How to Apply for Georgia Medicaid [Guide]

Last Updated on

If you live in Georgia and need assistance with medical bills or health care coverage, you may qualify to receive Medicaid benefits. Medicaid serves eligible adults, families, children, disabled, and elderly low-income households living in Georgia.

The Georgia Medicaid program is administered by the Department of Community Health (DCH) and is the largest division within the DCH. 

If you need help paying for your medical bills or can’t afford medical care, we will help you apply for Georgia Medicaid benefits.

In this guide on “How to Apply for Georgia Medicaid,” we will cover:

  • Georgia Medicaid Eligibility
  • Requirements for Georgia Medicaid
  • What you need to Apply for Medicaid
  • Application for Georgia Medicaid
  • How to Contact Georgia Medicaid
  • Georgia Medicaid Frequently Asked Questions (FAQ’s)

To get started, continue reading below.

How to Apply for Georgia Medicaid Benefits

Georgia Medicaid Eligibility

If you would like to apply for the Georgia medical assistance program, it’s important to first determine if you are eligible for benefits.

The most important factor in determining your eligibility for Georgia Medicaid is your income. There are set income limits that you must meet in order to qualify for medical assistance.

Income is defined as any money that you get from working, money that is given to you, or checks that you receive, such as Social Security or unemployment benefits.

We have listed the Georgia Medicaid Income Limits for you below.

Georgia Medicaid Income Limits

The Medicaid income limit for Georgia is set each year and calculated as a percentage of the Federal Poverty Level (FPL). Whether your income qualifies for Medicaid depends on the size of your family/household and the Medicaid program you are applying for.

The Georgia Medicaid Income Limit Charts are divided into three different groups – Adults, Children, and Elderly/Disabled/Blind.

For more information on the three different groups, as well as a full breakdown of the income limits with charts, read our article on the 2019 Georgia Medicaid Income Limits here.

The chart below shows the current Federal Poverty Level Guideline for 2019:

2019 Federal Poverty GuidelinesGeorgia Medicaid Income Eligibility Levels

In order to determine if you are eligible for Medicaid, you need to refer to the income eligibility level for your group.

Below is the Georgia Medicaid income eligibility levels for children and adults (pregnant women, parents, and other non-disabled adults):

  • Households with children under age 1 with an income up to 205% of FPL
  • Adults with children ages 1-5 with an income up to 149% of FPL
  • Households with children under 19 with an income up to 133% of FPL
  • Pregnant women with an income up to 220% of FPL
  • Households with parents of minor children with an income up to 35% of FPL
  • Elderly, blind and disabled households with an income up to 75% of FPL
  • Women with Breast/Cervical Cancer with an income up to 200% of FPL

Additionally, if you live in a household with children under the age of 19 and have an income up to 205% of the FPL, you may be eligible for low-cost health insurance under the Right from the Start Medicaid (RSM) Program.

Get more information about the RSM Program, here.

Georgia Medicaid checklist

Requirements for Georgia Medicaid

In addition to meeting the Georgia income limit criteria, you must also meet a set of basic requirements to be eligible for Medicaid. These requirements are based off of the category you fall into.

You must fall into one of these categories to be eligible for benefits.

Georgia Medicaid Eligible Categories

You may be eligible for medical assistance benefits in Georgia, if you are:

Parent or Caretaker of a Child under the age of 19

Households with children under the age of 19 may be eligible for Georgia Medicaid benefits if they are U.S. citizens or legal immigrants and household income does not exceed $653 (for a family of 4). 

Pregnant or Expecting Women

Pregnant women can expedite the Medicaid application process and start receiving medical coverage right away by completing a Presumptive Eligibility (PE) Medicaid Application. PE Medicaid applications may be completed at your local county health department office. 

Your eligibility for PE Medicaid is determined the same day and is active from the approval date to the end of the following month.

PE Medicaid benefits provide temporary coverage to pregnant women until the determination for full Medicaid benefits is processed.

For more information on Medicaid for pregnant women, read our Georgia Pregnancy Medicaid article.

Undergoing treatment for Breast or Cervical Cancer

Women that have been diagnosed with breast of cervical cancer and are currently receiving medical treatment may be eligible for Women’s Health Medicaid (WHM) benefits.

To qualify for Women’s Health Medicaid, you must be:

  • Diagnosed and undergoing treatment for breast or cervical cancer
  • Income must be at or below the 200% FPL Income Guidelines
  • Under the age of 65
  • Currently uninsured
  • Biological or transgender woman
  • Georgia resident 
  • U.S. Citizen or legal immigrant

If you meet all of the requirements listed above, visit your local county health department office to complete a PE Medicaid Application.

This is temporary healthcare coverage until your Women’s Health Medicaid application has been processed.

Over the Age of 65, Disabled or Legally Blind

If you are over the age of 65, disabled or living with a disability, are legally blind, or require nursing home care, you must meet all income limit and basic requirements to qualify for Medicaid.

The basic requirements that all categories must meet are provided below.

Basic Requirements for Medicaid Benefits

If you fall into one of the categories listed above, then you must also:

  • Be a U.S. Citizen or Legal Immigrant
  • Must have a valid Social Security Number (SSN)
  • Have a valid form of Identity Verification (government-issued ID)
  • Must be a Georgia Resident
  • Have an assignment of Medical Benefits

Exceptions to Georgia Medicaid Requirements

If you do not meet any of the eligibility or basic requirements listed above, then you may still be eligible for Georgia Medicaid. There are a few exceptions that may still make you eligible for benefits.

Other situations that may make you eligible for Georgia Medicaid include:

  • In need of health coverage and are leaving Temporary Assistance for Needy Families (TANF).
  • You’re a family with children under 19 and have very low or no income.
  • If your income is higher than the limits and you have medical bills you owe (and you are pregnant, under 18 or over 65, blind, or disabled).
  • Your child is in foster care or adopted.
  • When you or someone in your family needs health care, you should apply for Medicaid even if you are not sure whether you qualify.

Also, please note that your child may still be eligible for Medicaid even if you are not. However, they must be a U.S. citizen or a legal immigrant for this to apply.

Eligibility for children is based on the child’s status, not the parent’s status. However, the parent’s income is counted toward the income limit.

If you have more questions regarding your eligibility for Medicaid, check out our post here.

Georgia Medicaid Eligibility

 

What you need to Apply for Medicaid

If you meet the income limits and basic requirements for Georgia Medicaid, then the next step is to prepare for the application process.

In order to successfully apply for the Medicaid benefits in Georgia, there are a number of documents you will need to provide.

 

Georgia Medicaid Documents RequiredYou will need:

  • Copy of Birth Certificate, Proof of Identity or Citizenship
  • Identification cards issued by the federal, state or local government
  • Social Security Number (SSN)
  • Last 4 weeks of Paycheck Stubs or W-2 forms
  • Letters or forms showing Social Security, SSI, and any other income
  • Proof of Current Health Insurance Policy
  • Health Insurance Cards
  • Life Insurance Policy Documentation
  • Last four Bank Statements
  • Documentation about any Property you own

It is important to have all of these documents ready before completing your Medicaid application. It will make the application process go more smoothly and quickly.

Once you have gathered all of this information, you are ready to complete your Georgia Medicaid Application.

Application for Georgia Medicaid

Currently, there are three ways to apply for Georgia Medicaid – online, in-person, or by mail. We will provide you with step-by-step instructions on how to apply each of the three ways.

Apply for Georgia Medicaid Online

Apply for Georgia Medicaid Online

If you would like to apply for Georgia Medicaid online, you will need to use the Georgia Gateway online portal.

For instructions on how to apply for Medicaid using Georgia Gateway, follow the steps below:

1.) Visit the Georgia Gateway website

The first step when applying for Medicaid benefits, is to go to the Georgia Gateway website. You can find the website at www.gateway.ga.gov.

2.) Login or Create a Georgia Gateway Account

Once you are on the Georgia Gateway website, the next thing you will want to do is login your Georgia Gateway account. If you would like help logging in, visit our Gateway Login Help Guide here.

If this is your first time using the Georgia Gateway portal, then you will first need to create an account. Follow the step-by-step instructions here on how to create your Georgia Gateway account.

3.) Start your Medicaid Application

Now that you are logged into your Georgia Gateway account, you can begin your Medicaid application.

To start a new application for Medicaid benefits, click the “Begin Application” link located at the top of your account homepage.

Please note: You do not need to complete your Georgia Medicaid Application in the same session. You can save your application and come back to it later.

To do this, just click the “Save” button located at the bottom of your application page. You can resume your application by logging back into your Georgia Gateway account.

4.) Submit your Georgia Medicaid Application

Once you have completed and filled out all required information on the Georgia Medicaid Application, you can now submit it for review.

You can expect to find out if you are approved for Georgia Medicaid benefits within 45 to 60 days after you submitted your application.

To check the status of your application, log into your Georgia Gateway account.

Apply for Georgia Medicaid In-Person

Apply Georgia Medicaid In-Person

If you would like to apply for Georgia Medicaid in-person, you can do so at several different local county office locations.

Currently, you can apply for Georgia Medicaid at:

  • Division of Family and Children Services (DFCS) Offices
  • Right from the Start Medicaid (RSM) Group Offices
  • Social Security Administration Offices
  • Public Health Department County Offices
  • Select Hospitals and Nursing Homes

We have provided step-by-step instructions on how to apply for Georgia Medicaid at the office locations below.

GA DFCS

Georgia Division of Family and Children Services Office

 

To apply for Georgia Medicaid at a Georgia DFCS office, follow these steps:

1.) Locate your local county DFCS office

To find a DFCS office near you, use our DFCS office locator here. You can also call the Georgia DFCS information phone number at 1-877-423-4746. They will help direct you to your local DFCS office.

2.) Visit your local county DFCS office

Once you have found your local DFCS office, visit the office during their operating hours to fill out your Medicaid Application.

3.) Complete the Georgia Medicaid Application

Complete your Georgia Medicaid application at your local DFCS office. Be sure to bring all the documents listed in the “What you need to Apply” section above. You will need these in order to complete your application.

4.) Submit your Georgia Medicaid Application

Once you have successfully filled in all the information on the Georgia Medicaid Application, you can submit it to a DFCS caseworker.

If you have any questions while you are filling out the Medicaid application, you can ask one of the DFCS caseworkers for help.

You can expect to find out if you are approved for Georgia Medicaid benefits within 45 to 60 days after you submitted your application.

To check the status of your application, call your local DFCS office.

Right from the Start Medicaid

Right from the Start Medicaid Office

Right from the Start Medicaid offices are dedicating to helping women ages 18-44 apply for Medicaid benefits.

To apply for Georgia Medicaid at a Georgia RSM office, follow these steps:

1.) Locate your local RSM office

To find a RSM office near you, click here. You can also call the Right from the Start help hotline at 800-809-7276. They will help you find a RSM office near you.

2.) Visit your local RSM office

Once you have found your local RSM office, visit the office during their operating hours to fill out your Medicaid Application.

3.) Complete the Georgia Medicaid Application

Complete your Georgia Medicaid application at your local RSM office. Be sure to bring all the documents listed in the “What you need to Apply” section above. You will need these in order to complete your application.

4.) Submit your Georgia Medicaid Application

Once you have successfully filled in all the information on the Georgia Medicaid Application, you can submit it to a RSM worker.

If you have any questions while you are filling out the Medicaid application, a RSM worker can help answer those for you.

You can expect to find out if you are approved for Georgia Medicaid benefits within 45 to 60 days after you submitted your application.

To check the status of your application, call your local RSM office for an update.

SSA Office

Social Security Administration Office

If you are aged (65 or older), blind or disabled, you can apply for Georgia Medicaid at your local Social Security Administration (SSA) office.

To apply for Georgia Medicaid at a Georgia SSA office, follow these steps:

1.) Locate your local Social Security office

To find a SSA office near you, use the office locator tool here. You can also call the Social Security hotline at 800-772-1213. They will help you find a Social Security office near you.

If you are deaf or hearing impaired, please call the TTY phone number at 800-325-0778.

2.) Visit your local SSA office

Once you have found your local Social Security office, plan a visit during their operating hours to fill out your Medicaid Application.

3.) Complete the Georgia Medicaid Application

Complete your Georgia Medicaid application at your local SSA office. Be sure to bring all the documents listed in the “What you need to Apply” section above. You will need these in order to complete your application.

4.) Submit your Georgia Medicaid Application

Once you have successfully filled in all the information on the Georgia Medicaid Application, you can now submit to a Social Security worker.

If you have any questions while you are filling out the Medicaid application, a SSA worker can help answer those for you.

You can expect to find out if you are approved for Georgia Medicaid benefits within 45 to 60 days after you submitted your application.

Other Places you can apply for Georgia Medicaid in-Person:

County Public Health Department Office

If you think you may be pregnant and would like to apply for Georgia Medicaid benefits, contact your county Health Department office. To find the location near you, call the Department of Public Health at 404-657-2700.

You may be eligible to receive a Medical Assistance certification form on the same day that you apply. This would give you prenatal care yourself and your baby immediately.

Select Hospitals, Health Centers and Doctor Offices

If you think you are pregnant, you may also apply for Medicaid benefits in Georgia at federally-eligible hospitals, health centers, and primary care centers. To find out if your local health office or center is approved for Medicaid application, please give them a call.

You may be eligible to receive a Medical Assistance certification form on the same day that you apply. This would give you prenatal care yourself and your baby immediately.

Apply for Georgia Medicaid by Mail

Apply Georgia Medicaid by Mail

The last way to apply for Georgia Medicaid is by mail. If you would like to apply for Georgia Medicaid benefits by mail, follow the step-by-step instructions below.

1.) Print your Georgia Medicaid Application

The first step when applying by mail is to print out your Medicaid application. You can download and print the Georgia Medicaid Application here.

If you do not have access to a printer, you can request a paper application to be mailed to you. To request a paper application, please call 877-423-4746.

2.) Complete the Georgia Medicaid Application

Once you have printed or received your Medicaid application, you can begin completing it. In order to complete your application, you will need all of the documents listed in the “What you need to Apply” section above. We recommend collecting these documents before you begin your application.

If you need help or have questions while you are filling out your application, please call the Georgia Medicaid Help Center phone number at 1-877-423-4746.

4.) Mail in your Georgia Medicaid Application

Once you have successfully filled in all the information on the Georgia Medicaid Application, you can submit it by mailing it to the DFCS Customer Contact Center.

The Georgia DFCS Customer Contact mailing address is:

Division of Family and Children Services
Customer Contact Center
P.O. Box 4190
Albany, GA 31706 

Make sure your application is signed and completely filled out before mailing. Sending in an application with missing information will only delay your benefits decision.

You can expect to find out if you are approved for Georgia Medicaid benefits within 45 to 60 days after you submitted your application.

To check the status of your application, call your local DFCS office. To find the contact information for your local DFCS office, click here.

If you need additional help applying for the Georgia Medicaid program, use the contact information provided below.

contact Georgia Medicaid

How to Contact Georgia Medicaid

If you are trying to get in contact with someone about Georgia Medicaid, you will need to contact the Georgia Department of Community Health (DCH). The DCH is responsible for administering the Medicaid program in Georgia, as well as PeachCare for Kids. 

We have listed all contact information for Georgia Medicaid by department/service below.

Georgia Medicaid Application Request Phone Number

877-423-4746

PeachCare for Kids Phone Number

877-427-3224

Georgia Medicaid Eligibility Phone Number

404-651-9982

Georgia Medicaid Member Services Phone Number

866-211-0950

Georgia Medicaid Provider Services Phone Number

800-766-4456

Georgia Medicaid Customer Service Phone Number

404-657-5468

Georgia Medicaid Claims Resolution Phone Number

404-657-5468

Georgia Medicaid Policy Phone Number

404-651-9606

Georgia Medicaid Hospital Services Phone Number 

404-651-9606

Georgia Medicaid Long-Term Care Phone Number

404-232-1411

If you do not see the Georgia Medicaid contact information you are looking for listed above, you can also send an email to the Georgia Division of Family and Children Services (DFCS). To email the DFCS with additional questions, visit the link here.

Georgia Medicaid FAQs

Georgia Medicaid Frequently Asked Questions (FAQs)

Get answers to some of the most frequently asked questions about Georgia Medicaid.

How long does it take to find out if I am approved for Medicaid?

You can expect to find out if you are approved for Medicaid in Georgia within 45 to 60 days after you submitted your application.

How long do Medicaid benefits last?

Medicaid benefits are based on monthly eligibility. If you are over the age of 65, disabled, or legally blind, then your Medicaid benefits are reevaluated every 12 months. The yearly Medicaid reevaluation determines whether or not you are still eligible to receive Medicaid benefits. 

What does Georgia Medicaid cover?

The Georgia Medicaid Program covers a variety of healthcare and medical services treat illnesses and help keep households healthy. Currently, the following services are covered through Georgia Medicaid:

  • Prescriptions
  • Doctor Visits
  • Inpatient & Outpatient Hospital Care
  • Lab Tests
  • X-Rays
  • Home Health Care
  • Hospice Care
  • Medical Equipment & Supplies
  • Non-Emergency Medical Transportation Services
  • Dental Care (up to the age of 21)

Will Georgia Medicaid cover braces?

Georgia Medicaid does not cover cosmetic dental procedures such as teeth whitening or braces. It will cover annual dental exams, checkups, x-rays and fluoride treatments for children, but only covers emergency situations for adults.

Can you use Georgia Medicaid out of state?

Since Medicaid is administered as a joint program between each state and the federal government, each state has its own rules regarding out-of-state coverage.  If you want to use your Medicaid benefits out of state please contact the Georgia DCH Medicaid Member Services phone number at 1-866-211-0950 to discuss out of state coverage options.

How do I get a Georgia Medicaid replacement card?

If your Medicaid card was lost, stolen, or destroyed, you can request a replacement by contacting the Georgia DCH Medicaid Member Services. You can reach them by phone at 1-866-211-0950.

What is the Georgia Medicaid fee schedule?

The Georgia Medicaid Fee Schedule is administered through the Georgia Medicaid Management Information System (GAMMIS). You can view and download the current Georgia Medicaid fee schedule (with rates), here

Summary

We hope you found this guide on How to Apply for Georgia Medicaid was helpful. If you still need help completing your application for Georgia Medicaid, contact the GA Medicaid Help Center phone number at 1-877-423-4746.

If you have more questions about the Georgia Medicaid program, leave those in the comments section below. We are happy to help answer them for you.

Be sure to check out some of our other articles on Georgia Medicaid including Medicaid eligibility for pregnant women and PeachCare for Kids medical assistance program.

Comments

comments

Leave a Reply

Your email address will not be published. Required fields are marked *