What is a Medicaid Waiver?
For persons with limited financial resources, Medicaid pays for nursing home care. For those who wish to live at home or in assisted living, sometimes Medicaid will pay for care in those locations if it can be obtained at a lower cost than in a nursing home. It does this through "Medicaid Waivers."
For qualified low-income seniors, SOURCE helps cover the costs of both medical care and non-medical, personal care.
SOURCE is an acronym for Service Options Using Resources in a Community Environment. The program is designed for frail, elderly, and disabled Georgians who require the level of care typically provided in a nursing home. However, this program allows eligible individuals to receive care in their homes or communities (such as in assisted living facilities, also referred to as personal care homes) and avoid having to use long-term nursing home care. For some very low-income participants, this program provides both medical care and non-medical personal care services.
Originally this program was only available in certain areas of the state, but now it is open to residents statewide. As of 2019, approximately 19,000 Georgians receive assistance under this program. However, even with increased capacity, it is possible that a waiting list for services may exist. If an individual is already on Medicaid, the general enrollment time is two months.
This waiver is operated under Medicaid’s Elderly and Disabled Home and Community Based Services (HCBS) Waiver and is administered by the Georgia Department of Community Health.
Did You Know? Seniors can receive free estimates for bathroom safety modifications including walk-in tubs installations to help enable aging in place. Get started here.
To be eligible for the SOURCE Waiver, an individual must be 65 years of age and older, or if he or she is under the age of 65, must be physically disabled. As the waiver is intended to divert individuals from nursing home placement, a requirement is that they need nursing home level care. To make this determination, an assessment must be completed. Income and savings also play a role in the eligibility requirements.
This Georgia Medicaid waiver has both income limits and financial resource (asset) limits. These criteria are slightly less restrictive than regular Georgia Medicaid for adults who do not require long-term care. For 2019, the income limit for an individual is $2,313 per month, which is three times the Supplemental Security Income (SSI) / Federal Benefit Rate (FBR). If the applicant is married and his/her spouse is not also applying for Medicaid, only the income in the name of the applicant is counted towards the income limit. That said, an applicant spouse is able to transfer a portion, or all, of his/her income to the non-applicant spouse. (A non-applicant spouse is also referred to as a community spouse). This is called a monthly maintenance needs allowance (MMNA), and as of 2019, up to $3,160.50 / month can be transferred to the healthy spouse.
The individual asset limit is $2,000, but several assets are considered “non-countable” or exempt. This includes the applicant’s home and the land the home is on as long as the applicant or their spouse lives in the home and the equity value of the home is under $585,000. Other exempt assets include a burial contract up to $10,000, an automobile, life insurance policies with a face value up to $1,500, household goods, and personal items, such as clothing. “Countable” or non-exempt assets include total cash on hand, bank accounts (checking and savings), and other liquid (easily convertible to cash) investments and retirement accounts. Make note, unlike income, a couple’s assets are considered jointly owned. (Learn more about Medicaid and joint assets here). However, in Georgia, the individual retirement account of the applicant's spouse is not counted. Also, the non-applicant spouse is permitted to retain up to $126,420 in financial resources. This is known as the Community Spouse Resource Allowance (CSRA).
It is possible to receive Medicaid even if one's income or assets are over the limits. Georgia has a Medically Needy Medicaid program that will considered persons with exceptionally high medical and care costs even though they are over the limits. Another option is to restructure one's finances through the creation of Medicaid exempt trusts and annuities so that one's countable income and assets are within the acceptable limits. Persons hoping to qualify using these approaches should be aware that legal or financial expertise is necessary. One can find Medicaid planning assistance here.
Georgia residents might also find assistance from the CCSP Waiver. Learn more.
Benefits and Services
Services are determined on a case-by-case basis and can include any of the following:
24-hour Medical Access
Skilled Nursing Services
Adult Day Health / Adult Day Care
Alternative Living Services / Assisted Living Services (does not include room and board costs)
Emergency Response System
Home Delivered Meals
Home Delivered Services
Personal Support Services – Housecleaning, shopping, laundry, assistance with activities of daily living, such as eating, dressing, moving about, etc.
Respite Care – Both in-home and out-of-home
How to Apply / Learn More
More information about this program can be found on the Georgia SOURCE Factsheet. One can apply for the SOURCE waiver by calling 866-552-4464 or by contacting the local Department of Human Services, Division of Family and Children county offices. A list of contact information is available here.