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 an average of $7,200 per month, the math is brutal:
- $50,000 in savings: gone in 7 months
- $100,000 in savings: gone in 14 months
- $250,000 in savings: gone in 35 months — nearly 3 years
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 (if you are past required minimum distribution age), 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 for repayment out of the home’s value through the probate process.
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 files a claim against the probate estate for every dollar Medicaid paid during the nursing home stay.
Georgia is a probate-only recovery state. This means the state can only recover through the probate process. Assets that pass outside probate — payable-on-death accounts, joint tenancy property, TOD deeds, and assets held in a funded revocable trust — are not subject to recovery.
The home, however, usually goes through probate. Without advance planning, the family home passes through probate and the state files its claim there. Georgia waives recovery claims under $25,000 — but nursing home stays that last 12 to 24 months will far exceed that threshold.
The only tool that protects both from the spend-down AND from estate recovery is a Medicaid Asset Protection Trust established at least 60 months before applying. Assets in a MAPT are not in the probate estate — they pass directly to beneficiaries and are not subject to estate recovery. 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 $7,200 per month in nursing home costs, that penalty costs the family roughly $65,000 out of pocket — while still losing the gifted assets to Medicaid’s calculation.
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 $5,000 to $9,000 but 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 and protects your home and savings from both the spend-down and estate recovery. This is the only scenario where full protection is still available at the lowest cost.
