Georgia Medicaid Asset Spend-Down Strategies 2026

Georgia Medicaid asset spend-down strategies reduce a single applicant's countable assets to the $2,000 limit, and the wrong transfer means months when Medicaid won't pay for long-term care.1,2

Georgia Medicaid Spend-Down Strategies in 2026: The Key Numbers

A reader usually arrives with one question: what are the actual limits? Here are the 2026 Georgia figures that drive every spend-down decision.

• Asset limit (single applicant): $2,000 in countable resources. Both spouses applying: $3,000.1
• Income cap (institutional/waiver Medicaid): $2,982 per month for a single applicant, set at 300% of the SSI Federal Benefit Rate ($994 per month in 2026), and $5,964 for a couple. Georgia prints these figures in its DFCS Appendix A1 ABD Financial Limits (effective July 2026), and they replace the $2,901/$5,802 figures that ran through 2025. Income at or above the cap requires a Qualified Income Trust.1,3
• Home equity limit: the 2026 Medicaid home equity limit starts at a federal minimum of $752,000, and a state may elect a higher amount, up to $1,130,000. Brevy has not located a Georgia-specific home equity figure in the state's published ABD financial-limits appendix, so confirm the standard DFCS applies to your case.2 The limit does not apply at all when the applicant's spouse, the applicant's child under age 21, or the applicant's blind or permanently and totally disabled child of any age is lawfully residing in the home.4
• Community Spouse Resource Allowance (CSRA): the 2026 federal resource standards run from $32,532 to $162,660, and each state elects its standard inside that range. Georgia's 2026 Appendix A1 resource chart lists $164,660 ($162,660 plus $2,000) for a long-term-care applicant with a community spouse. A fair hearing or a court order can set the allowance above $162,660.5,1
• Monthly Maintenance Needs Allowance (MMNA): the 2026 federal minimum standard is $2,705.00 per month and the maximum is $4,066.50 per month; a state sets the standard it applies within that band, so confirm Georgia's figure with DFCS. A fair hearing can raise it when exceptional circumstances cause significant financial duress.5
• Personal Needs Allowance (PNA): $70 per month for a Georgia nursing-facility resident (a separate $90 applies to a VA pensioner or surviving spouse without dependents, whose VA check is then reduced to that amount).6
• Look-back period: 60 months (5 years) before the application date.2
• Transfer penalty divisor: the averaging nursing home private pay billing rate in DFCS Appendix A1, published at $11,122.00 per month effective April 2026. The chart stamps the rate with its effective date, so re-read it from the newest Appendix A1 edition before you calculate a penalty.4

How Georgia Medicaid Spend-Down Works

Spend-down exists because Medicaid long-term care has a hard asset test. The single-applicant limit is $2,000 in countable resources. Money the applicant can reach counts toward it, including a retirement fund they can withdraw as a lump sum. A family above the limit cannot qualify until countable resources come down to it.1,7

The constraint is how you bring them down. The 60-month look-back means any gift or below-market transfer in the prior five years can create a penalty period during which Medicaid will not pay for long-term care, so simply giving money to adult children before applying backfires. Compliant spend-down avoids that trap by converting countable assets into exempt assets, paying legitimate debts and expenses, or using protections the law already allows. The "medically needy" or excess-income spend-down pathway is a separate concept: it lets people whose countable income exceeds the standard qualify by incurring medical expenses equal to the excess.2,8

The Federal Framework

Section 1917(c): The 60-Month Look-Back and Transfer Penalty

Section 1917(c) establishes the 60-month look-back for transfers of assets for less than fair market value.2

Key elements:

Look-back period. Applications are reviewed for transfers made during the 60 months before the application date. Transfers older than 60 months fall outside the look-back and carry no penalty.

Transfer for less than fair market value. Any transfer where the applicant received less than fair market value is reviewable, including:

• Gifts to family members.
• Transfers into a trust that the applicant can never be paid from.4
• Sales of assets for less than market value.

Transfer penalty period. When a transfer for less than fair market value is found inside the look-back, the penalty period equals the transferred amount divided by Georgia's average monthly private-pay nursing-facility cost (the transfer penalty divisor). During the penalty period, Medicaid will not pay for long-term care.2

Penalty start date. For transfers on or after February 8, 2006, the penalty begins on the later of the transfer date or the date the applicant is otherwise eligible and receiving institutional-level care. A transfer shortly before application can have outsized impact: the clock starts when the person enters the facility and would otherwise qualify, not when the gift was made.2

Exceptions. Certain transfers are exempt from penalty. Georgia's DFCS Medicaid manual (PAMMS 2342) implements the federal exemptions, among them:4

• Transfers to the community spouse, or to another individual for the sole benefit of the spouse.
• Transfers to a blind or disabled child of any age.
• Transfers to a trust established for the sole benefit of a disabled individual under 65.
• Transfer of the home to a son or daughter who resided in the home for at least 2 years immediately before institutionalization and who, as determined by the State, provided care that let the applicant stay at home.4
• Transfer of the home to a sibling who holds an equity interest in it and resided there for at least 1 year immediately before the applicant entered long-term-care Medicaid (the manual's LA-D class of assistance).4
• Transfers where the applicant can show they intended to receive fair market value but did not.
• Transfers made exclusively for a purpose other than qualifying for Medicaid (the manual says this one does not apply to a transfer of the home).
• Transfers where all the transferred assets have been returned.4,2

Undue hardship. Separately from those exceptions, 42 U.S.C. 1396p(c)(2)(D) lets the State excuse a penalty where denying eligibility would work an undue hardship, which the Deficit Reduction Act defines as depriving the person of medical care such that their health or life would be endangered, or of food, clothing, shelter, or other necessities of life.2 Georgia's manual says undue hardship must be considered in every case (PAMMS 2345), so a family facing a penalty they cannot pay through should raise it with DFCS rather than assume the penalty is absolute.4

Section 1917(d): Medicaid-Compliant Trusts

Section 1917(d) specifies how trusts are treated:

Revocable trusts. The whole corpus of a revocable trust the applicant funded counts as the applicant's resource, and payments from it to anyone else are treated as transfers. It does not protect assets for Medicaid.

Irrevocable trusts. Treatment depends on what the trust could pay the applicant. Any portion that could, under any circumstances, be paid to or for the applicant counts as a resource. A portion that could never be paid to the applicant is treated as a transfer as of the date the trust was set up, so it falls under the 60-month look-back.4

Section 1917(d)(4)(A) Special Needs Trusts ("d4A trusts"). For a disabled individual under 65, a properly structured first-party special needs trust holds the individual's own assets outside the Medicaid trust-counting rules, and a transfer into it carries no transfer penalty. It must be established for a disabled individual under 65 by a parent, grandparent, legal guardian, the individual themselves (allowed for trusts set up on or after December 13, 2016, under the 21st Century Cures Act), or a court, and the state must receive what remains at death up to the total Medicaid paid.4

Section 1917(d)(4)(B) Qualified Income Trusts ("Miller Trusts"). A Miller Trust is authorized by Section 1917(d)(4)(B), codified at 42 U.S.C. 1396p(d)(4)(B) and enacted by the Omnibus Budget Reconciliation Act of 1993. The trust may hold only the person's pension, Social Security, and other income, and the state must receive what remains at death up to the total Medicaid paid. The exception works only in a state that does not cover nursing-facility care through its medically needy pathway, which is why it belongs to income-cap states.4 Georgia is one: its manual uses the trust to shelter income from the Medicaid CAP test, and its Medically Needy pathway does not pay the nursing home.3

Section 1917(d)(4)(C) Pooled Trusts. Similar to d4A trusts but established and managed by a nonprofit association that keeps a separate account for each disabled beneficiary while pooling the accounts for investment. The statute sets no age cap on who may hold an account, though a transfer into one at 65 or older can still draw a transfer penalty.4

Section 1917(e): Annuities

Federal law (42 U.S.C. 1396p(c)(1)(F) and (G), and 1396p(e), as amended by the Deficit Reduction Act of 2005) sets the tests an annuity bought by an applicant or spouse must pass, plus a disclosure duty. An annuity that fails is treated as a penalized transfer. To pass, it must:

• Name the state as remainder beneficiary in the first position for at least the total Medicaid paid, or in the second position after a community spouse or a minor or disabled child (the state moves to first if that spouse, or the child's representative, disposes of the remainder for less than fair market value).
• Be actuarially sound, as measured by the Social Security Administration's actuarial publications.
• Be irrevocable and non-assignable.
• Pay out in equal amounts over its term, with no deferral and no balloon payment. Georgia's manual also requires the payments to be monthly.

A retirement-type annuity, such as one bought with IRA funds, is tested differently.4

These rules are technical, and a Medicaid-compliant annuity should be designed with an elder law attorney.

Section 1924: Spousal Impoverishment Protections

Section 1924 protects the community spouse of an institutionalized applicant. These protections are critical for married couples.5

Community Spouse Resource Allowance (CSRA). The community spouse may keep a share of the couple's countable resources without affecting the institutionalized spouse's eligibility. The 2026 federal resource standards run from a minimum of $32,532 to a maximum of $162,660, and each state elects its standard within that range. Georgia's 2026 Appendix A1 resource chart lists $164,660 ($162,660 plus the $2,000 individual limit) for a long-term-care applicant with a community spouse, so the figure in Georgia's own chart sits at the top of the federal range.1 Those standards are not an absolute ceiling on the allowance: a CSRA set at a fair hearing, to give the community spouse enough to reach the minimum maintenance allowance, or set by a court order can lawfully exceed $162,660, though the hearing route counts the institutionalized spouse's available income first. Confirm with DFCS how the allowance is figured in your case before you plan around a number.5

Monthly Maintenance Needs Allowance (MMNA). The community spouse is entitled to a minimum monthly income drawn from the institutionalized spouse's income. The 2026 federal minimum standard is $2,705.00 per month and the federal maximum is $4,066.50 per month; each state elects the standard it applies within that band, so ask DFCS which figure Georgia uses in your case rather than assuming the floor. If the community spouse's own income falls below the allowance, income shifts from the institutionalized spouse to fill the gap, and a fair hearing can set a higher allowance when exceptional circumstances cause significant financial duress.5

Snapshot date. The couple's total resources, and the spousal share of half that total, are computed as of the start of the institutionalized spouse's first continuous period of institutionalization.

Resource assessment. At the start of that period, either spouse can ask the state to assess and document the couple's total resources. The state must give each spouse a copy with notice of the right to a fair hearing, and it may charge a fee if the request is not part of a Medicaid application.9

Georgia Medicaid Spend-Down Rules and Limits

Georgia Long-Term Care Asset Limits

Georgia applies these 2026 asset limits for long-term care Medicaid:1

• Single applicant: $2,000 in countable resources.
• Married couple, one spouse applying: Georgia's 2026 resource chart lists $164,660 ($162,660 plus $2,000) for a long-term-care applicant with a community spouse, so the $2,000 figure alone is not the test. A fair hearing or court order can set the community spouse's share higher.
• Married couple, both applying: $3,000 combined for the standard category.1,5

Georgia Income Cap and the Qualified Income Trust

Georgia is an income-cap state, and it calls the cap the Medicaid CAP. Georgia's DFCS Appendix A1 ABD Financial Limits, effective July 2026, prints the Medicaid CAP at $2,982 per month for an individual and $5,964 for a couple, effective January 2026. That figure is 300% of the 2026 SSI Federal Benefit Rate of $994, the same ceiling CMS publishes for 2026. It replaces the $2,901 individual and $5,802 couple figures that applied through 2025, so a household working from an older Georgia chart or from the state's Elderly and Disabled Waiver Program fact sheet, which still prints $2,901 because it has not been reissued since 2025, is working from a superseded number. The stakes are concrete, and the test is normally run against the individual figure, with no $20 deducted and the spouse's income left out even when the couple lives together at home: an applicant whose own gross monthly income is at or above $2,982 is income ineligible under every long-term-care class of assistance until a Qualified Income Trust (Miller Trust) is established, and Medically Needy budgeting in the meantime does not pay the nursing home. The $5,964 couple cap applies only when both spouses are Medicaid applicants living together in long-term care (at home, or in the same nursing home, hospice, or hospital) and the individual cap would leave one of them ineligible; DFCS then compares their combined gross income to $5,964. A married applicant whose spouse is not also applying should not read the $5,964 column as the trigger.1,3

A Miller Trust works like this:

1. The trust is established in Georgia and must be irrevocable. It cannot be backdated: it takes effect in the month it is completed and signed by everyone required, and a trust set up in another state cannot be used for Georgia Medicaid.3
2. Each month, the applicant's income above the cap is deposited into the trust. Only the applicant's own income may fund it; savings and other resources cannot.
3. The trustee makes the monthly payments out of the trust under its terms and state law.
4. The Georgia Department of Community Health receives what remains at the applicant's death, up to the amount Medicaid spent on care.10,3

Income placed in the trust is sheltered from the Medicaid CAP test.3 Arizona's published rules for the same federal trust add that it still counts in figuring the share of cost, so ask DFCS how Georgia budgets it.10 Miller Trusts require careful drafting and monthly management. See our Georgia Miller Trust guide for detail.

Georgia HCBS Waivers

Georgia funds Medicaid long-term care outside a nursing facility through Section 1915(c) Home and Community-Based Services (HCBS) waivers, and its Medicaid pages describe four of them as operating programs. The Elderly and Disabled Waiver Program (EDWP), administered by the Department of Community Health, serves frail elderly and disabled Georgians who are otherwise eligible under a nursing facility level of care, through two service-delivery models, the Community Care Services Program (CCSP) and Service Options Using Resources in a Community Environment (SOURCE); neither model is a separate waiver. The state also runs the Independent Care Waiver Program (ICWP) for adults who apply between the ages of 21 and 64 with severe physical disabilities or traumatic brain injury, and the New Options Waiver (NOW) and Comprehensive Supports Waiver (COMP) for people with intellectual and developmental disabilities.11 DFCS runs the same Medicaid CAP budgeting for EDWP, ICWP, and NOW/COMP applicants as for nursing-home applicants, so the same income rules and spend-down strategies apply.3

Georgia Transfer Penalty Divisor

Georgia calculates a transfer penalty by dividing the penalized transfer amount by the state's average monthly private-pay nursing-facility cost, the transfer penalty divisor. Georgia's DFCS Medicaid manual (PAMMS 2342, Transfer of Assets) directs caseworkers to divide the total uncompensated value of the transferred resource by the average Georgia private-pay rate in Appendix A1.4

The divisor. The figure published in the Appendix A1 chart is an averaging nursing home private pay billing rate of $11,122.00 per month, effective April 2026, in the current Appendix A1 edition dated July 2026. The chart stamps the rate with its effective date and Georgia posts each edition at its own address, so check the newest Appendix A1 for a newer figure before you calculate a specific penalty.4

Transfer penalty calculation:

• Penalty period (months) = transferred amount divided by the current monthly divisor.

To show the arithmetic: at the April 2026 rate of $11,122.00, a $60,000 gift inside the look-back would produce roughly 5.4 months of ineligibility ($60,000 divided by $11,122.00). Run the same division against the divisor in force when the case is decided. During the penalty period, Medicaid does not pay for long-term care even though the applicant otherwise meets eligibility criteria, so the family must pay privately.4

Georgia Exempt Assets

The following are generally exempt from countable resources:

1. Primary residence, in some cases. Georgia excludes the home of an applicant who is not institutionalized regardless of its value, but for a nursing-facility applicant its manual treats the home as a countable resource that is exempt only in certain instances, and it applies a yearly-updated excess home equity limit to long-term-care applicants. Ask DFCS how the home is treated in your case.12 The 2026 federal home equity limit starts at $752,000, and a state may elect to raise it as high as $1,130,000.2 When the applicant's spouse, the applicant's child under age 21, or the applicant's blind or permanently and totally disabled child of any age is lawfully residing in the home, the equity limit does not apply at all; it constrains only an applicant with no such relative living there.4 The sibling-with-an-equity-interest and caregiver-child situations listed under Section 1917(c) above are exceptions to the transfer penalty, a separate rule from how the home is counted as a resource.4
2. One vehicle of any value, used to transport the applicant or a household member.12
3. Personal property and household goods, such as furniture, appliances, clothing, and personal items.
4. Term life insurance that builds no cash surrender value. For nursing-home and EDWP applicants, a policy with a face value above $10,000 has its cash surrender value counted; one of $10,000 or less may be considered under the burial exclusion.
5. Burial plots designated for immediate family members.
6. An irrevocable burial contract, one per person.
7. A designated burial fund of up to $10,000 each for the applicant and spouse (nursing-home and EDWP applicants), reduced by the value of irrevocable burial contracts and excluded life and burial insurance.
8. Property essential to self-support, up to $6,000 of equity if it earns net income of at least 6% of that amount.7
9. Special needs trusts (d4A or d4C) that meet the federal conditions described above.4
10. Certain retirement funds (see below).

Georgia Treatment of Retirement Accounts

Georgia's manual treats retirement funds (pensions, IRAs, Keogh plans) this way:

• Countable if the owner can withdraw the fund as a lump sum.
• Excluded if the owner is eligible for and receives periodic payments that include a portion of the principal, or must leave a job to get any payment.
• A spouse's fund. The manual excludes a retirement fund owned by an ineligible spouse; ask DFCS how that applies to a community spouse in your case.7

Families with significant retirement balances should consult an elder law attorney.

Georgia Personal Needs Allowance

A Medicaid nursing-facility resident in Georgia keeps a personal needs allowance of $70 per month. Georgia's $70 exceeds the federal floor, which 42 CFR 435.725 sets at a minimum of $30 a month. A separate $90 PNA applies to a VA pensioner or surviving spouse in a nursing home who has no dependents, and it is not simply a larger allowance: that person's VA check is reduced to the amount of the PNA regardless of other income. A VA pensioner or surviving spouse who has dependents keeps the same $70. The remainder of the resident's income, after allowed deductions such as a community-spouse allowance and health-insurance premiums, goes toward the cost of care as patient liability.6

How Georgia Administers Eligibility

Georgia Medicaid eligibility is determined by the Georgia Division of Family and Children Services (DFCS), part of the Department of Human Services, while the Georgia Department of Community Health (DCH) administers the Medicaid program. Applications run through Georgia Gateway and DFCS offices. Caseworkers review applications, request documentation, calculate eligibility, and issue determinations; applicants have appeal rights if denied.

Georgia Medicaid Compliant Spend-Down Strategies

Strategy 1: Pay Off Debts

Paying existing debt is one of the most straightforward compliant strategies. The applicant can use countable assets to pay:

• A mortgage on the exempt primary residence (this converts countable cash into exempt home equity).
• Credit card balances.
• Auto loans (the vehicle stays exempt).
• Medical bills.
• Personal loans, including documented loans from family.
• Federal, state, or property taxes owed.

Georgia's manual lists an asset used to pay a valid debt among the transfers that carry no penalty.4

Strategy 2: Prepay Funeral and Burial Expenses

Prepaying funeral and burial costs converts substantial countable assets into exempt assets and delivers a real benefit to the family. You can prepay:

• Burial plots for immediate family members.
• A casket and funeral services through an irrevocable prepaid funeral contract.
• Transportation, embalming, and preparation included in the contract.
• A designated burial fund, within the $10,000 burial exclusion for nursing-home and EDWP applicants.7

A common plan prepays a funeral and burial package through an irrevocable burial contract, converting countable cash to exempt value without a transfer penalty.

Strategy 3: Home Modifications and Repairs

Where the home is exempt (see Georgia Exempt Assets above), spending on it moves countable cash into exempt value:

• Roof repair or replacement.
• HVAC replacement.
• Accessibility work: ramps, grab bars, a walk-in shower, a stairlift, widened doorways.
• Kitchen and bathroom renovations.
• New appliances and general maintenance.

These are not transfers; the applicant keeps the modified property. For couples, the work raises the value of the exempt home the community spouse retains.

Strategy 4: Vehicle Replacement or Repair

One vehicle of any value is excluded when it is used to transport the applicant or a household member.12 The applicant can trade up to a newer vehicle, invest in repairs, or add accessibility equipment such as a wheelchair lift or hand controls, converting countable cash to exempt value.

Strategy 5: Personal Property and Household Goods

Reasonable purchases of furniture, appliances, electronics, clothing, and uncovered medical equipment convert countable cash to exempt personal property. Keep the purchases reasonable and keep the receipts.

Strategy 6: Spousal-Impoverishment Strategies

For married applicants, spousal-impoverishment protections are powerful:5

Maximize the CSRA. Position assets so the community spouse retains the largest allowable share. Georgia's 2026 resource chart lists $164,660 ($162,660 plus $2,000) for an applicant with a community spouse, and a fair hearing or court order can set the allowance higher, so ask DFCS how it applies to your case before you move anything.5,1

Understand the snapshot. Federal law computes a spousal share of half the couple's resources at the snapshot date, and in some states that share sets the allowance. Georgia's chart lists the $162,660 maximum standard for a spouse at home, so ask DFCS whether the snapshot changes anything in your case.9,1

Shift income. The MMNA can route income from the institutionalized spouse to the community spouse, preserving more household income.

Transfer the CSRA to the community spouse. Federal law lets the institutionalized spouse transfer the CSRA to the community spouse without a transfer penalty, as soon as practicable after eligibility is first determined. After that month, the community spouse's resources are not counted toward the institutionalized spouse.9

Community-spouse annuity. An annuity bought by either spouse must pass the federal tests described under Section 1917(e) above, so have an attorney design it.4

Strategy 7: Qualified Income Trusts (Miller Trusts)

For an applicant whose own gross income is at or above Georgia's Individual Medicaid CAP ($2,982 a month in 2026; the $5,964 couple cap is used only when both spouses are Medicaid applicants living together in long-term care and the individual cap would leave one of them ineligible):1,3

1. Establish the trust in Georgia through a written, irrevocable document. It takes effect in the month everyone required signs it and cannot be backdated, so complete it no later than the first month you need coverage.3
2. Each month, deposit income above the cap, typically by directing Social Security and pension income into the trust account.
3. The trustee makes the monthly payments out of the trust under its terms and state law.
4. The state receives what remains at death, up to what Medicaid paid.10,3

A Miller Trust does not reduce resources, but it is essential for income-above-cap applicants. See our Georgia Miller Trust guide.

Strategy 8: Half-a-Loaf Strategies

Half-a-loaf strategies are used in crisis situations, when the family has not planned years ahead:

Annuity-based. Transfer part of the assets (creating a penalty period), then use the rest to buy a Medicaid-compliant annuity whose income covers the penalty months. After the penalty ends, the applicant qualifies, and the family keeps the transferred amount.

Promissory-note-based. The same idea using a promissory note, which federal law tests under its own conditions.

These are complex and Georgia-specific; an error can lengthen the penalty or cause a denial. Use an elder law attorney.

Strategy 9: Personal Care Contracts

A personal care contract (caregiver agreement) lets the applicant pay a relative for care. Georgia's DFCS manual (section 2349) says the payments may be treated as an uncompensated transfer unless the contract meets all of its conditions, which include:

• Executed before the services are provided.
• In writing, signed and dated by each party, and notarized.
• Specifies the type, frequency, and number of hours of each service.
• Services provided at market rate.
• Payment made when the services are rendered or within 30 days.
• The caregiver is not the applicant's spouse or parent. An adult child, sibling, or other relative may be paid.

A valid contract still has to show real value: DFCS measures the pay against open-market rates for the services actually provided, and care a relative would normally give out of love and affection does not count. Because the contract must come before the services and pay as they are rendered, it is not a way to pay for care already given or to prepay a lump sum for care to come. It also ends when the applicant dies or enters a nursing facility, so it fits the years of care at home. Keep time logs, care notes, and payment records, and have an elder law attorney draft it.4

Strategy 10: Special Needs Trusts

For a disabled individual under 65, a first-party special needs trust (d4A) holds the individual's own assets outside the Medicaid trust-counting rules, which protects a lawsuit settlement, inheritance, or gift from disqualifying the beneficiary; the state receives what remains at death up to the total Medicaid paid.4 A pooled trust (d4C) works similarly but is managed by a nonprofit, and at death it repays the state to the extent it does not keep the remaining funds.4

Strategy 11: Life Estate Deeds

A life estate deed transfers ownership of property, usually the home, to a remainder beneficiary while the applicant keeps the right to live there for life. Giving away the remainder interest is a transfer, so it can fall inside the look-back.2 Georgia's estate-recovery rule uses an expanded estate definition that reaches property passing by life estate, so the deed does not by itself put the home beyond recovery; use an attorney.13

Strategy 12: Caregiver Child Exemption

Transfer of the home to a caregiver child is exempt from the transfer penalty if the child lived in the home with the parent for at least 2 years immediately before institutionalization and, as determined by the State, provided care that permitted the parent to stay at home rather than in an institution. The State makes that determination, so the exemption is not automatic.4 Document it with affidavits, medical records, and care logs.

Strategy 13: Disabled Child Exemption

Transfers to a disabled child of any age, or to a trust established for the sole benefit of a disabled child, are exempt from penalty. The disabled child need not live with the parent.4

Strategy 14: Spousal Transfers

Transfers to the community spouse, or to another person for the spouse's sole benefit, are exempt from penalty, so couples can move assets toward the community spouse before applying.4

Non-Compliant Georgia Medicaid Spend-Down Strategies to Avoid

Do not use these without an elder law attorney. They can trigger penalties, denials, or fraud exposure.

Direct Gifts to Family Members

Giving cash or assets to relatives is a transfer for less than fair market value. A gift inside the 60-month look-back creates a penalty period equal to the gift amount divided by Georgia's penalty divisor, and the family must pay privately for the entire period.2

Transfers to Revocable Trusts

Assets in a revocable trust stay countable; the trust does not protect them.4

Transfers to Improperly Structured Irrevocable Trusts

An irrevocable trust can trigger a penalty unless properly structured (for example, a special needs trust, or a Medicaid Asset Protection Trust funded more than 60 months before application).4

Hiding Assets

Leaving assets off the application is not a spend-down strategy, and it puts both the application and the family at legal risk. Disclose honestly.

Selling Assets Below Market Value

A below-market sale is a transfer; the gap between fair market value and the sale price is the penalized amount.

Annuities That Fail Section 1917(e)

An annuity that does not name the state as remainder beneficiary, or is not actuarially sound, irrevocable, non-assignable, and paid in equal installments, can be treated as a transfer for less than fair market value, which triggers a penalty.4

Improper Trust Distributions

Payments from an irrevocable trust the applicant funded, made to family members or for any purpose other than the applicant, are treated as transfers.4

The Role of Elder Law Attorneys

Spend-down is too complex for most families to handle alone, and the cost of an error is severe. An elder law attorney can:

• Analyze the family's full picture: assets, income, debts, relationships, and goals.
• Identify the compliant strategies that fit.
• Calculate the optimal CSRA, MMNA, and related numbers.5
• Draft and execute the documents: Medicaid Asset Protection Trusts, special needs trusts, Qualified Income Trusts, personal care contracts, life estate deeds, and annuity or promissory-note arrangements.
• Coordinate transfer timing and the application itself, including documentation and DFCS interactions.
• Represent the family in any dispute or appeal.

To find an attorney: the State Bar of Georgia, which cannot refer an attorney itself but publishes a list of local bar associations, many of which offer referral services; and the Georgia Legal Services Program, which gives free civil legal help in the 154 counties outside metro Atlanta and asks people to apply to learn whether they are eligible.14,15

Worked Examples

These examples show compliant spend-down across common Georgia situations. The names and circumstances are illustrative; the limits each family plans against (the $2,000 asset limit, the income cap discussed above, and the CSRA) are the real 2026 figures.1

Margaret, 78, Savannah: a widow who must spend down savings

Margaret is widowed, lives in her own Savannah home, and was recently diagnosed with moderate Alzheimer's disease; her physician expects nursing-facility placement within six months. Her home and one vehicle are exempt, but her savings put her over the $2,000 asset limit, while her Social Security and small pension stay below the income cap, so she needs no Miller Trust. With an elder law attorney she spends the excess on compliant categories only: paying off credit card debt, a new roof and HVAC system, a walk-in-shower accessibility renovation, an irrevocable burial contract, burial plots, and replacement appliances. Each item either pays a real debt or converts countable cash into an exempt asset, so she applies months later and is approved with no transfer penalty.1

Henry, 75, and Linda, 72, Atlanta: a couple protecting the community spouse

Henry needs care for advancing Parkinson's disease and Linda is his community spouse. Their home and one vehicle are exempt; the rest sits in savings and certificates of deposit. When Henry enters a facility, the snapshot fixes Linda's Community Spouse Resource Allowance. Georgia's 2026 resource chart lists $164,660 ($162,660 plus $2,000) for an applicant with a spouse at home, so the couple plans against that figure rather than Henry's bare $2,000.5,1

They spend Henry's share on compliant categories: moving his older car's value to Linda as an exempt spousal transfer, paying off a family auto loan, accessibility and home modifications, roof and HVAC work, a kitchen renovation, and irrevocable burial contracts and burial plots for both. Afterward the couple's countable resources fit within Georgia's limit for an applicant with a community spouse. If Linda's own income falls below her monthly maintenance allowance (between $2,705.00 and $4,066.50 in 2026), part of Henry's income shifts to her; the rest of his income, after his $70 personal needs allowance, becomes his patient liability.5,6,1

Robert, 65, Macon: a recent gift caught inside the look-back

Robert was diagnosed with stage-4 cancer and expects to need nursing care within months. His home and vehicle are exempt, his savings exceed the $2,000 limit, and his income runs above the cap, so he needs a Miller Trust. The problem is the gift he made to his daughter half a year ago, not knowing about the look-back: it sits inside the 60 months and creates a penalty equal to the gift amount divided by Georgia's penalty divisor, a stretch when Medicaid will not pay for his care that starts when he enters the facility and otherwise qualifies.1,2

His plan, with an attorney, is to spend his remaining savings down to the $2,000 limit on compliant categories, establish a Qualified Income Trust for the income above the cap, and decide whether his daughter returns the gift (a return of all the transferred assets is one of the grounds on which a penalty is excused) or the family absorbs the private-pay cost. Had he seen an attorney first, that money could have reached his daughter another way, such as a personal care contract, without a penalty.2,1

Sarah, 62, Athens: protecting an inheritance with a special needs trust

Sarah has multiple sclerosis, lives in subsidized housing, and receives SSI and Medicaid. An inheritance from her mother would push her over the $2,000 asset limit and end her eligibility if taken directly. Instead, her attorney directs the inheritance into a first-party special needs trust (d4A): the trust must be for Sarah's sole benefit, and at her death the remainder repays Medicaid up to what it spent. Sarah keeps Medicaid, and the trust funds quality-of-life needs over time. A nonprofit-run pooled trust (d4C) is an alternative.1,4

David, 80, Augusta: a personal care contract with a caregiving daughter

David is widowed and in failing health, and his daughter Karen is moving home to care for him. His home and vehicle are exempt, but his savings exceed the $2,000 limit and his income runs above the cap. His plan combines accessibility home modifications, roof and HVAC work, an irrevocable burial contract and burial plots, replacement household goods, and a personal care contract that pays Karen a reasonable Augusta-area rate for documented care. The contract must be carefully drafted with real records, because an improper one triggers a penalty. He also establishes a Qualified Income Trust for the income above the cap. Years later, when he needs nursing care, every step proves compliant and he qualifies with no transfer penalty.1

Frances, 85, Columbus: the caregiver-child exemption

Frances has been cared for by her son for three years; he moved into her Columbus home and provides daily care. Her savings exceed the $2,000 limit. Her situation opens several options: the caregiver-child exemption may let her transfer the home to her son without penalty, because he has lived there providing care for at least 2 years that delayed institutionalization; a personal care contract can compensate his future care; and she can spend her savings down to the $2,000 limit on compliant categories such as debt, an irrevocable burial contract, burial plots, and accessibility work. When she applies, she documents the caregiver-child exemption and the personal care contract. Estate recovery is a separate process that runs at death, and its caregiver-child rule is a different test from the transfer exemption above. Under federal law that rule covers a home on which the state placed a lien during a permanent nursing-facility stay, and it restricts when the state may recover rather than protecting the home permanently: adjustment or recovery may be made only at a time when no son or daughter who resided in the home for at least two years immediately before the parent's admission to the medical institution, and who establishes to the satisfaction of the State that he or she provided care permitting the parent to reside at home, is lawfully residing there, having lived there continuously since that admission. So that protection holds only while her son goes on lawfully living in the home. If he moves out, the home is still not automatically exposed: recovery also waits while a spouse survives or a child under 21 or a blind or disabled child survives, and every state must offer an undue-hardship waiver.4 Georgia also waives any claim against the first $25,000 of an estate for deaths on or after July 1, 2018, and lets the personal representative or any heir ask for a hardship waiver above that.13 See our Georgia estate recovery guide.1,4

Key Steps Before You Spend Down

Spend-down is one of the most consequential moves a Georgia family makes in long-term care planning. The right approach preserves Medicaid eligibility while protecting family resources; the wrong one leaves the family paying full private-pay rates for months. Three steps matter most:

Brevy helps Georgia families understand spend-down. Brevy does not provide legal, tax, or financial advice. For your situation, consult an elder law attorney licensed in Georgia and other qualified professionals.

Get Help With Georgia Medicaid Asset Spend-Down

If you are facing Medicaid long-term care eligibility and need to spend down assets, these resources can help.

Find personalized help navigating Georgia Medicaid spend-down at brevy.com.

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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.