Plan for Care Before You Need It — When You Still Have Options

Long-term care planning is the process of arranging your finances, legal documents, and care preferences before a serious illness or disability requires someone to manage your affairs or pay for care on your behalf. In Georgia, it primarily addresses two things: the legal authority structure (who manages your finances and healthcare if you cannot) and the financial structure (how assets are arranged so Medicaid can cover nursing home costs without a full spend-down). A complete long-term care plan includes a Medicaid asset protection trust, a durable financial power of attorney, an advance healthcare directive, and a written care preference document that your family can follow when they need to make decisions for you.

The best time to start is at least five years before you might need nursing home care — because Georgia Medicaid imposes a five-year lookback on all asset transfers. Assets transferred into a Medicaid asset protection trust more than five years before a Medicaid application are fully protected. Assets transferred within five years create a penalty period. For most people, starting in their late 50s or early 60s gives the lookback period enough time to run before care is needed. For families where a parent is already in their 70s or showing early signs of decline, the time to act is now — the lookback clock does not pause while you are deciding.

Georgia Medicaid covers the full cost of nursing home care — room, board, nursing services, and most medical care — for residents who meet the financial and functional eligibility requirements. Financial eligibility requires countable assets of $2,000 or less (individual) or up to $154,140 for the community spouse (2025 figure). Functional eligibility requires a level of care assessment confirming the need for skilled nursing facility placement. Medicaid also covers some in-home care through waiver programs including the SOURCE program and the Community Care Services Program, though these programs have enrollment caps and waiting lists. Medicaid does not cover assisted living in Georgia — only nursing home and certain home and community-based settings.

Nursing home costs in the Atlanta metro area run $8,000 to $10,000 per month for a semi-private room, with private rooms running higher. Specialized memory care units — for residents with Alzheimer’s or other forms of dementia — typically run $5,500 to $8,000 per month in Atlanta assisted living facilities, though nursing home memory care units are covered by Medicaid once eligibility is met. At $9,000 per month, a three-year nursing home stay costs $324,000. A five-year stay costs $540,000. These figures represent out-of-pocket costs for families without a Medicaid plan in place and without long-term care insurance coverage sufficient to offset the expense.

Yes — a Medicaid asset protection trust (MAPT) is specifically designed to remove assets from your countable estate for Medicaid purposes. Once assets are transferred into the trust and five years have passed, they are no longer counted toward the Medicaid asset limit. You give up control of the principal, but you can retain the income the trust assets generate. The trustee manages the assets, and the beneficiaries you name receive them at your death. A MAPT is the primary legal tool for protecting savings, investment accounts, and real estate from nursing home spend-down. The revocable trust commonly used for probate avoidance does not provide this protection — only an irrevocable trust structure does.