Georgia Nursing Home Medicaid: Understanding Options for Working Spouses

Over the last thirteen years, we have worked with hundreds of spouses. Some are in their 80s and 90s, but many are also in their 50s and 60s.  Dementia, stroke, Parkinson’s disease, and many other illnesses are not restricted to only the old-old and oldest-old. These diseases are more likely to affect those over age 80, but they do not discriminate based on age.  Because of this, many of our spousal caregivers are still working.

Working and caregiving is a reality for many couples.

Many of the spouses caring for a loved one with dementia or another debilitating illness are still working full or part-time. They do this out of financial need or because Medicare age has not yet been reached.  Some also keep working as a form of emotional and psychological well-being.  Working keeps them engaged and connected to others.  The workplace can be a respite from the demands of caregiving and a stressful home situation.

Although important, it may not make financial sense to keep working.

For our couples dealing with nursing home care, though, working may not make good financial sense. As we covered in a blog last month , Medicaid has special laws to protect married individuals.

Working may increase the amount you pay to the nursing home.

As we discussed in that blog, Medicaid allows for a spousal diversion.  That is, the nursing home spouse can divert a portion of his/her income to the spouse still living at home.  If the spouse at home makes less than $3,160.50 per month, that spouse may be able to keep a portion of their institutionalized spouse’s income.  This reduces how much the couple pays the nursing home, and increases how much is paid by Medicaid.  If the spouse at home works, their earned income could offset their spousal diversion; this means that the couple is paying more to the nursing home.

But it may be important to keep working despite the lost income.

Even though it may not make financial sense, many spouses may keep working for other reasons. Access to health insurance and a retirement plan could be a big reason to keep working. It is also important to consider the non-tangible things work gives—purpose, structure, socialization, routine, etc.  This is not just a financial decision, but a thorough evaluation of the options and pros and cons should be considered.

The experts at Hurley Elder Care Law are ready to provide you with a thorough analysis and recommendations. We will discuss the options and create a customized plan.  To start this process, please call our office at (404) 843-0121 or contact us through our website

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