How to Qualify for Medicaid for Long-Term Care

If you or a loved one may need nursing home care, in-home assistance, or another form of long-term support, one of the first questions that comes up is: how do we pay for this? Long-term care is expensive. In Georgia, nursing home costs usually run $6,000 to $9,000 or more per month. Medicare, which many people confuse with Medicaid, generally does not cover long-term care beyond a short rehabilitation stay. That leaves Medicaid as the main public program most families turn to.

What Is Medicaid for Long-Term Care?

Medicaid is a joint federal and state program that pays for health and care services for people who meet certain financial and medical criteria. In Georgia, the program that covers long-term care services, including nursing facility care, assisted living support, and home- and community-based services, falls under Georgia Medicaid, administered by the Georgia Department of Community Health (DCH).

Unlike regular health insurance, Medicaid for long-term care is specifically designed for people who need ongoing help with daily activities like bathing, dressing, eating, or managing medications. To receive these benefits, you must qualify in two separate ways: medically and financially.

Step 1: Meeting the Medical Eligibility Requirement

Before finances are even reviewed, Georgia Medicaid requires that an applicant have a documented medical need for a nursing facility level of care. This means a doctor or care assessor must determine that you need significant help with activities of daily living (ADLs) or that you needskilled nursing services on an ongoing basis.

This is not a high bar for most people who are genuinely seeking long-term care. If you or your loved one has reached the point of needing a nursing home or substantial in-home assistance, you likely meet this standard. But it does need to be formally documented through a medical evaluation.

Step 2: Meeting the Financial Requirements

Georgia Medicaid has strict rules about both income and assets.

Income Limits

In Georgia, Medicaid uses an income cap for long-term care applicants. As of 2026, the monthly income limit is $2,982. This figure is updated periodically, so always verify the current threshold. The cap includes all sources of income: Social Security, pension payments, retirement distributions, and any other regular income.

But if your income exceeds this limit, don’t worry, you are not automatically disqualified. Georgia allows the use of a Qualified Income Trust (QIT), sometimes called a Miller Trust. This is an estate planning tool that allows you to redirect excess income into a trust each month so that you can still meet Medicaid's income requirements. You can set one up with an estate planning attorney.

Asset Limits

Georgia Medicaid limits how much an applicant can own in countable assets. For a single individual, the limit is $2,000. For a married couple where one spouse is applying and the other remains at home, the rules are more nuanced. The at-home spouse is allowed to keep significantly more.

Countable assets generally include checking and savings accounts, investment and brokerage accounts, secondary real estate such as vacation homes or rental properties, the cash value of life insurance policies above a certain threshold, and vehicles beyond one.

Exempt or non-countable assets generally include your main home (with important conditions addressed below), one vehicle, personal belongings and household furnishings, and pre-paid funeral and burial plans up to certain limits.

The Home: A Special Case

The main residence is mainly exempt while the Medicaid recipient is living there or while a spouse, minor child, or disabled dependent lives there. But, Georgia participates in Medicaid Estate Recovery, which means the state can seek reimbursement from the value of the home after the recipient passes away. 

The Look-Back Period: Why Timing Matters

One of the most important, and most misunderstood, rules in Medicaid long-term care planning is the 60-month look-back period. When you apply for Medicaid in Georgia, the state reviews all financial transactions made in the five years before your application date.

If you gifted money to family members, transferred property, or gave away assets during that window, Georgia Medicaid may impose a penalty period. This is a stretch of time during which you are ineligible for benefits, even if you now meet the financial requirements. The length of the penalty is calculated based on the total value of the transfers.

This does not mean you can never give gifts or help your family. It means timing and structure matter enormously, and that planning should ideally happen years before a long-term care need arises, not days before applying.

Spousal Protections

Georgia follows federal rules designed to prevent an at-home spouse from going into poverty. The Community Spouse Resource Allowance (CSRA) allows the healthy spouse to retain a portion of the couple's combined assets. In 2026, that amount is up to $162,660. There is also a Monthly Maintenance Needs Allowance (MMNA), which allows income to be shifted to the at-home spouse if their monthly income falls below a certain level. In Georgia, that threshold is $4,066.50 per month in 2026, meaning if the at-home spouse earns less than that, they may be entitled to receive a portion of the applicant spouse's income to make up the difference.

How to Apply in Georgia

Applications for Georgia Medicaid long-term care benefits are submitted through the Georgia Department of Human Services (DHS). You can apply online through the Gateway portal at gateway.ga.gov, in person at your local Division of Family and Children Services (DFCS) office, or by mail.

Be prepared to provide extensive documentation. This typically includes proof of income, recent bank statements, asset records, insurance policies, and medical records. The application process can be lengthy, and errors or missing documents are a common reason applications are delayed or denied. Having an experienced Medicaid attorney on your side makes all the difference.