Expert Tips for Georgia Medicaid: How Mr. Smith Pays for His Wife’s Nursing Home Care

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Mr. and Mrs. Smith have been married for 50 years.  About six years ago, Mrs. Smith began showing signs of dementia. At first, Mr. Smith refused to acknowledge that there was any problem, but their children and church family finally convinced him to take her to a neurologist. Mrs. Smith was diagnosed with dementia, and she was able to live at home with her husband as a primary caregiver for the next 4 ½ years.  Six years after her first symptoms, Mrs. Smith is no longer able to walk, dress herself, feed herself or use a toilet. She requires total assistance, and Mr. Smith is no longer able to care for her on his own.  She spends most of the day in her bed, and her children want their dad to get more help.

After reviewing all of their options, it seems as if a nursing home is their only viable option. Assisted living communities and personal care homes cannot offer her an apartment because she can no longer walk or transport herself (a requirement set by the state for all new admissions into personal care homes and assisted living communities). At $20/hour, private duty home care is too expensive for the amount of hours Mr. and Mrs. Smith need help. Spending that money on her care would quickly deplete all of their assets, and Mrs. Smith could live another 3-5 years. This leaves nursing home care.  Sure, nursing homes cost $8,000/month, but Mr. Smith has been told that his wife can get on Medicaid and that Medicaid can help pay for her nursing home care.

Mr. Smith was shocked when he was told that his wife could be eligible for Medicaid. Although they have never been wealthy, Mr. and Mrs. Smith always worked decent paying jobs and saved for retirement in their IRAs.  They have one car and a home that they own outright that is worth about $200,000.  Their savings total about $120,000 and their IRAs combined total over $180,000.  With their IRA distributions and Social Security checks, they have about $4,400/month in income ($3,000 for him, and $1,400 for her). Mr. Smith never even considered Medicaid for them—he thought Medicaid was only for extremely poor people.

Let’s analyze the requirements for nursing home Medicaid in Georgia and the Smiths’ financial situation.

To get Medicaid:

• The resident going into the nursing home must have less than $2,250/month of income;
• Mrs. Smith only makes $1,400.
• A married couple must have less than $125,600;
• Mr. and Mrs. Smith have a $200,000 house, $120,000 in the bank, $180,000 in IRAs, and a car—this puts them with assets over $500,000.  Fortunately, the house, car, and IRAs are exempt for Medicaid eligibility. This means they have $120,000 in assets and are eligible for Medicaid.

For the Smiths, not only are they eligible for Medicaid, but Mr. Smith will also be able to keep a portion of Mrs. Smith’s income every month. Medicaid allows the spouse still living at home to have up to $3,090 in income.  Since Mr. Smith’s income is $3,000, he can keep $90/month of Mrs. Smith’s income (and then the rest of her income will go to the nursing home).

Moving Mrs. Smith into the nursing home was very hard for Mr. Smith. They had been inseparable for the last 50 years, and he was committed to caring for her until the end. Her care became too much for him; and he, with the urging from his family, had to move her into a nursing home.  It was a relief to Mr. Smith that his wife could get Medicaid to help pay for her care.

Many families are finding themselves in similar situations as the Smiths. If you or someone you know has questions about nursing home Medicaid, please call our office for a complimentary consultation at (404) 843-0121.