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What nursing home care is covered by Medicaid in Georgia?

As residents of Georgia age, they often worry about how they will receive medical and nursing care if they are unable to care for themselves. One of the most important government programs that addresses these questions is Medicaid, a federal aid program that is administered to Georgia residents by the state Department of Community Health.

In determining the availability of nursing home care provided by Medicaid, a person must first determine if they qualify based upon their income and net assets. The state sets the limits for eligibility, and these limits change frequently. In 2017, the maximum monthly income limit was $735 for an individual and $1,103 per couple. Resources were capped at $2,000 per individual and $3,000 per couple. Various legal arrangements, such as an Irrevocable Income Trust and other income shifting devices, may assist in meeting the eligibility requirements, but no one should draft a trust without first consulting an attorney experienced in such matters.

An applicant must also demonstrate that they have a medical condition that satisfies the Medicaid requirements. Medicaid has three groups of conditions that determine medical eligibility. To qualify, a person must have one symptom listed in category A and at least one symptom listed in either Category B or C. The chart is too lengthy to be easily summarized here, but Category A includes symptoms, such as nutritional management and catheter care. Category B, which relates to mental status, includes memory deficiency and behavioral problems. Category C includes limited ability to move around and needing assistance with eating.

The requirements for qualifying for nursing home care under Medicaid are strictly enforced. Anyone who is considering nursing home care for themselves or a loved one may wish to consult an attorney experienced in handling Nursing Home/Medicaid disputes.

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