Allowance for a non-applicant spouse, must be paid to the nursing home. This is called Patient Liability.
†Based on one’s living setting, a program beneficiary may not be able keep monthly income up to this level.
IMPORTANT: Not meeting all of the criteria does not mean one is ineligible or cannot become eligible for Georgia Medicaid. Review the Medicaid Planning Strategies section for more information on how to qualify for Medicaid Long-Term Care.
Additional Resources
Medicaid Planning Strategies: How to Qualify for Medicaid Long Term Care
There are many income and asset planning techniques used to qualify for long-term care Medicaid when one is over the limit(s), for example, Irrevocable Funeral Trusts and/or Spousal Asset Transfers. There are also planning techniques available to protect one’s home from Medicaid’s Estate Recovery Program. Some of these strategies are exceedingly complex, while others are surprisingly simple.
For planning resources and information, we recommend checking out the following sites:
Waiting List
Please note that most Older Americans Act services in Georgia currently have a waiting list. Individuals who meet the high priority criteria may not receive services immediately; individuals who do not meet the high priority criteria are generally expected to have a waiting time of more than 12 months.