Sandy Springs Estate Planning for Medicaid Eligibility and Asset Protection

For many Sandy Springs families, the question isn’t just “how do we protect our assets?” It’s “how do we protect them and still qualify for Medicaid if long-term care becomes necessary?” These two goals can feel like they’re pulling in opposite directions, but with the right planning in place, they don’t have to. At Atlanta estate planning lawyer firm Slowik Estate Planning, located in Atlanta, Georgia, we help families across the Sandy Springs area build plans that address both concerns at the same time, before a health crisis forces your hand.

Table of Contents

• Why Sandy Springs Residents Need Medicaid Planning Now
• Understanding Georgia’s Medicaid Asset Rules and What Counts
• The 60-Month Look-Back Rule and How It Affects Your Planning
• Medicaid Asset Protection Trusts and Other Legal Strategies
• Integrating Medicaid Planning With Your Broader Estate Plan
• FAQs About Sandy Springs Estate Planning for Medicaid Eligibility and Asset Protection

Why Sandy Springs Residents Need Medicaid Planning Now

Sandy Springs sits along the northern edge of Atlanta, just inside I-285, with residents who have built real wealth over a lifetime. Whether your family home is near Abernathy Road, you have investment accounts, or you own rental property close to the Perimeter Center corridor, those assets are at risk if long-term care costs aren’t planned for properly. A private-pay nursing home in the Atlanta metro area currently costs around $7,200 to $7,500 per month. That adds up to $86,000 to $90,000 per year, and most families can’t sustain that for long without depleting everything they’ve worked to build.

Medicaid is the primary public benefit that covers long-term nursing home care for those who qualify financially. But qualifying isn’t automatic, and it doesn’t happen without planning. To qualify for long-term care Medicaid in Georgia, an applicant must meet two separate financial tests: the income test and the asset test. The 2026 income limit is $2,982 per month for an individual applicant. For a single applicant in 2026, the asset limit is $2,000, which means they must have $2,000 or less in countable assets. Those thresholds are strict, and most Sandy Springs residents exceed them by a wide margin.

The good news is that Georgia law and federal law both allow for legal planning strategies that can help you reduce countable assets while protecting your family’s financial future. The key is starting that planning early, well before a care need arises. Waiting until a health crisis hits, like a stroke near Northside Hospital or a fall that leads to a nursing home admission, leaves very few options and very little time.

Slowik Estate Planning works with Sandy Springs families to build Medicaid eligibility plans that are grounded in Georgia law and federal Medicaid rules. Reach out to our office in Atlanta to schedule a consultation and learn what your options look like today.

Understanding Georgia’s Medicaid Asset Rules and What Counts

Not every asset you own counts against the Medicaid limit. Georgia Medicaid draws a clear line between “countable” and “non-countable” assets, and understanding that distinction is where planning begins. Countable assets include bank accounts, retirement accounts, stocks, bonds, certificates of deposit, cash, and any other assets that can be easily converted to cash. These are the assets that put most Sandy Springs residents over the $2,000 limit immediately.

Non-countable assets are a different story. Exemptions include personal belongings, household furnishings, an automobile, irrevocable burial trusts up to $10,000 in Georgia, and generally one’s primary home. The home exemption is significant, but it comes with conditions. For eligibility purposes, Georgia Medicaid considers the home exempt if the applicant lives in the home or has intent to return, and in 2026, their home equity interest is no greater than $752,000. For most Sandy Springs homeowners, that threshold isn’t a problem, but the home is still at risk after death through Georgia’s Medicaid Estate Recovery Program.

While one’s home is generally exempt from Medicaid’s asset limit, it is not exempt from Medicaid’s Estate Recovery Program. Following a long-term care Medicaid beneficiary’s death, Georgia’s Medicaid agency attempts reimbursement of care costs through whatever estate of the deceased still remains. This is often the home. Without proper planning strategies in place, the home will be used to reimburse Medicaid for providing care rather than going to family as inheritance.

For married couples, the rules offer more protection. For a married applicant with just one spouse applying, the 2026 asset limit is $2,000 for the applicant spouse and $162,660 for the non-applicant spouse, thanks to the Community Spouse Resource Allowance. That’s a meaningful protection, but it still requires careful planning to make the most of it. An experienced trust attorney can help you structure ownership of assets in a way that maximizes these protections for your spouse while positioning you for Medicaid eligibility.

The 60-Month Look-Back Rule and How It Affects Your Planning

One of the most misunderstood rules in Medicaid planning is the look-back period. Many people assume they can simply give away assets to family members right before applying for Medicaid. That assumption can be costly. Under 42 U.S.C. § 1396p(c) of the Social Security Act, Medicaid reviews financial transactions made within 60 months (5 years) before an application to determine if assets were transferred improperly.

Georgia enforces a 60-month look-back period for all HCBS waiver programs and nursing home Medicaid. Every asset transfer below fair market value within 60 months of the application date may trigger a penalty period of ineligibility. The penalty isn’t a fine. It’s a period during which Medicaid will not pay for your care, even though you otherwise qualify. Georgia’s penalty divisor reflects its average monthly private-pay nursing home cost of approximately $7,500 per month in 2026. A $100,000 uncompensated transfer produces approximately 13.3 months of ineligibility in Georgia.

Think about what that means in practice. If your parent transfers $100,000 to you or your siblings in good faith, thinking they’re protecting the family home, and then needs nursing home care 18 months later, that transfer could leave them ineligible for Medicaid for over a year. During that penalty period, someone has to pay the nursing home bill out of pocket, often the very family members who received the transfer.

There are exceptions to the look-back rule. Under 42 U.S.C. § 1396p(c)(2), certain transfers are exempt from penalty. These include transfers to a spouse, transfers of a home to a child who is blind or permanently disabled, and transfers to a sibling who has an equity interest in the home and has lived there for at least one year before the applicant entered institutional care. Federal law also requires states to offer a hardship waiver process when applying the transfer penalty would deprive an individual of medical care or basic necessities of life. These exceptions are narrow, and relying on them without legal guidance is risky. The right move is to plan far enough in advance that the look-back period is not an issue at all.

Medicaid Asset Protection Trusts and Other Legal Strategies

The most effective way to protect assets from Medicaid spend-down while still qualifying for benefits is to use a Medicaid Asset Protection Trust, often called a MAPT. This is an irrevocable trust that holds your assets outside your name. Because you no longer legally own the assets inside the trust, they are not counted toward Medicaid’s asset limit, as long as the trust was created more than 60 months before you apply. Timing is everything.

A MAPT can prevent Medicaid estate recovery because the trust legally owns the home, not the Medicaid recipient. Medicaid cannot place a lien on an irrevocable trust’s assets, protecting the home for heirs. For Sandy Springs families with significant home equity, especially those in neighborhoods near Hammond Drive or the Roswell Road corridor, this can mean the difference between leaving a home to your children and watching it consumed by nursing home costs.

A Qualified Income Trust, also called a Miller Trust, is another tool for families whose income exceeds the Medicaid limit. Because the excess income is legally diverted into the trust, it’s no longer counted against the applicant, allowing them to become income-eligible. This is a separate tool from a MAPT and addresses the income test rather than the asset test. Many Sandy Springs families need both.

Other strategies include spending down countable assets on exempt items, paying off a mortgage, purchasing a Medicaid-compliant annuity, or making home improvements. Each strategy has specific rules and limitations. Working with an estate tax planning lawyer who understands how Medicaid planning intersects with your broader estate plan ensures that your choices don’t create unintended tax consequences or disqualify you from benefits you’ve earned. Slowik Estate Planning, based in Atlanta, Georgia, helps clients evaluate every option and build a plan that holds up under scrutiny.

Integrating Medicaid Planning With Your Broader Estate Plan

Medicaid planning doesn’t exist in a vacuum. It connects directly to your wills, trusts, powers of attorney, and healthcare directives. A plan that qualifies you for Medicaid but leaves your spouse without income protection, or that transfers assets without a clear inheritance structure, isn’t a complete plan. It’s a partial fix that can create new problems.

A durable power of attorney is essential. If you become incapacitated near Northside Hospital’s Sandy Springs campus without one, your family may need to seek a guardianship or conservatorship through the Fulton County Probate Court on Pryor Street, a process that is expensive and time-consuming. A properly drafted durable power of attorney allows your agent to take the legal steps needed to qualify you for Medicaid, including transferring assets into a trust, without court involvement.

Healthcare directives and living wills work alongside Medicaid planning by making your care preferences clear. If your family knows what level of care you want, they can make decisions faster and avoid costly delays. These documents are part of a complete estate plan, and they matter just as much as the financial pieces.

Revocable living trusts, which are a common probate-avoidance tool, work differently from Medicaid Asset Protection Trusts. A revocable trust does not protect assets from Medicaid because you retain control over the assets inside it. Assets in a revocable trust are still countable. This is a common point of confusion, and it’s one reason why working with an attorney who understands the full picture matters.

Slowik Estate Planning serves clients throughout the Sandy Springs and greater Atlanta area. Our office is located in Atlanta, Georgia, and we welcome families who want to build a plan that addresses both Medicaid eligibility and long-term asset protection. Contact us today to schedule a consultation and take the first step toward protecting what you’ve built.

FAQs About Sandy Springs Estate Planning for Medicaid Eligibility and Asset Protection

How early should I start Medicaid planning in Sandy Springs?

The earlier you start, the more options you have. Because Georgia enforces a 60-month look-back period, assets transferred to a Medicaid Asset Protection Trust must be placed there at least five years before you apply for benefits. Starting in your 60s gives you the most flexibility. Waiting until a health crisis hits leaves very few legal options and can result in a penalty period that forces your family to pay nursing home costs out of pocket.

Can I give my home to my children to protect it from Medicaid?

Transferring your home directly to your children within 60 months of a Medicaid application will likely trigger a penalty period under 42 U.S.C. § 1396p(c). There are narrow exceptions, such as a transfer to a child who is blind or permanently disabled, but most outright gifts of a home to adult children create problems rather than solving them. A Medicaid Asset Protection Trust is a more reliable strategy for protecting the home while still qualifying for benefits, provided it is set up well before the look-back window opens.

What is a Qualified Income Trust and does Georgia allow them?

A Qualified Income Trust, sometimes called a Miller Trust, is a legal tool that allows applicants whose monthly income exceeds Georgia’s Medicaid limit to redirect that excess income into a trust account. Because the income is diverted into the trust rather than received directly by the applicant, it is no longer counted against the eligibility threshold. Georgia does allow Qualified Income Trusts, and they are a standard planning tool for seniors whose Social Security, pension, or other income pushes them over the $2,982 per month limit in 2026.

Does Medicaid take your house after you die in Georgia?

Georgia operates a Medicaid Estate Recovery Program that allows the state to seek reimbursement from a deceased beneficiary’s estate for care costs paid on their behalf. The home is often the primary target of this recovery effort. However, proper planning, such as placing the home in an irrevocable trust before the look-back period, can remove the home from your estate and protect it from recovery. Spousal protections also apply when a surviving spouse remains in the home.

Does a revocable living trust protect assets from Medicaid in Georgia?

No. A revocable living trust does not protect assets from Medicaid. Because you retain control over the assets in a revocable trust, those assets are still considered countable for Medicaid eligibility purposes. A revocable trust is a useful tool for avoiding probate and managing your estate, but it serves a different purpose than a Medicaid Asset Protection Trust. If Medicaid planning is one of your goals, you need an irrevocable trust structure, and the timing of when you create it matters significantly. An attorney at Slowik Estate Planning can help you determine which type of trust fits your situation.