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:

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):

Counted:

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:

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

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.