Long-term care in the United States is paid for primarily by Medicaid, not by Medicare or by private insurance.1 In Georgia, the pathway runs through either a nursing facility placement or one of two home- and community-based services (HCBS) waivers. The five-year look-back is enforced. Asset and income rules track the federal floor.
The two HCBS waivers: CCSP and SOURCE
Most states operate one or two HCBS waivers for older adults. Georgia operates two with overlapping but not identical eligibility:
- CCSP (Community Care Services Program). The general HCBS waiver. Covers personal care services, adult day health, respite, home-delivered meals, emergency response systems, and home modifications. Available to Medicaid-eligible individuals meeting nursing-facility level of care, regardless of Medicare enrollment status.2
- SOURCE (Service Options Using Resources in a Community Environment). For individuals dually eligible for Medicare and Medicaid. SOURCE coordinates Medicare primary care with Medicaid HCBS through enhanced case management. Includes the CCSP service package plus enhanced primary-care coordination.
Practical implication: if your parent is on both Medicare and Medicaid (a dual-eligible), SOURCE is typically the better fit because of the integrated primary care coordination. If your parent is on Medicaid only (rare for the 65+ population), CCSP is the path.
The three eligibility tests, in order
1. Medical eligibility (level of care)
Before the financial math, your parent needs to meet Georgia’s nursing-facility level-of-care threshold. Georgia uses a standardized assessment conducted by Division of Aging Services or contracted personnel that scores the applicant on activities of daily living — bathing, dressing, transferring, toileting, eating — and instrumental activities of daily living.3 The assessment is typically completed in person.
Schedule this assessment early. Statewide intake runs through the ADRC at 1-866-552-4464. Wait times depend on regional capacity at the Area Agency on Aging level.
2. Income
Georgia uses the standard 300% of SSI federal benefit rate as its income cap for long-term care Medicaid — approximately $2,901/monthin 2026 . If your parent’s gross monthly income from all sources exceeds this cap, they’re not automatically disqualified. Georgia allows a Qualified Income Trust (QIT), sometimes called a Miller Trust.
3. Assets
The applicant’s countable assets must be at or below $2,000 at the moment of application. “Countable” is doing the real work in that sentence.
Not counted (in most cases):
- The primary residence, up to approximately $752,000 of equity (federal lower limit, which Georgia applies)
- One vehicle of any value
- Personal effects and household goods
- A burial plot and limited burial pre-need
- Term life insurance and small whole-life policies under the exemption threshold
Counted:
- Checking, savings, money-market, CDs
- Brokerage accounts and most retirement accounts in payout
- Cash value of whole-life insurance above the exemption
- Second properties, vacation homes, investment real estate
- Additional vehicles
The 5-year look-back, in Georgia
Georgia applies the same 60-month look-back as every state. Any transfer of assets for less than fair market value in the 60 months prior to the application generates a penalty period— a window during which your parent is otherwise eligible but Medicaid will not pay for long-term care.
The penalty math is straightforward: the value of the transfer divided by Georgia’s penalty divisor. Georgia’s divisor is set annually by DCH and approximates the statewide average private-pay nursing home rate; figure approximately $7,500-$9,000/month in 2026 . A $100,000 gift produces roughly an 11-13 month penalty. The clock does not start until your parent is otherwise eligible — meaning spent down to $2,000 and in care.
The community-spouse situation
If one spouse needs long-term care and the other doesn’t, Georgia follows the federal framework for community-spouse protections:
- Monthly Maintenance Needs Allowance (MMNA): community spouse keeps a monthly income allowance between the federal minimum and maximum (approximately $2,555 and $3,948 in 2026)
- Community Spouse Resource Allowance (CSRA): community spouse retains up to approximately $157,920 of countable assets in 2026
- The homestead, vehicle, and personal effects remain exempt
Estate recovery in Georgia
Federal Medicaid law requires every state to attempt recovery from the estate of a deceased Medicaid LTC recipient for services paid after age 55. Georgia pursues recovery through DCH against probate assets — meaning assets passing through the decedent’s probate estate. Assets held in revocable trust, transferred during life with retained life estate, or passing outside probate (joint tenancy, beneficiary designations) are generally not subject to recovery. Recovery is deferred when there is a surviving spouse, disabled child, or minor child.4
The Georgia non-expansion factor
Georgia has not expanded Medicaid under the Affordable Care Act. The practical consequence for caregiving is that the under-65 Medicaid program is more restrictive — the income threshold for the parents-of-minor children category is well below the federal poverty line, and childless adults under 65 generally cannot enroll.5 This affects working-age caregivers who themselves might need Medicaid but does not change the LTC Medicaid framework for the 65+ population.
Georgia’s Pathways to Coverage program (launched July 2023) provides a limited expansion of Medicaid to certain low-income adults who meet work requirements. The program operates separately from the LTC framework and affects a small subset of working-age adults.
What to do this month
- Gather the documents. Five years of bank statements, tax returns, real-estate records, brokerage statements, and life-insurance policies. DCH will ask for all of it.
- Stop any “creative” transfers. If gifting has happened recently, document it; do not continue it.
- Talk to a Georgia elder-law attorney. The consultation typically runs $250–$500. Modest insurance against a six-figure mistake.
- Request the level-of-care assessment through ADRC. Call 1-866-552-4464.
For the broader Medicaid context nationally, see our Medicaid pillar overview. For Georgia-specific legal planning, including the retirement income exclusion and Georgia’s no-estate-tax framework, see Legal & Financial in Georgia.