01/07/2021
When Medicaid in Georgia Will Pay for a Nursing Home, Assisted Living, or Home Health Care
In Georgia, aged, blind and disabled Medicaid will pay for long-term care, including some assisted living and home care.
By Douglas Witten
Updated January 3, 2021
In Georgia, Medicaid is a very common source of funding for long-term care. Approximately 72% of nursing home residents in Georgia use Medicaid to pay for their nursing home care. Without Medicaid, long-term care like nursing homes, assisted living facilities, and home health care is unaffordable for most people. In 2018, the average daily cost of a private room in a nursing home in Georgia was approximately $223, or over $81,000 per year. Private health insurance policies generally do not cover long-term care, and very few people purchase private long-term care insurance policies. Medicare coverage for long-term care services is limited. As a result, Medicaid picks up the tab for many Georgians who need long-term institutional care or home care.
There are several different ways to become eligible for Medicaid in Georgia, and there are specific eligibility rules for long-term care services like nursing homes, assisted living facilities, and home health care services.
Income Limit for Georgia's Medicaid Program
People who are sixty-five or older, disabled, or blind, can qualify for Medicaid if they also meet income and asset limits. Georgia’s Medicaid program for elderly, blind, and disabled residents is called aged, blind, and disabled (ABD) Medicaid. If you receive Supplemental Security Income (SSI), then you automatically qualify for ABD Medicaid. If you are elderly, blind, or disabled and need long-term care in a nursing home or in the community but are not receiving SSI, then your monthly income must be less than $2,250 (in 2019) to qualify for ABD Medicaid.
If your income is above the limit, you can still qualify for Medicaid in two other ways. First, you can put your extra income each month into a special bank account that is set up under the terms of a Qualified Income Trust (also known as a Miller Trust). For help with a Qualified Income Trust, consult an attorney.
The second way to qualify for Medicaid if you are over the income limit is through Georgia’s Medically Needy Program. In the Medically Needy Program, you can use medical bills that you incur each month to “spend down” your income and qualify for Medicaid. The program is available to pregnant women, children, the elderly, and blind or disabled adults.
In 2019, the income limit for the ABD Medically Needy Program is $317 per month, meaning that you must show that you have incurred medical expenses each month that would leave you with no more than $317. Once you show that you have those expenses, you qualify for Medicaid coverage for the rest of that month.
