A Georgia Medicaid 1915(c) waiver pays for care at home instead of a nursing facility, but unlike regular Medicaid it is capped and waitlisted, so you can qualify and still wait for a slot. This guide explains how Georgia's EDWP (which delivers the CCSP and SOURCE service models), ICWP, NOW, and COMP waivers work, who qualifies, and what to do while you wait.,

In This Guide

How a Georgia Medicaid 1915(c) waiver works, and why you can qualify and still wait

A Georgia Medicaid 1915(c) waiver lets the state spend Medicaid dollars on care at home or in the community for someone who would otherwise need the level of care provided in a hospital, a nursing facility (NF), or an intermediate care facility for individuals with intellectual disabilities (ICF/IID). The authority comes from Section 1915(c) of the Social Security Act, at 42 U.S.C. 1396n(c).

Every 1915(c) waiver rests on three federal tests, and each one shapes what a family experiences. First, cost neutrality: the state must assure that the average per-person cost under the waiver will not exceed 100 percent of what that care would have cost in an institution. Second, level of care: each person must be independently evaluated as needing the institutional level of care the waiver replaces, with a reevaluation at least once a year. Third, limited enrollment: the waiver application specifies a maximum number of unduplicated participants per waiver year, which caps the size of the program, and the only federal floor is that the Secretary of Health and Human Services may not hold that number below 200.

That third test is why you can be fully eligible and still wait: regular Medicaid is an entitlement, a waiver is not, and when its slots are full, qualified applicants wait. For NOW and COMP, that wait happens on a planning list. The wait reflects capacity and budget, not a judgment that you do not need the care.

Who qualifies for a Georgia Medicaid 1915(c) waiver: income, assets, and level of care

Qualifying for any Georgia waiver means clearing three gates: functional (do you need institutional level of care), financial (income and assets), and categorical (age, disability, or diagnosis for that specific waiver).

The functional gate is level of care. Federal law requires each waiver enrollee to be independently evaluated as needing the institutional level of care the waiver replaces, and reevaluated at least once a year. For the older-adult and physical-disability waivers that level is nursing-facility level of care, or NFLOC: the clinical determination that a person needs the kind of care a nursing facility provides, with the deciding criteria set in state rule rather than in a federal eligibility test. DCH's EDWP fact sheet lists twelve eligibility criteria, among them approval of an intermediate level-of-care certification for nursing home placement, a functional impairment caused by physical limitations, and an unmet need for care. DCH's fact sheet adds that Alzheimer's and dementia count as physical conditions, and that you do not have to be homebound. ICWP accepts either a nursing-facility or a hospital level of care, and NOW and COMP require the level of care of an intermediate care facility for people with intellectual or developmental disabilities.,

The financial gate uses the institutional special income rule. Georgia calls its version the Medicaid CAP and applies it across its long-term-care classes of assistance, EDWP, ICWP, and NOW/COMP among them. For 2026 the cap is $2,982 a month, 300 percent of the $994 SSI federal benefit rate, tested against the applicant's own gross countable income without counting a spouse's. A $5,964 couple cap applies only when both spouses live together in a long-term-care living arrangement and the individual cap would leave one of them ineligible. The resource limit is $2,000 in countable resources for an individual and $3,000 for a couple, and because Georgia excludes some property from that count, a homeowner should not read the $2,000 alone as a verdict.

Being over the cap is not a dead end. Georgia policy lets an applicant whose gross income is at or above the Medicaid CAP establish a Qualified Income Trust, commonly called a Miller trust, and deposit income into it to shelter all or part of that income from the eligibility income test. The trust must be irrevocable, contain only the applicant's income and no resources, and pay what remains at death to the Department of Community Health, up to what Medicaid spent on the applicant's care. It cannot be backdated (it takes effect in the month everyone required has signed it), and it must be established in Georgia; an out-of-state trust does not count. Without one, an applicant at or above the cap is income ineligible for every long-term-care class of assistance until the trust exists, and is budgeted as Medically Needy instead.

If you are married, the spousal impoverishment rules under Section 1924 (42 U.S.C. 1396r-5) are what keep the spouse who stays at home from being left with nothing. In 2026 the federal resource standards run from $32,532 to $162,660, with each state electing its standard in that range, though a fair hearing or court order can set the at-home spouse's resource allowance higher. The minimum monthly maintenance needs allowance is $2,705.00 from July 1, 2026 through June 30, 2027, and the maximum is $4,066.50. Georgia's chart puts the resource limit for a married applicant whose spouse stays home at $162,660 plus $2,000, or $164,660.

Georgia's Medicaid 1915(c) waivers at a glance

Georgia's 1915(c) waivers include four that each target a specific population and are gated by the institutional level of care they replace: EDWP (the Elderly and Disabled Waiver Program) serves older adults and adults with physical disabilities at nursing-facility level of care through its two service models, CCSP and SOURCE, which are not separate waivers (run by DCH); ICWP serves a limited number of adults who apply between the ages of 21 and 64, on either a nursing-facility or a hospital level of care, for severe physical disabilities or traumatic brain injury (DCH); and NOW and COMP serve people with intellectual and developmental disabilities at ICF/IID level of care (administered by DCH, which delegates day-to-day operation to DBHDD through six regional field offices). Georgia Medicaid's list of waiver programs also carries the Georgia Pediatric Program (GAPP) for medically fragile children., For a side-by-side profile of each program, see our Georgia Medicaid HCBS waivers directory.

The NOW and COMP waivers share one planning list, and it is long. About 7,900 Georgians were on it in September 2025. Roughly 4,900 of them were 22 or older, and the state auditors' wait-time figures cover only those adults: 43 percent of them (about 2,100 people) had been on the list at least six years, and likely longer, because a 2019 systems update reset their entry dates; on average those adults had been waiting nearly five years. DBHDD typically prioritizes the people with the greatest unmet needs, and those whose circumstances are more urgent under DBHDD's criteria may be served first, so a place on the list is not a place in line: prioritization is based on need rather than on how long you have waited.

About 3,000 people on that list, 38 percent, were under 22. For a child, a 1915(c) waiver is not the only door: Georgia's DFCS manual notes that a child may be eligible for EDWP, NOW, COMP, or Katie Beckett, and directs that the benefits of each be explained to the family. Our guide to Georgia Medicaid school-based services covers the care the program pays for at school.

Two other Georgia pathways serve home-based care but are not 1915(c) waivers. Katie Beckett (TEFRA) is a Georgia Medicaid class of assistance established in 1982 under the Tax Equity and Fiscal Responsibility Act, not under Section 1915(c): it waives the deeming of a parent's income and resources so a child 18 years of age or younger who needs an institutional level of care can qualify for Medicaid on the child's own income and resources while living at home. Turning 18 does not end it: whatever happens with the SSI application the child is advised to file, the class of assistance stays open through the month the child turns 19. Georgia also runs Money Follows the Person, a demonstration DCH implemented on September 1, 2008 with DBHDD and the Division of Aging Services. Its goal is to move people out of institutions and into the community, primarily through Georgia's waiver programs, though a transition coordinator can also arrange other Medicaid services.

Your rights once you are on a waiver

Waiver services are furnished under a written plan of care, and the level-of-care finding that put you on the waiver is reevaluated at least once a year. That annual reevaluation is not a formality: it is the point at which a change in your condition, or in what your family can still manage, belongs in the record. Ask your case manager or support coordinator for a copy of your current plan and for the date of your next reevaluation, and say so in writing if the plan no longer matches what you need.

You may also be able to direct your own services. Federal self-direction comes in two forms: employer authority, where you recruit, hire, train, schedule, supervise, and fire the workers who furnish your services, and budget authority, where you control an individual budget and use it to purchase the supports in your plan. Self-direction options can be built into 1915(c) waivers, among other federal authorities, so ask your case manager or support coordinator whether your specific waiver offers it. Hiring a spouse or another legally responsible relative as a paid worker is a state election, not a federal guarantee.

Electronic visit verification and what it means for your care

If your waiver includes personal care or home health, the worker will clock each visit through electronic visit verification, or EVV. Section 12006 of the 21st Century Cures Act requires states to capture six data elements for each visit: the type of service, the person receiving it, the date, the location, the person providing it, and the times the visit starts and ends.

The personal care requirement applies to services furnished from January 1, 2020, and the home health requirement from January 1, 2023. A state that does not comply faces an incremental reduction in its federal medical assistance percentage. A state that showed a good-faith effort to comply and unavoidable system delays was spared that reduction for personal care in 2020 and for home health in 2023, and those reprieve years have passed.

The federal HCBS Access Rule: an 80 percent pay floor by 2030

A second federal rule is aimed at the pay of the people who do that hands-on work. The CMS Ensuring Access to Medicaid Services final rule (CMS-2442-F), codified for 1915(c) waivers at 42 CFR 441.302(k), created the HCBS payment adequacy requirement, better known as the 80/20 rule: the state must ensure that each provider of homemaker, home health aide, or personal care services spends 80 percent of the total payments it receives for those services on total compensation for the direct care workers who furnish them. The 80 percent is figured after excluding exactly three costs: required trainings, travel, and personal protective equipment for direct care workers. Self-directed services where you set the worker's pay rate are left out of the calculation, and a state may, through a transparent public process, set a different percentage for small providers and exempt a reasonable number facing extraordinary circumstances.

The timing matters as much as the number. States do not have to comply with 42 CFR 441.302(k) until six years after July 9, 2024, which is July 9, 2030; for HCBS delivered through managed care, it is the first rating period on or after that date. So the 80 percent floor is something to watch rather than something to expect on your current plan of care. If your waiver includes personal care, homemaker, or home health aide services, ask your provider agency what it pays its direct care workers now, because that is the number the rule will eventually measure.

How 1915(c) compares to Georgia's other HCBS options

A 1915(c) waiver is one of several federal doors to home-based care, and which door you are under changes whether you can be capped and waitlisted. A waiver requires institutional level of care and may be capped, which is what creates the planning lists.

The state-plan options work differently, and Georgia's waiver programs do not run on them. Section 1915(i) lets a state cover HCBS through a state plan amendment without seeking a federal waiver; only a minority of states operate an approved 1915(i) benefit, and Georgia is not among the states documented as operating one, delivering its HCBS programs under 1915(c) authority instead. Section 1915(k), Community First Choice, is an optional state plan attendant-care benefit that not every state elects. Because it is a state plan benefit rather than a capped 1915(c) waiver, a state that elects it must provide it statewide, without regard to age or to the type or severity of disability, and gets a 6 percentage point increase in its federal match for those services. The person must still be determined, at least annually, to need an institutional level of care without it, unless the state waives the yearly recheck for someone not expected to improve. EDWP, ICWP, NOW, and COMP are all 1915(c) waivers, so the capped and waitlisted route is the one to plan around; confirm with DCH before counting on a state plan alternative.

How to apply, and what to do if you are denied

Where you apply depends on which waiver fits your situation: applications for EDWP, under either its CCSP or its SOURCE model, go through Georgia's Aging and Disability Resource Connection (ADRC) offices; ICWP is administered by the Georgia Department of Community Health (DCH); for NOW or COMP, apply through the Georgia Collaborative ASO's Individual IDD Connects portal, creating an account and uploading the required documents there. DBHDD prefers the online route because paper applications have to be retyped into the portal, but you may instead fax or mail a paper application to a DBHDD Regional Field Office, and that office will help you if you call and ask. Regional Field Office Intake and Evaluation staff review each application, and applicants found pre-eligible go on the shared NOW/COMP planning list.,, Every path then runs through the same two gates: an evaluation confirming institutional level of care and the financial test against the $2,982 Medicaid CAP, or a Qualified Income Trust if you are over it., Step-by-step application help lives in our HCBS waivers directory and our guide to how to apply for Georgia Medicaid.

If your application is denied, or your waiver services are cut, federal law gives you the right to a fair hearing before the state agency: 42 CFR 431.220 requires the agency to grant a hearing to anyone who believes it acted erroneously or denied a claim for eligibility or for covered services. The one stated exception is a change that flows automatically from a federal or state law affecting some or all beneficiaries. Watch the date on the notice, because keeping your services during the appeal depends on it. Under 42 CFR 431.230(a), if the agency sent the required advance notice and you request the hearing before the date the action takes effect, it may not reduce or terminate your services until a decision is issued, unless the hearing finds the only issue is one of federal or state law or policy and the agency promptly tells you in writing. After that date, 42 CFR 431.231 lets the agency reinstate services if you ask within 10 days of the date of action, and requires it if you got no advance notice, you ask within 10 days of receiving the notice, and the action did not come from applying federal or state law or policy. If the action is upheld, the agency may recoup the cost of the continued services. In Georgia, ask for continuation explicitly: the DFCS manual lets eligibility continue if your request arrives within 10 days of the notice date, and DCH can require repayment if you lose. Georgia hearings are held by the Office of State Administrative Hearings (OSAH), reachable at (404) 657-2800 or 1-877-809-0007. For a lawyer, OSAH refers people with limited income to the Georgia Legal Services Program, (800) 498-9469, and Atlanta residents to the Atlanta Legal Aid Society, (404) 524-5811.

Your next step To join the NOW/COMP planning list, start an Individual IDD Connects account with the Georgia Collaborative ASO and upload your documents there, or fax or mail a paper application to your DBHDD Regional Field Office. For EDWP (CCSP or SOURCE), start with an Aging and Disability Resource Connection (ADRC) office; ICWP runs through DCH.

Frequently Asked Questions

What is a Georgia Medicaid 1915(c) waiver?

It is a Medicaid benefit, authorized by Section 1915(c) of the Social Security Act (42 U.S.C. 1396n(c)), that pays for care at home or in the community for someone who would otherwise need a hospital, nursing facility, or ICF/IID. Georgia's include EDWP (whose CCSP and SOURCE models are delivery arms of the single waiver), ICWP, NOW, and COMP. The authority lets the Secretary waive certain Medicaid requirements so the state can cover those home and community-based services.

Why can I qualify and still be on a waiting list?

Because a 1915(c) waiver is not an entitlement. Unlike regular Medicaid, a waiver lets Georgia cap the number of people each waiver serves, so when the slots are full, qualified applicants wait.

What income and assets can I have and still qualify?

Georgia's 2026 Medicaid CAP is $2,982 a month in gross countable income for an individual, 300 percent of the SSI federal benefit rate. Countable resources must be at or below $2,000 for an individual, or $164,660 if your spouse stays at home.,

What if my income is over Georgia's cap?

You are not automatically out. Georgia lets you shelter income in a Qualified Income Trust, or Miller trust: irrevocable, containing only your income, set up in Georgia, effective only from the month it is signed, and repaying the Department of Community Health at your death up to what Medicaid spent. Until one exists, an applicant at or above the cap is income ineligible for every Georgia long-term-care class of assistance and is budgeted as Medically Needy instead.

Can my spouse keep our income and savings if I go on a waiver?

Partly. In Georgia the resource limit for a married applicant whose spouse stays home is $164,660. The at-home spouse's monthly maintenance needs allowance is at least $2,705.00 from July 1, 2026, up to a $4,066.50 maximum, and a fair hearing can raise it in exceptional circumstances. Our Georgia spousal impoverishment guide covers how the calculation runs here.

How long is the wait for NOW or COMP?

It is often years. About 7,900 Georgians were on the shared NOW/COMP planning list in September 2025, and among the roughly 4,900 who were 22 or older, 43 percent (about 2,100 people) had already waited at least six years. On average, those adults had waited nearly five years. DBHDD typically serves the people with the greatest unmet needs first, and those whose circumstances it classifies as more urgent may be served ahead of others, so time on the list is not what moves you up.

Can I hire and manage my own caregiver under a Georgia waiver?

Sometimes, through self-direction, which can be built into a 1915(c) waiver. Where it is available, it takes one of two forms: employer authority, where you hire, schedule, supervise, and manage your own workers, or budget authority, where you control an individual budget for the supports in your plan. Ask your case manager or support coordinator whether self-direction is available for your specific waiver, and see our guide to self-directed services in Georgia. Paying a spouse or another legally responsible relative is a state election, not a federal guarantee.

Learn More

MedicaidGeorgia Medicaid hubGeorgia Medicaid 2026: income and asset limits, the EDWP waiver (CCSP and SOURCE), Pathways to Coverage, Miller Trusts, estate recovery, and how to apply. MedicaidGeorgia Medicaid long-term careGeorgia Medicaid long-term care in 2026: nursing facility coverage, HCBS waivers (EDWP with CCSP and SOURCE, ICWP, NOW, COMP), PACE, and how to apply. MedicaidGeorgia CCSP, an EDWP service modelGeorgia CCSP Waiver 2026: who qualifies for the Community Care Services Program, what it covers, and how to apply through your Area Agency on Aging. MedicaidGeorgia SOURCE, an EDWP service modelHow the Georgia SOURCE waiver works in 2026: a delivery model inside the 1915(c) Elderly and Disabled Waiver Program, eligibility, sites, and how to apply. MedicaidGeorgia Miller trusts (Qualified Income Trusts)Georgia Medicaid Miller Trust (Qualified Income Trust) in 2026: who needs one above the $2,982 income limit, how to set it up, and the monthly funding rules. MedicaidGeorgia ICWP waiverGeorgia's Independent Care Waiver Program (ICWP) funds home care for adults 21-64 with severe physical disabilities or TBI. Eligibility, services, how to apply. MedicaidGeorgia NOW and COMP waiversHow Georgia's NOW and COMP waivers serve people with I/DD: eligibility, the ~7,900-person Planning List, services covered, and how to apply through DBHDD. MedicaidGeorgia Medicaid 1915(i) HCBS State Plan OptionGeorgia's Medicaid home care runs under Section 1915(c) waiver authority, not the Section 1915(i) HCBS state plan option. Here is what that means for you.

Find personalized help choosing and applying for a Georgia Medicaid HCBS waiver at brevy.com.

The information on Brevy.com is for educational purposes only and is not a substitute for professional legal, financial, or medical advice. Rules vary by state and program and change frequently. Always verify with the relevant agency or a qualified professional. Brevy is not a law firm, financial advisor, or healthcare provider.

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