Navigating Long-Term Care in Georgia

The State of Georgia participates in the federal/state partnership program offering owners of qualified Long-Term Care Insurance policies dollar-for-dollar asset protection from the future costs of extended health care. 

While many qualified care providers are available throughout Georgia when you need long-term health care services, the costs are rising due to the increasing demand for care services throughout the state. 

The variety of quality care options available in Georgia for those who require long-term health care services include:

• adult day care centers
• assisted living facilities
• continuing care retirement communities
• home health care providers
• memory care facilities
• rehabilitation facilities
• traditional nursing homes

Top insurance companies have several insurance options to help residents safeguard income and assets, protect lifestyles, and preserve a legacy. Plus, policyholders will have access to quality care options giving loved ones the time to be family instead of caregivers.

Plus, all tax-qualified Long-Term Care Insurance policies in Georgia have several consumer protections in addition to federal tax benefits.

Federal Partnership Program

The State of Georgia participates in the federal/state partnership program authorized by Congress and signed into law by President George W. Bush in 2005. The Long-Term Care Partnership Program is administered by the Department of Community Health in collaboration with the Office of the Commissioner of Insurance and the Department of Human Resources, Division of Aging Services. Georgia Long-Term Care Partnership policies provide an alternative to spending down or transferring assets by forming a partnership between Medicaid and private long-term care insurers.

This public-private partnership creates an innovative program offering consumers access to quality, affordable long-term care insurance and a way to receive needed care without depleting all their assets. Georgia Partnership Long-Term Care policies provide Medicaid asset protection. For every dollar that a partnership policy pays out in benefits, a dollar of assets can be protected (disregarded) from the long-term care Medicaid asset limit. The protected assets will also be exempted from Estate Recovery in the amount equal to the benefits paid by the partnership policy.

Once private insurance benefits are used, special Medicaid eligibility rules are applied if additional coverage is necessary. This dollar-for-dollar asset protection makes sure you never exhaust all your assets no matter how long your care situation lasts.

Policy Example

For example, if your policy pays, let say $400,000 in benefits when it exhausts, you would get $400,000 in asset disregard. This means you would be able to retain $400,000 in addition to the normal allowance and still access Medicaid’s Long-Term Care benefit.

Reciprocity

Most states have reciprocity with other states' long-term-care partnership programs including Georgia. This means if you move from or to Georgia your partnership asset protection follows you as well. 

Medicaid

Georgia's Medicaid program will pay for long-term health care if an individual has little or no income and assets. The Long-Term Care Medicaid spend down is $2,000. A spouse’s minimum asset allowance is $137,400. Your spouse’s minimum monthly income allowance is $$3,435 * The home equity limit is $636,000.

For more information about the Medicaid program visit www.medicaid.gov

Georgia Medicaid Estate Recovery Program

When a person applies for the Medicaid program for long-term care services and supports in Georgia, they understand the state may recover assets when they pass away to reimburse the state for the cost of their long-term health care. The estate is subject to the Medicaid Estate Recovery Program, otherwise known as MERP.

Following the death of the care recipient, the deceased's assets are used to reimburse the taxpayers for the long-term health care provided through Medicaid.  

The state will recover the cost of long-term care services if assets remain in the estate at the time of death. The total gross value of the estate must be valued at over $25,000 for Georgia to attempt recovery. An estate includes all real and personal property (homes, land, vehicles, cash, bank accounts) held individually or jointly. All deceased assets are subject to recovery, including holdings in most trusts.

Any spouse must have also passed away for recovery; otherwise, the recovery will be delayed. After the individual's death, the state will notify the executor, personal representative, or heirs before attempted recovery from the estate. Georgia can place a lien on real estate. Also, it is essential to note that a penalty might be applied if there was a transfer of real or personal property without adequate consideration, meaning for less than fair market value.

The state may "look back" up to 60 months before application for Medicaid long-term care services to determine when income was reduced and resources were transferred.

Remember, Georgia's Medicaid program will provide long-term care services only if you have little or no income and assets. However, the state will never require a living spouse to move out of their home. 

If a person had a qualified Partnership Long-Term Care Insurance policy, the total amount of benefits paid by the policy would be sheltered from asset recovery. 

State Resources for Aging and Long-Term Care in Georgia

There are a variety of state resources available in Georgia to help residents and their families with issues of aging and long-term health care. Many of these services benefit low-income families. 

• Area Agencies on Aging - 866-552-4464

There are thirteen regional offices throughout Georgia providing a variety of free and low-cost services to seniors aged 60 and older. The AAA offices develop, provide, coordinate, and advocate for services that assist older individuals, at-risk adults, persons with disabilities, their families, and caregivers.

Some of the services provided include Alzheimer's Adult Day Care, Elderly Legal Assistance, home modifications, homemaker and personal care services, respite care services, transportation, and nutrition and wellness services. 

The AAA office will also provide information and assistance for Medicare recipients, helping them navigate the available options. 

• Aging and Disability Resource Connection  - 866-552-4464

Georgia's Aging and Disability Resource Connection (ADRC) is a coordinated system of partnering organizations that provide various services.

The goal of the ADRC is to provide accurate information for Georgia residents and their families on both public and private services for long-term health care. The agency wants to make it easy for residents and families to find accurate information and support those with aging and disability issues. 

The ADRC also assists those with questions on Social Security and Medicaid.

• Georgia Long-Term Care Ombudsman - 866-522-4464

The Office of the State Long-Term Care Ombudsman in Georgia provides advocacy and informal resolution of residents' concerns in long-term care facilities. 

Their staff volunteers provide free information on Georgia's long-term care laws and regulations for residents and their families and help resolve disputes involving nursing homes and other long-term health care facilities. The Ombudsman can escalate complaints or concerns on behalf of a long-term care resident. 

The office will visit long-term care facilities to be accessible to residents and monitor their conditions.

• The Georgia Division of Health Care Facility Regulation (HFR)  - 800-878-6442 

The HFR licenses and inspects long-term health care facilities to ensure all facilities comply with laws and regulations. Although HFR is not a "resident advocate" like the Ombudsmen, the agency investigates the quality of care complaints and alleged abuses, neglect, and exploitation occurring within these facilities as mandated by law. 

Rate Stability Rules

In addition, Georgia consumers enjoy additional peace-of-mind as the state has adopted Long-Term Care Insurance Rate Stability Rules.  These rules, developed the National Association of Insurance Commissioners, makes it much harder for an insurance company to get an approved rate increase.

Products Approved in Georgia

There are several products approved in Georgia for Long-Term Care planning. These include traditional plans including partnership certified policies,  asset-based “hybrid” plans, and short-duration plans.

Tax Incentives

There are no current state tax incentives available at this time; federal tax incentives do apply.

Reverse Mortgages in Georgia

A reverse mortgage is a loan that you don't have to pay back - or make payments on as long as you are still living. In Georgia, residents use reverse mortgages to help them in many ways, although it may not be appropriate in all situations. It can, however, provide you with tax-free cash, but it uses the equity in your home, so there could be fewer assets for you and your heirs.

Borrowers get to remain in their homes without making payments until the last surviving borrower dies, no longer lives in the home as a primary residence, or sells the house. At that time, the lender will sell the home to pay off the reverse mortgage. 

To qualify for a reverse mortgage, you must be at least 62 years old, and at least one owner must live in the house most of the year. Eligible homes include single-family dwellings, two to four-unit, owner-occupied dwellings, and some condominiums and manufactured homes. 

By law, you can never owe more than your home's value when the loan is repaid. So, in the event your home loses value, you are protected. You don't make mortgage payments, but you still must pay the property taxes, insurance and properly maintain the residence.

Learn more about reverse mortgages by clicking here.

The tax-free money from a reverse mortgage can be used for many things, including 

• Reduce expenses 
• Income 
• Fund Long-Term Care Insurance 
• Provide resources for in-home care if you are unable to obtain LTC Insurance due to poor health

By law, you can never owe more than your home's value when the loan is repaid. So, in the event your home loses value, you are protected. You don't make mortgage payments, but you still must pay the property taxes, insurance and properly maintain the residence.

Learn more about reverse mortgages by clicking here.

_{*The federal government sets a new minimum and maximum amounts each year, but states can set their own minimum requirements at any level between the federal limits. This information is based on the best available sources.}