Expert Tips for Georgia Medicaid: Getting Medicaid Even When You Have Too Much Income

Medicaid is a means-tested, government-provided health insurance benefit. It is the largest payer of nursing home care in Georgia. It is also commonly misunderstood. For instance, many people believe that they may have too much income for Medicaid. It is true that Georgia has an income cap. For 2018, that income cap is $2,250. This cap, however, does not mean that if a person makes over $2,250/month that he/she cannot qualify for nursing home Medicaid in Georgia.

This is where things get confusing for many people.

How to get Medicaid if you make more than $2,250/month:

In Georgia, the average cost of a nursing home bed for long-term care is $6,768 (it is closer to $9,000/month in the Metro Atlanta area). How is a person supposed to make up that $4-6,000 difference between their income and the cost of the nursing home? In reality, a nursing home resident can be eligible for Medicaid if the resident’s income is below the private pay rate of the nursing home despite what the income cap is.

In most cases, a person must make less than $6,768/month in order to qualify for Medicaid. That’s much higher than most expect and that is way higher than Georgia’s stated income cap.

You must use a Miller Trust:

There is one catch, though: for nursing home residents that have an income higher than the $2,250 income cap, they must use a Qualified Income Trust (or Miller Trust). This trust is for resident’s income (it’s not like most Trusts that deal with assets); and it must be zeroed out each month. An earlier blog explained more about the Qualified Income Trust

It is important just to know that a person can qualify for nursing home Medicaid in Georgia even if their income is higher than the income cap. If you would like to learn more, please contact us at (404) 843-0121 or here.