You Pay the Full Cost Until Your Assets Are Gone
Georgia Medicaid requires you to spend your countable assets down to $2,000 before the state pays a dollar for nursing home care. There is no exception for homeowners, no exception for people who never expected to need Medicaid, and no grace period.
At Georgia’s 2025 median price of $9,429 a month for a private nursing home room (CareScout), the math is brutal:
- $50,000 in savings: gone in about 5 months
- $100,000 in savings: gone in about 11 months
- $250,000 in savings: gone in about 27 months, roughly 2 years and 3 months
Only then does Medicaid step in. The home is exempt while you are applying. It does not count toward the $2,000 limit, but it becomes a recovery target after death. See How Much Does Medicaid Planning Cost in Georgia? for what advance planning would have cost by comparison.
What the Spend-Down Looks Like in Practice
Countable assets, the ones that must be spent down, include: savings accounts, checking accounts, CDs, stocks, bonds, mutual funds, IRAs and 401(k)s (unless you are getting regular payments from the account that include part of the principal, in which case those payments count as income instead), second homes, and second vehicles.
Exempt assets, the ones Medicaid does not count, include: your primary residence (while you or your spouse lives there), one vehicle, household goods, personal belongings, a prepaid funeral plan up to a reasonable amount, and a wedding or engagement ring.
The exemptions sound generous. They are not a protection plan. The home is exempt only while you are alive and applying. After you die, the exemption ends. Georgia’s estate recovery program can then file a claim against the home’s value.
For a full list of what Medicaid counts and what it does not, see What Assets Are Protected from Medicaid in Georgia?
After You Qualify: You Keep $70 a Month
Once Medicaid starts paying for nursing home care, your monthly income situation changes completely. Georgia Medicaid requires you to contribute almost all of your monthly income, Social Security, pension, annuity payments, everything, directly to the nursing home as your “patient pay amount.”
You keep $70 per month. That is the personal needs allowance Georgia allows Medicaid nursing home recipients to keep for haircuts, toiletries, phone calls, and other personal expenses.
If your monthly income exceeds Georgia’s Medicaid income limit of $2,982 per month in 2026, you are not automatically disqualified, but you must place the excess into a Qualified Income Trust each month before it counts against you. Without a QIT, that income disqualifies you from coverage entirely.
After You Die — Georgia’s Estate Recovery Program
Georgia participates in Medicaid estate recovery under O.C.G.A. § 49-4-147.1. After a Medicaid recipient dies, the state can file a claim against the estate for what Medicaid paid during the nursing home stay.
Georgia does not limit recovery to what goes through probate. Under Georgia’s estate recovery rule, your estate includes property that passes by joint tenancy, survivorship, life estate, trust, annuity, IRA, or any other arrangement. So payable-on-death accounts, joint tenancy property, TOD deeds, and assets in a funded revocable trust are not reliably outside the state’s reach. No Georgia court has decided how far this rule can be enforced, so no one can promise these assets are safe.
The home is usually the biggest asset in the estate. Without advance planning, the state can file its claim against it. Georgia waives its claim against the first $25,000 of any estate. Any amount over that can still be claimed, up to what Medicaid actually paid.
The strongest tool against both the spend-down AND estate recovery is a Medicaid Asset Protection Trust established at least 60 months before applying. Its strength does not come from skipping probate. It comes from giving up ownership. Once assets are in the trust and you keep no right to the principal, you no longer own them, and federal Medicaid law (42 U.S.C. § 1396p) lets a state claim only assets you still had a legal title or interest in when you died. So trust assets are generally outside what Georgia can claim. But Georgia’s rules do mention trusts, any income you keep from the trust may still count, and no Georgia court has settled the question. No trust is a guarantee. For details on how to protect your home specifically, see How to Protect Your Home from Medicaid Estate Recovery in Georgia.
If You Made Gifts in the Last 5 Years
Georgia Medicaid reviews all asset transfers made in the 60 months before you apply, the look-back period. If you gave money to your children, transferred property to a family member, or put assets into any trust within that window, Medicaid treats those transfers as disqualifying unless you received fair market value in return.
The penalty is calculated by dividing the total uncompensated transfer amount by Georgia’s penalty divisor, $11,122 per month as of April 2026 (set annually by the Georgia Department of Community Health based on average private-pay nursing home rates). During the penalty period, Medicaid does not pay for care. Your family must fund nursing home costs privately while the penalty runs.
Example: You gave $100,000 to your children two years before applying for Medicaid. Penalty period = $100,000 ÷ $11,122 = 8.99 months of ineligibility. At the $9,429 monthly median for a private room, the family pays roughly $85,000 out of pocket during the penalty, and the $100,000 gift is already gone.
For a full explanation of how the look-back works, see What Is the Medicaid 5-Year Lookback Period in Georgia?
If You Are Married — What Happens to the Spouse at Home
When one spouse enters a nursing home and needs Medicaid, the spouse who remains at home (the “community spouse”) gets stronger protections than a single applicant.
The community spouse can keep up to $162,660 in countable assets in 2026 under the Community Spouse Resource Allowance. The institutionalized spouse must still spend their own assets down to $2,000, but the community spouse’s share is protected up to that limit.
The community spouse also keeps a minimum monthly income under the Minimum Monthly Maintenance Needs Allowance. The state will not leave the at-home spouse with nothing.
The home remains exempt as long as the community spouse lives there. Estate recovery against the home is deferred until the community spouse also dies. But when both spouses are gone, Georgia can still file its estate recovery claim, and the home is the primary target.
Without a MAPT established before the look-back period cleared, spousal protections are the best available option, but they leave the estate exposed to recovery after both spouses die.
What You Can Still Do If You Have No Plan
If you are reading this because a parent is about to enter a nursing home and there is no plan in place, you still have options, but they are narrower and more expensive than advance planning.
If nursing home admission is imminent: Crisis Medicaid planning costs more than planning ahead, but it can still help. An elder law attorney can: convert countable assets into exempt assets (prepaid funeral, home improvements), set up a Qualified Income Trust if income exceeds the limit, document spousal protections, and structure the application to minimize the spend-down period.
If you are already in a nursing home: A full Medicaid Asset Protection Trust is no longer an option. But spousal planning, QIT setup, and exempt asset strategies may still be available. Call an elder law attorney immediately. The options that remain shrink the longer you wait.
If you have 5+ years before you need nursing home care: A Medicaid Asset Protection Trust costs $6,500 at The Hive Law. It gives your home and savings the strongest protection available against both the spend-down and estate recovery, and it costs the least when you start early, though no trust is a guarantee against estate recovery.
