Appendix A1 ABD Financial Limits 2025

Georgia State Seal

Georgia Division of Family and Children Services
Medicaid Policy Manual

Policy Title:

ABD Financial Limits

Effective Date:

July 2026

Chapter:

Appendix A1

Policy Number:

Appendix A1

Previous MT Number(s):

MT 76

Updated or Reviewed in MT:

MT 80
CHART A1.1 - ABD MEDICAID RESOURCE LIMITS
Type Limit Individual Limit Couple Limit LA-D Individual with a Community Spouse Effective Date

SSI/LA-D

$2000

$3000

N/A

7-88

AMN

$2000

$4000

N/A

4-90

QMB/SLMB/QI-1

$9,660

$14,910

N/A

1-25

QDWI

$4000

$6000

N/A

1-89

Spousal Impoverishment

N/A

N/A

$162,660 + 2000 = $164,660

1-26
CHART A1.2 - ABD MEDICAID NET INCOME LIMITS (GROSS - $20)
Type Limit Living
Arrangement		 Individual
Limit		 Couple
Limit		 Effective
Date

AMN

All

$317

$375

10-90

FBR

(SSI Limit)

A

$994

$1491

1-26

B

$663

$994

C

$994

N/A

D

$30

N/A

Medicaid CAP

D

$2982

$5964

1-26

QDWI

A

$5,405

$7,299

3-26

Effective 3-98, ISM no longer applies to this COA eliminating LA-B.

C

$5,302

N/A

D

$5,302

N/A

QMB

A

$1,330

$1,804

4-26

SLMB

A

$1,596

$2,164

4-26

QI-1

A

$1,796

$2,435

3-26
CHART A1.3 - TRANSFER OF RESOURCE PENALTY DETERMINATION

Averaging Nursing Home Private Pay Billing Rate

$11,122.00

4-26
CHART A1.4 - PRESUMED MAXIMUM VALUE (PMV) OF ISM AND LIVING ALLOWANCE TO EACH INELIGIBLE CHILD
Income Limit PMV for an Individual PMV for a Couple Living Allowance Effective Date

AMN

$351.33

$517.00

$497.00

1-26

FBR

$351.33

$517.00

$497.00

1-26

QMB

N/A

N/A

$608.00

4-26

SLMB

N/A

N/A

$728.00

4-26

QI-1

N/A

N/A

$818.33

3-26
CHART A1.5 - SUBSTANTIAL GAINFUL ACTIVITY
Category Income Limit Effective Date

Non-Blind individuals

$1690

1-26

Blind individuals

$2830
CHART A1.6 – BREAK-EVEN POINTS

Living Arrangement

Earned Income

Unearned Income

Effective Date

Individual

Couple

Individual

Couple

A

$2073.00

$3067.00

$1014.00

$1511.00

1-26

B

$1410.34

$2073.00

$682.67

$1014.00

D

$145.00

$205.00

$50.00

$80.00

7-88
CHART A1.7 – MONTHLY AVERAGED MEDICAID RATES FOR KATIE BECKETT
Level of Care Monthly Amount Effective Date

Skilled Nursing Facility

$8,455.00 (31 days)

04-26

ICF/ID

$28,701.00 (31 days)

Hospital

$185,883.00 (31 days)
A1.8 – MEDICARE EXPENSES
Year Effective Medicare Part B Premium Rate

2014

$104.90

2016

$121.80

2017

$134.00

2019

$135.50

2020

$144.60

2021

$148.50

2022

$170.10

2023

$164.90* (or higher depending on income)

2024

$174.70* (or higher depending on income)

2025

$185.00* (or higher depending on income)

2026

$202.90* (or higher depending on income)

Effective 01/2016 Medicare Part B Premium rates may vary. Check BENDEX for applicable rate. *Most SSA recipients will pay less than this amount, $202.90 on average.
CHART A1.9 - PERSONAL NEEDS ALLOWANCES (PNA) FOR AN LA-D RECIPIENT
IF the LA-D Recipient is THEN use the following as the PNA in the Patient Liability/Cost Share Budget:

an individual in a nursing home or Institutionalized Hospice

$70

Effective 7-19

a VA pensioner or his/her surviving spouse in a nursing home who has dependents

$70

Effective 7-19

a VA pensioner or his/her surviving spouse in a nursing home who has no dependents

The VA check for these individuals is reduced to the amount of the PNA, regardless of other income.

$90

Effective 1-92

(Effective 1-93 for the Surviving Spouse)

an individual in EDWP

the current amount of the Individual FBR for LA-A

an individual in ICWP

the current amount of the Community Spouse Maintenance Need Standard

an individual in NOW or COMP

the current Medicaid Cap
CHART A1.10 - NEED STANDARDS FOR DIVERSION OF INCOME TO A COMMUNITY SPOUSE OR DEPENDENT FAMILY MEMBER IN A PATIENT LIABILITY/COST SHARE BUDGET
Diversion Standard Amount Effective Date

Community Spouse Maintenance Need Standard

$4,066.50

1-26

Dependent Family Member Need Standard

$2,706.00

4-26
CHART A1.11-TANF Standard of Need (SON)
Household Size SON Household Size SON Effective Date

1

$235.00

7

$672.00

2022

2

$356.00

8

$713.00

3

$424.00

9

$751.00

4

$500.00

10

$804.00

5

$573.00

11

$860.00

6

$621.00

12

$884.00
CHART A1.12 - LOW-INCOME PART D PREMIUM SUBSIDY AMOUNT
Year Subsidy Amount Year Subsidy Amount

2010

29.62

2019

25.68

2011

32.83

2020

25.34

2012

31.18

2021

29.80

2013

34.22

2022

32.38

2014

29.32

2023

37.30

2015

26.47

2024

44.23

2016

25.78

2025

39.99

2017

26.43

2026

25.42

2018

24.53
Chart A1.13 – MEDICALLY NEEDY MILEAGE REIMBURSEMENT RATE
Effective Dates Cents Per Mile Effective Dates Cents Per Mile

09/10/05 – 12/31/05

48.5

01/01/16 – 12/31/16

54.0

01/01/06 – 01/31/07

44.5

01/01/17 - 12/31/17

53.5

02/01/07 – 03/31/08

48.5

01/01/18 – 12/31/18

54.5

04/01/08 – 07/31/08

50.5

01/01/19 - 12/31/19

58.0

08/01/08 – 12/31/08

58.5

01/01/20 - 12/31/20

57.5

01/01/09 – 12/31/09

55.0

01/01/21 - 12/31/21

56.0

01/01/10 – 12/31/10

50.0

01/01/22 - 06/30/22

58.5

01/01/11 – 04/16/12

51.0

07/01/22- 12/31/22

62.5

04/17/12 – 12/31/12

55.5

01/01/23 - 12/31/23

65.5

01/01/13 – 12/31/13

56.5

01/01/24 - 12/31/24

67.0

01/01/14 – 12/31/14

56.0

01/01/25 - 12/31/25

70.0

01/01/15 – 12/31/15

57.5

01/01/26 - present

72.5
Chart A1.14 – ABLE ACCOUNT MAXIMUM ALLOWABLE CONTRIBUTION AMOUNT
Year Contribution Limit Year Contribution Limit

2017

$14,000

2022

$16,000

2018

$15,000

2023

$17,000

2019

$15,000

2024

$18,000

2020

$15,000

2025

$19,000

2021

$15,000

2026

$20,000
Chart A1.15 – EXCESS HOME LIMIT
Year Excess Home Limit Amount Year Excess Home Limit Amount

2016

$552,000

2022

$636,000

2017

$560,000

2023

$688,000

2018

$572,000

2024

$713,000

2019

$585,000

2025

$730,000

2020

$595,000

2026

$752,000

2021

$603,000

.