Georgia Medicaid Nursing Home Eligibility: A Complete Guide

Georgia nursing home costs average approximately $70,000–$85,000 annually for a semi-private room. Georgia Medicaid, administered by the Department of Community Health (DCH), covers nursing home care for eligible residents. Planning ahead can mean the difference between financial devastation and protected assets.

Who Qualifies

1. Medical necessity — Physician certifies need for nursing facility level of care.
2. Financial eligibility — Income and asset limits.
3. Georgia residency — U.S. citizenship or qualifying immigration status.

Income Requirements

• Monthly income limit: $2,829/month (300% of SSI, 2025)

A Qualified Income Trust (Miller Trust) is required when income exceeds the cap. Community spouse: Monthly Maintenance Needs Allowance up to approximately $3,715/month.

Asset Requirements

• Individual applicant: $2,000 in countable assets
• Community spouse: Up to $148,620 (2025 CSRA)

Exempt assets: Primary home (if intent to return or spouse/dependent lives there), one vehicle, personal property and household goods, irrevocable prepaid burial arrangement.

Look-back period: Georgia enforces a 60-month (5-year) look-back period.

Application Process

Apply through the Georgia Division of Family and Children Services (DFCS):

1. Find your county DFCS at dfcs.georgia.gov or call 1-877-423-4746.
2. Apply online at Georgia Gateway (gateway.ga.gov) or in person at a DFCS office.
3. Submit: income documentation, 60 months of bank statements, asset records, physician certification.

Processing takes approximately 45 days. Retroactive coverage up to 3 months prior may be available.

What Georgia Medicaid Covers

Covered: Semi-private room and board, skilled and custodial nursing care, physical/occupational/speech therapy, physician and specialist visits, prescriptions, medical equipment.

Not covered: Private rooms (unless medically required), personal comfort items, cable and telephone charges.

Home- and Community-Based Programs

• CCSP (Community Care Services Program): Georgia's primary HCBS waiver. Provides homemaker/home health aide, personal care, adult day health, respite, and emergency response. Administered through Area Agencies on Aging.
• SOURCE (Service Options Using Resources in a Community Environment): Available in select counties. Integrates care coordination with a primary care model for frail seniors 65+.
• Independent Care Waiver Program (ICWP): For adults with physical disabilities.
• PACE Georgia: Available in select counties.

Frequently Asked Questions

What's the difference between SOURCE and CCSP?

SOURCE is available in select counties and integrates care coordination with primary care. CCSP is available statewide through Area Agencies on Aging. A social worker or AAA can help determine which is right for your situation.

How do I appeal a Medicaid denial?

Request a Fair Hearing through DFCS within 90 days of a denial notice. An elder law attorney or Legal Aid can assist.

Is my spouse's income counted in my Medicaid application?

The community spouse's income is generally not counted in the applicant's income test.