Medicaid vs Medicaid Waiver Programs in Georgia: What Families Need to Know
When caring for an aging parent or loved one in Georgia, one of the most confusing questions families face is: What is the difference between Medicaid and a Medicaid Waiver Program? If you’ve ever tried to navigate Georgia’s online Medicaid portal, you know how overwhelming it can feel. The truth is, these programs are nuanced, and the information is often buried behind layers of government language.
This blog will break down the basics in plain language, so you can understand the options available, the financial requirements, and where to turn for extra help.
Medicaid in Georgia: The Basics
Medicaid is a federal and state partnership that provides health coverage for low-income individuals. In Georgia, Medicaid covers doctor visits, hospital stays, prescriptions, and, for seniors who qualify, nursing home care.
If your loved one is medically fragile and has very limited income and assets, Medicaid can pay for long-term care in a nursing home. However, standard Medicaid does not usually cover in-home care or assisted living. That’s where Medicaid Waiver Programs come in.
What is a Medicaid Waiver Program?
A Medicaid Waiver Program is a special program that “waives” some of Medicaid’s traditional rules, allowing funds to be used outside of a nursing home. Instead of requiring your loved one to move into a facility, waiver programs can help them stay at home or in the community with supportive services.
In Georgia, the two most common waivers for seniors are:
- CCSP (Community Care Services Program) – Now the Elderly and Disabled Waiver Program (EDWP)
- Provides support services to help seniors remain in their homes, such as personal care assistance, adult day health, and respite care.
- Participants must qualify for a nursing home level of care, but instead of moving to a facility, they can receive help at home.
- More on the CCSP Medicaid Waiver Program→
- SOURCE (Service Options Using Resources in a Community Environment)
- Designed for frail, elderly, and disabled adults who need coordinated care management.
- Includes medical oversight in addition to personal care services.
- More on SOURCE Medicaid Waiver →
Both programs are limited by waiting lists and funding availability, so applying early is critical.
Medicaid vs Waiver: The Key Difference
- Medicaid (traditional): Pays for nursing home care.
- Medicaid Waiver (CCSP, SOURCE): Pays for services that help your loved one stay at home or in the community.
Think of it this way:
- Medicaid = Facility care.
- Waiver = Flexibility to stay at home.
Financial Requirements: Income & Assets
One of the most difficult parts of Medicaid planning is understanding the financial rules. In Georgia:
- Income Limit: For 2025, an individual applying for long-term care Medicaid must have income at or below $2,742/month. If income is higher, families sometimes use a Qualified Income Trust (also called a “Miller Trust”) to qualify.
- Asset Limit: Generally, an individual can have no more than $2,000 in countable assets (not including a home, one vehicle, or certain personal belongings).
- Spousal Protection: If one spouse needs care and the other remains at home, special rules allow the “community spouse” to keep more assets and income.
These rules apply to both Medicaid nursing home care and Medicaid Waiver Programs.
Important: Financial eligibility is just one part of the process. Your loved one must also meet medical and functional criteria (such as needing help with daily activities or requiring nursing-level care).
How Elder Law Attorneys Can Help
Because the financial requirements are strict, many families worry they’ll have to spend down all their savings before qualifying for Medicaid. This is where Elder Law Attorneys can make a big difference.
Elder Law Attorneys specialize in Medicaid planning and can:
- Help structure income and assets to legally qualify.
- Guide families in creating Miller Trusts or other tools.
- Protect the healthy spouse from financial hardship.
- Avoid costly mistakes during the application process.
While not everyone will need an attorney, families with savings, retirement accounts, or complex situations often benefit from professional guidance.
Find an Elder Law Attorney in Georgia →
(Look for someone with Medicaid experience)
Why the Online Portal is So Confusing
Families often say that the Georgia Gateway online portal (where you apply for Medicaid) is one of the most confusing parts of the process. That’s because the portal is designed for all Medicaid services – not specifically the waivers.
It’s easy to get lost in drop-down menus, duplicate forms, or unclear terminology. Many families give up or accidentally apply for the wrong type of Medicaid.
Insider Tip: How to Access the Right Information
Here’s a shortcut most families don’t know:
- Don’t just rely on the Georgia Gateway website. Instead, contact your local Area Agency on Aging (AAA) and ask to speak with a care coordinator about Medicaid Waivers.
- The AAA staff can screen your loved one for CCSP or SOURCE eligibility and walk you through the right application process.
You can reach your local AAA through Empowerline, a trusted resource run by the Atlanta Regional Commission.
Which Option is Right for Your Family?
If your loved one needs 24/7 medical care in a facility, traditional Medicaid may be the right fit.
If your loved one can still live at home safely with some support, a Medicaid Waiver Program may provide the services needed to avoid or delay nursing home placement.
Final Thoughts
The Medicaid Waiver Program in Georgia is complex, but it exists to give families more options and help loved ones stay where they feel most comfortable – at home. While the application process can be confusing, there are local resources and professionals who can help you cut through the red tape.
Helpful Links & Resources:
- Georgia Medicaid
- Georgia Medicaid Eligibility
- Community Care Services Program (CCSP)
- SOURCE Program
- Georgia Gateway Portal
- Empowerline (Atlanta Area Agency on Aging)
- Elder Law Attorneys in Atlanta