Georgia Medicaid pays for long-term care in nursing homes and, through five HCBS waivers and the PACE program, in a person's own home or an assisted living community. It covers care that lasts longer than a short hospital or rehabilitation stay, for people who meet both a level-of-care and a financial test. The Georgia framework is built on five HCBS waivers plus traditional nursing facility coverage, the federal 300 percent SSI Special Income Limit (with the Miller Trust workaround), the spousal impoverishment protections that prevent at-home spouses from becoming destitute, and a separate intake pathway for each waiver.

This guide explains how each piece fits together, how level-of-care determination works for institutional Medicaid versus the HCBS waivers, the financial-eligibility framework you must meet regardless of setting, how to apply for each program through the right intake door, what waiver waitlists look like in 2026, how patient liability and waiver cost share work, what Medicaid covers and excludes, the Structured Family Caregiving option that allows relatives to be paid caregivers, and how to choose between settings.

The 60-Second Version

Federal and Georgia Authority

The LTC framework is layered: federal statute creates the categories, state plan and waiver applications operationalize.

Federal Authority

  • 42 USC 1396a(a)(10)(A) (mandatory and optional Medicaid groups)
  • 42 USC 1396a(a)(10)(A)(ii)(V) (300 percent SSI Special Income Limit for institutional)
  • 42 USC 1396n(c) (Section 1915(c) HCBS waivers; framework for CCSP, ICWP, NOW, COMP)
  • 42 USC 1396n(b) (Section 1915(b) managed care waivers; framework for SOURCE overlay)
  • 42 USC 1396r (Nursing Facility requirements, including PASRR at 42 USC 1396r(e)(7))
  • 42 USC 1395eee and 42 USC 1396u-4 (PACE; federal framework for Georgia PACE programs in development)
  • 42 USC 1396p(d)(4)(B) (Miller Trust)
  • 42 USC 1396r-5 (spousal impoverishment)
  • 42 CFR Part 441 Subpart G (HCBS waiver regulations)

Georgia Authority

  • O.C.G.A. Title 49 Chapter 4 (Public Assistance, including Medicaid administration)
  • DCH Medicaid Policy Manuals (operational procedures for each LTC program)
  • CCSP Provider Manual (DCH and DHS Division of Aging Services)
  • SOURCE Provider Manual
  • ICWP Provider Manual
  • NOW and COMP Provider Manuals (DBHDD)
  • PASRR Operational Manual (DCH)

Nursing Facility Medicaid

What nursing facility Medicaid is

Long-term institutional care in a Medicaid-certified nursing facility (NF). Georgia has roughly 350 Medicaid-certified facilities statewide. The state pays the facility's daily rate (varies by facility and case-mix) for room, board, nursing care, therapy, medications, and most personal care needs.

Nursing facility eligibility

  • Functional: NF level of care, determined through PASRR screening at admission and ongoing through the Minimum Data Set (MDS) assessment.
  • Financial: Special Income Limit $2,982 in 2026 (with Miller Trust above), asset limit $2,000 single, full spousal impoverishment for married applicants, 60-month lookback, $752,000 home equity limit.

Patient Liability

NF residents contribute all of their income to the cost of care, except:

  • $70 Personal Needs Allowance
  • Medicare Part B premium ($202.90 in 2026)
  • Medicare Part D premium
  • Medigap premium
  • Health insurance premiums other than Medicare
  • CSMIA to community spouse (if applicable)
  • Family allowance for dependent family members (if applicable)
  • Trust administrative fees (if Miller Trust is used)

The remainder is the patient liability, paid to the facility each month. Medicaid pays the facility's daily rate minus the patient liability.

What NF Coverage Includes

  • Room and board in a semi-private room
  • Skilled nursing care 24 hours/day
  • Personal care services (bathing, dressing, toileting, eating, mobility)
  • Medication administration
  • Routine medical services
  • Restorative therapy services
  • Social services
  • Activities programming
  • Three meals per day plus snacks
  • Laundry and linen service

What NF Coverage Excludes

  • Private room (unless medically necessary)
  • Personal services beyond the standard care plan (private duty nursing, hairdressing, cable TV, personal phone)
  • Items paid through the $70 PNA (clothing, personal hygiene, snacks beyond facility meals)
  • Specialized therapies not in the care plan
  • Outside medical care not authorized

PASRR

Pre-Admission Screening and Resident Review under 42 USC 1396r(e)(7) is required for every NF admission to identify residents with serious mental illness or intellectual/developmental disabilities who might be better served in a non-institutional setting. PASRR Level I screens at admission; Level II is required when Level I identifies concerns. PASRR can result in admission denial or required specialized services within the facility.

Community Care Services Program (CCSP)

What CCSP is

CCSP is Georgia's largest Section 1915(c) HCBS waiver, serving older adults (typically 60+) and adults with physical disabilities who meet NF level of care but want to remain at home or in an assisted living community. It is administered by the DHS Division of Aging Services in coordination with DCH.

CCSP services covered

  • Adult day health
  • Alternative living services (small group homes)
  • Emergency response services
  • Home delivered meals
  • Home-delivered services
  • Out-of-home respite
  • Personal support services (PSS)
  • Skilled nursing services
  • Structured Family Caregiving (SFC, paying a live-in family caregiver)

CCSP intake

  • Empowerline (Area Agency on Aging): 1-404-463-3333
  • The AAA conducts a functional assessment, determines NF level of care, and develops a care plan
  • Medicaid eligibility is then determined through DFCS

CCSP waitlist

CCSP has a waitlist in most counties. As of 2026, waits range from several months (small rural counties) to multiple years (high-demand metro counties). Crisis priority (immediate risk of NF placement) jumps the line.

CCSP cost share

CCSP cost share is calculated individually based on income, the cost of the care plan, and the maintenance allowance. Most CCSP participants pay a modest monthly cost share or none.

Service Options Using Resources in a Community Environment (SOURCE)

What SOURCE is

SOURCE is an integrated primary care + HCBS waiver, structured as a 1915(c) waiver with a 1915(b) managed-care overlay. A SOURCE primary care physician (PCP) coordinates both medical care and long-term services. SOURCE participants must enroll with an approved SOURCE site (a physician group or community-based organization).

SOURCE services covered

Same as CCSP plus:

SOURCE intake

  • Empowerline: 1-404-463-3333
  • SOURCE site selection (geographic and clinical)
  • Functional assessment by AAA
  • Care coordination by SOURCE site

SOURCE waitlist

SOURCE generally has shorter waits than CCSP because it operates within existing managed-care capacity. Some counties have minimal or no wait.

SOURCE cost share

Similar to CCSP. Calculated per care plan.

Independent Care Waiver Program (ICWP)

What ICWP is

ICWP serves working-age adults (21 to 64) with severe physical disabilities or traumatic brain injury who would otherwise require institutional care. Limited statewide capacity; smaller than CCSP and SOURCE.

ICWP services covered

  • Personal support services
  • Skilled nursing
  • Respite care
  • Adult day health
  • Counseling
  • Specialized medical equipment

ICWP intake

  • DCH direct: 1-866-211-0950
  • Functional assessment for ICWP eligibility (severe physical disability or TBI requiring NF or hospital level of care)

ICWP waitlist

ICWP has limited slot capacity. Wait times vary. Crisis priority applies.

ICWP cost share

Calculated per care plan; typically small.

New Options Waiver (NOW) and Comprehensive Supports Waiver Program (COMP)

What They Are

NOW and COMP are the two Section 1915(c) waivers for individuals with intellectual and developmental disabilities (IDD). Both are administered by the Department of Behavioral Health and Developmental Disabilities (DBHDD).

  • NOW is lower-intensity, designed for individuals living with family or in less supervised settings.
  • COMP is higher-intensity, designed for individuals needing 24-hour residential support.

NOW and COMP services covered

  • Community living supports
  • Community access (group)
  • Community access (individual)
  • Behavior supports
  • Specialized medical supplies
  • Specialized medical equipment
  • Skilled nursing
  • Speech, occupational, and physical therapy
  • Transportation
  • Vehicle adaptation
  • Environmental accessibility adaptations
  • Residential supports (COMP)
  • Respite (both)

NOW and COMP eligibility

  • ICF/IID level of care (Intermediate Care Facility for Individuals with Intellectual Disabilities)
  • Diagnosis before age 22 of intellectual or developmental disability
  • DBHDD assessment

NOW and COMP intake

  • DBHDD: 1-800-436-7442
  • Regional field offices conduct assessment
  • Slot assignment based on category of need

NOW and COMP waitlist

Both NOW and COMP have substantial waitlists in 2026. DBHDD prioritizes slot allocation based on category of need (crisis, urgent, planning).

PACE (Programs of All-Inclusive Care for the Elderly)

What PACE is

PACE provides comprehensive medical and social services to participants age 55+ who meet NF level of care and live in a PACE service area. PACE is dually paid by Medicare and Medicaid for dual-eligible participants. Services are delivered through a PACE center and through home and community-based providers.

Georgia status: As of May 2026, PACE in Georgia is in a pre-launch phase and not yet operational at scale. Contact the National PACE Association for current enrollment status.

Georgia PACE Status (2026)

As of May 2026, Senior CommUnity Care InnovAge (Atlanta region) and TriHealth PACE (selected counties) are in development and not yet accepting general enrollment. Contact npaonline.org to track when enrollment opens.

PACE services covered

All Medicare and Medicaid covered services delivered through the PACE interdisciplinary team, including:

  • Primary care
  • Specialty care
  • Hospital and emergency care
  • Nursing facility care (if needed temporarily)
  • Adult day health
  • Home health
  • Personal care
  • Transportation to and from medical appointments and PACE center
  • Meals
  • Social services
  • Recreational and rehabilitative activities

PACE eligibility

  • 55 or older
  • NF level of care
  • Live in PACE service area
  • Medically eligible for community living through PACE

PACE cost

For dual-eligible (Medicare + Medicaid) participants, no premium or copay. For Medicare-only participants, there is a premium (rare for PACE applicants).

Structured Family Caregiving (SFC)

What SFC is

SFC is a service within CCSP and SOURCE that allows a family member (or other approved caregiver) to live with the Medicaid recipient as a paid live-in caregiver. The family caregiver receives a monthly stipend from an approved SFC provider organization.

Who Can Be Paid

  • Adult children (over 18)
  • Grandchildren
  • Siblings
  • Other relatives
  • Family friends (under some agency policies)
  • Spouses (limited; varies by SFC provider and DCH approval)

How It Works

  1. The Medicaid recipient enrolls in CCSP or SOURCE
  2. The recipient and family member choose an SFC provider organization
  3. The SFC provider conducts a home assessment
  4. A care plan is developed
  5. The family caregiver receives a daily or monthly stipend from the SFC provider
  6. The SFC provider provides care coordination, training, and oversight

Stipend

Typical SFC stipends range from $1,987 to $2,400 per month depending on the recipient's care needs and provider organization rates. The stipend is taxable income to the caregiver.

How to Choose the Right Setting

When NF Is Right

  • Care needs are 24/7 and complex (significant skilled nursing, complex medication management)
  • Behavioral or cognitive needs cannot be safely managed at home
  • No family caregiver available
  • Spouse cannot serve as caregiver due to age, health, or geographic distance

When HCBS Waiver Is Right

  • Care needs can be safely met at home or in a small group setting with daily personal care
  • A family caregiver is available (full or part time)
  • Recipient prefers to remain in their own community
  • Recipient is eligible for SFC, allowing a family member to be the paid caregiver

When PACE Is Right

  • Recipient is dually eligible for Medicare and Medicaid
  • Lives in a PACE service area
  • Wants integrated primary care and long-term services through a single organization
  • Comfortable with adult day health attendance and PACE center model

When NOW or COMP Is Right

  • Recipient has intellectual or developmental disability
  • Diagnosed before age 22
  • Meets ICF/IID level of care
  • Family or community-based residential supports are appropriate

Patient Liability and Cost Share Math

NF Example

Mr. Foster, single, NF resident:

  • Gross income: $2,800/month (Social Security $1,800 + small pension $1,000)
  • $2,800 < $2,982 SIL, so no Miller Trust needed
  • Patient liability:
    • $2,800 gross income
    • minus $70 PNA
    • minus $202.90 Medicare Part B premium
    • minus $145 Medigap premium
    • minus $50 Medicare Part D premium
    • $2,332.10 patient liability paid to NF

Medicaid pays the facility's per-diem rate minus $2,332.10.

CCSP Example

Ms. Green, single, CCSP at home:

  • Gross income: $1,600/month (Social Security only)
  • Maintenance allowance (varies by DCH calculation, illustrative): ~$1,400/month for community living expenses
  • Health insurance: $202.90 + $50 = $252.90
  • Cost share: ~$0 to $50 depending on care plan cost

CCSP pays for adult day health, personal support services, home-delivered meals, etc.

PACE Example (Projected)

If Mr. Hill, dual-eligible (Medicare + Medicaid), were to enroll in a PACE program once a Georgia site opens:

  • No PACE premium
  • No copay for any covered service
  • All medical and LTC needs covered through PACE
  • Patient liability: $0 for PACE; Medicaid pays its capitation rate to PACE

How to Verify the Numbers

  • NF rates and Medicaid certification: DCH Healthcare Facility Regulation Division (dch.georgia.gov)
  • CCSP, SOURCE, ICWP, NOW, COMP provider manuals: dch.georgia.gov
  • DBHDD slot allocation and waitlist: dbhdd.georgia.gov
  • PACE service areas: npaonline.org (National PACE Association)
  • SFC provider list: request from local Empowerline AAA or SOURCE site

For free legal help on a Georgia LTC Medicaid case, contact Georgia Legal Services Program at 1-833-457-7529, Atlanta Legal Aid at 1-404-524-5811, or the Georgia Senior Legal Hotline at 1-888-257-9519. For more on the financial-eligibility framework see brevy.com's guides at /medicaid/georgia/eligibility-income-limits and /medicaid/georgia/miller-trust.

Frequently Asked Questions

Georgia Medicaid Long-Term Care FAQ

No. Georgia has five HCBS waivers (CCSP, SOURCE, ICWP, NOW, COMP) plus PACE that deliver long-term care in the home or community for people who meet a nursing facility level of care or, for NOW and COMP, an ICF/IID level of care. NF coverage is the institutional option; HCBS is the community option.

CCSP is a traditional 1915(c) HCBS waiver: you have a CCSP care coordinator and receive HCBS services with your own primary care doctor. SOURCE adds an integrated primary care layer: your primary care physician at the SOURCE site coordinates both your medical care and your HCBS services. SOURCE is structured as a 1915(c) waiver with a 1915(b) managed-care overlay. SOURCE generally has shorter waitlists.

Yes. The primary residence is an exempt asset for Medicaid eligibility purposes, subject to the federal home equity limit ($752,000 in 2026; flat $1,000,000 from 1/1/2028 under Pub. L. 119-21). The home is not counted against your $2,000 asset limit. Estate recovery under O.C.G.A. 49-4-147.1 may apply to the home after your death, but only if it passes through probate. See our Estate Recovery guide for details.

Your Social Security continues to be paid to you, but as an NF Medicaid recipient you must contribute most of it to the cost of care. You keep a $70 Personal Needs Allowance plus your health insurance premiums plus any community spouse allowance plus family allowance. The remainder is your patient liability, paid to the facility.

Application processing typically takes 45 days for non-disability Medicaid and 90 days for disability-based, but waitlists for CCSP, NOW, and COMP can extend the actual start of services by months to years. SOURCE waits are generally shorter. PACE enrollment is based on annual open enrollment plus eligibility verification.

Yes, subject to spousal impoverishment limits. The primary residence is exempt while the community spouse lives there. Of countable assets, the community spouse keeps up to $162,660 (2026 CSRA maximum) or a minimum of $32,532, depending on snapshot-date assets. The institutionalized spouse keeps $2,000. See our Spousal Impoverishment guide.

Yes, through Structured Family Caregiving under CCSP or SOURCE. The SFC stipend ranges from $1,987 to $2,400 per month depending on care needs and the SFC provider. Spouses are generally not eligible to be paid caregivers, but adult children, grandchildren, siblings, and other relatives often qualify.

You can still qualify for LTC Medicaid through a Miller Trust (Qualified Income Trust under 42 USC 1396p(d)(4)(B)). The trust is irrevocable, names the State of Georgia as primary residual beneficiary, and channels your income through a dedicated trust account each month. See our Miller Trust guide for the operational mechanics.

NF patient liability is calculated by subtracting allowances (PNA, premiums, CSMIA, family allowance) from gross income; the remainder is paid to the facility. HCBS waiver cost share is calculated based on the cost of the care plan and the participant's maintenance allowance (which is larger than the PNA because community living requires rent, utilities, food). NF patients pay much more out of their income than waiver participants.

For an older adult (60+), start with Empowerline at 1-404-463-3333 (the statewide AAA hotline). The AAA conducts an initial assessment and routes to CCSP, SOURCE, PACE, or NF as appropriate. For working-age adults with disabilities, contact DCH for ICWP at 1-866-211-0950. For individuals with intellectual or developmental disabilities, contact DBHDD at 1-800-436-7442 for NOW or COMP intake. For free legal help with eligibility and application, contact Georgia Legal Services Program at 1-833-457-7529.

Key Phone Numbers and Resources

Georgia Medicaid (DCH)

  • Member Services: 1-866-211-0950
  • DFCS Application Hotline: 1-877-423-4746

Empowerline (Area Agencies on Aging, CCSP/SOURCE/PACE intake)

  • 1-404-463-3333

Department of Behavioral Health and Developmental Disabilities (DBHDD, NOW/COMP intake)

  • 1-800-436-7442

Office of State Administrative Hearings (OSAH)

  • 1-404-651-7500

Long-Term Care Ombudsman

  • 1-866-552-4464 (Empowerline)

Adult Protective Services

  • 1-866-552-4464

Free Legal Help

  • Georgia Legal Services Program: 1-833-457-7529
  • Atlanta Legal Aid: 1-404-524-5811
  • Georgia Senior Legal Hotline: 1-888-257-9519

Elder Law Attorney Referrals

  • State Bar of Georgia Lawyer Referral: 1-800-330-0446
  • NAELA Georgia Chapter: naela.org

Medicare Counseling (GeorgiaCares / SHIP)

  • 1-866-552-4464

PACE Programs (pre-launch in Georgia as of May 2026; contact for enrollment interest)

Learn More

Find personalized help navigating Georgia Medicaid long-term care 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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Brevy Care Team

Expert eldercare guidance from Brevy's team of healthcare professionals and researchers.