Georgia Medicaid Income Limits for Home Care:How They Work

Georgia's Medicaid income limit for home care is not one fixed number; it depends on how your loved one qualifies, and it changes every January. For care at home, the key program is Georgia's Elderly and Disabled Waiver Program (EDWP). It uses a monthly income cap tied to the federal SSI benefit.

If your loved one's income is over the cap, that is not always the end of the road. Georgia allows a Qualified Income Trust, often called a Miller trust. A spouse who stays at home can also keep part of the couple's income.

This guide explains which income counts, how married couples are treated, and where to see the current limits. We do not print the figures here, because they change. We link to the official pages that show them.

Georgia Medicaid income limits at a glance

• Program for home care: the Elderly and Disabled Waiver Program (EDWP), which includes CCSP and SOURCE
• What is measured: gross monthly income, before deductions
• How the cap is set: by a federal formula linked to the SSI benefit amount
• When it changes: every January, when Social Security and SSI amounts rise
• Who decides: your county DFCS office, or Social Security for people on SSI
• If income is too high: a Qualified Income Trust may still allow eligibility
• Where to see current figures: the DFCS Medicaid manual, Appendix A1

Which income limit applies to my loved one?

Georgia has two main financial routes into EDWP. The route decides who reviews income and whether your loved one may owe a monthly cost share. The DCH EDWP fact sheet describes both.

Does your loved one get Social Security or a pension that is too high for SSI? Then the second column is the one that matters, and the waiver cap is the number to check.

The state's EDWP case management manual says the cap is tied to the SSI level. It also says the cap changes each January, when SSI rises. So a figure you saw last year may already be out of date.

Does my loved one need to be on Medicaid already?

No. EDWP accepts people who are Medicaid eligible or potentially eligible. People not yet on Medicaid apply through their county DFCS office. The Area Agency on Aging screening for EDWP starts with a call to 866-552-4464.

What income counts for Georgia Medicaid home care?

DFCS looks at your loved one's gross monthly income. Gross means the amount before anything is taken out.

The DFCS Qualified Income Trust worksheet lists the kinds of income a caseworker asks about. They include:

• Social Security
• State retirement
• VA pension
• Other pensions
• Interest and dividends
• Annuity payments
• Other regular income

Bring a recent award letter or statement for each source. Caseworkers verify income from documents, not from memory.

Is income the same as savings?

No. Income is money that comes in each month. Savings, property and accounts are assets, and Georgia tests them separately. The DCH EDWP fact sheet lists the asset limits next to the income limit.

How are married couples treated?

Federal "spousal impoverishment" rules protect the spouse who stays at home. Medicaid.gov explains that these rules stop the cost of care from draining a couple's savings. They apply to certain home and community-based waiver members, not only nursing home residents. See the Medicaid.gov spousal impoverishment page.

Here is how it works in plain terms:

• The applicant's own income is measured against the cap.
• If the at-home spouse has little income, part of the applicant's income can be set aside for them.
• That set-aside happens before Georgia works out what the applicant owes toward care.
• The at-home spouse can also keep a protected share of the couple's assets.

The federal standards behind these amounts update on a schedule. CMS says some change each January and others change each July. The yearly CMS bulletin on SSI and spousal impoverishment standards lists them.

What happens if income is too high?

Georgia allows a Qualified Income Trust (QIT). Many people call it a Miller trust. The DFCS manual covers it in Section 2407.

A QIT is a special bank account set up under a trust. Each month, income goes into the trust. Money deposited that way is not counted as income for eligibility. The trust then pays out only for allowed purposes.

How a Qualified Income Trust works

1. 1

   Set up the trust

   The trust document names a trustee, who manages the account. An elder-law attorney can draft it.

2. 2

   Open a separate account

   Only the applicant's income goes in. The DFCS trustee guide says the trustee must never add their own money.

3. 3

   Deposit every month

   At minimum, deposit the amount by which income exceeds the cap. DFCS encourages depositing all gross income.

4. 4

   Pay only allowed costs

   These include the cost share, a personal needs allowance, money for a spouse or dependent, and certain medical costs.

5. 5

   Keep records

   DFCS can ask for deposit and payment records at any time.

Timing matters. The DFCS worksheet warns that a missed or late deposit can cost eligibility for that month. The DFCS QIT trustee guide (Form 945) adds that the account should not have a debit card.

A QIT covers income only. It does not help with assets. When the member dies, money left in the trust goes first to the State of Georgia, up to the amount Medicaid paid. Anything left after that goes to the named beneficiaries.

What is the EDWP cost share?

Some EDWP members on the MAO route pay part of the cost of their services each month. This is the cost share. A DFCS eligibility specialist sets the amount. The case management manual says SSI members do not pay one.

The cost share does not apply to every service. Case management and home-delivered meals are not subject to it. Other waiver services can be. The DFCS manual explains the budget in its patient liability and cost share sections.

Income set aside for a spouse at home can lower the cost share. Ask DFCS to explain the figure in writing if it is not clear.

Where can I find the current income limits?

Go to the source. These official pages list the figures:

• DFCS Medicaid manual, Appendix A1: ABD Financial Limits shows Georgia's current limits. The page is labeled by year, so check you are on the newest one.
• The DCH EDWP fact sheet shows the waiver income limit and spouse figures for its edition year.
• The SSA page on SSI amounts shows the federal SSI benefit that the cap is tied to.

Websites that print one number often mix up years. They also mix up programs. Regular adult Medicaid, SSI and the waiver cap are three different tests.

How A1-GA Healthcare Agency helps

A1-GA Healthcare Agency is a Georgia DCH-approved Medicaid home care provider in Norcross. We have provided in-home care across metro Atlanta since 2008, and staffed caregivers since 2004. We serve families on EDWP with in-home personal support, respite and related services. We also offer Structured Family Caregiving for relatives who live with their loved one.

We are not DFCS, and we cannot decide eligibility. What we can do is explain the steps, tell you which papers to gather, and point you to the right office. Learn more about EDWP services or read what EDWP is and how it works.

• Phone: 678-446-1832
• Hours: Monday to Friday, 8am to 6pm
• Email: info@gahac.com
• Office: 4505 Peachtree Industrial Blvd, Suite K, Norcross, GA 30092
• Quick check: fill in our eligibility form or visit our eligibility page