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The Georgia Medicaid program provides medical coverage to low-income individuals and families. As of 2018, the program, along with the Children’s Health Insurance Program (CHIP) covered 1.8 million adults and children. Medicaid services in Georgia are administered by the Department of Community Health (DCH).
In this post, we will review the eligibility standards for qualification, including the Georgia Medicaid income limits. To learn more, please keep reading this post below.
Who Can Get Medicaid in Georgia?
You should apply for Medicaid if your income is low and you match one of the descriptions below:
- You think you are pregnant (see our Georgia Pregnancy Medicaid post here).
- The parent or caretaker of a child and/or teenager under the age of 19.
- You are a child or teenager age 18 or under.
- An adult age 65 or older.
- You are legally blind.
- Living with a disability or disabled.
- You are in need of nursing home care.
Georgia Medicaid Income Limit
The Georgia Medicaid Income Limit is calculated as a percentage of the Federal Poverty Line. To qualify, you must meet the Georgia Medicaid Income limits listed below.
Here is the Federal Poverty Level (FPL) for 2018:
Additionally, to be eligible for Medicaid, you cannot make more than the income guidelines outlined below:
- Children up to age 1 with family income up to 205 percent of FPL
- Any child age 1-5 with family income up to 149 percent of FPL
- Children ages 6- 18 with family income up to 133 percent of FPL
- Pregnant women with family income up to 220 percent of FPL
- Parents of minor children with family income up to 35 percent of FPL
- Individuals who are elderly, blind and disabled with family income up to 75% of the FPL
- Women with Breast and Cervical Cancer with Family Income up to 200% of the FPL
Income Limit Charts
The GA Medicaid eligibility income limit charts are divided by groups. For example, the first group is for children who qualify for Medicaid under the Right from the Start program.
For reference, see the chart below for eligible income limits for children.
Children Income Limit
After that, the second group is for adults who qualify for Medicaid. Georgia is one of the strictest states when it comes to adult qualification for Medicaid. However, since Georgia did not expand Medicaid under the Affordable Care Act (ACA), adults without children/dependents do not qualify for Medicaid as shown below.
Adults Income Limit
Other Groups Income Limit
How to Review the Georgia Medicaid Income Limits Charts
You cannot have an income higher than the Federal Poverty Level percentage described for your group to be eligible for Medicaid.
Similarly, when you identify the income group that applies to you, the income limit you see refers to the maximum level of income you can earn to qualify for benefits.
For example, if you are pregnant, to qualify for Medicaid, you cannot have an income higher than 220% of the Federal Poverty Level – which for a family of two is $37,212 as shown in the chart above.
Medically Needy Program Limits
In states with Medically Needy Medicaid programs, individuals may qualify for Medicaid if they have medical expenses that significantly reduce their income.
The Georgia Medically Needy Program has no income maximum. In other words, individuals are allowed to use medical expenses to “spend down” the difference between their income and the medically needy income level (MNIL).
The Medically Needy calculation is completed on a monthly basis and only pays for medical bills incurred after the spend-down is met.
Medically Needy Program for Pregnant Women
For Adults that are Elderly, Blind or Disabled, the MNIL is $317 for an individual and $375 for a couple. For reference, Medically Needy is calculated on a monthly basis and only pays for medical bills incurred after the spend-down is met.
Medically Needy Program for Adults (Elderly, Blind & Disabled)
What is Considered Income for Medicaid Eligibility?
Income eligibility is determined by your modified adjusted gross income (MAGI). In other words, your taxable income, plus certain deductions.
For most people, MAGI is identical or very close to your adjusted gross income (AGI). Similarly, this can be found on your tax return.
How to Calculate MAGI for Medicaid Eligibility
Follow the steps below, to calculate your MAGI for Medicaid Eligibility. Please note that this includes estimating any future income that may impact your MAGI.
Calculate your household’s adjusted gross income (AGI) by using your most recent federal income tax return. Additionally, you can find your AGI on line 7 of IRS Form 1040.
Second, add the following types of income (if applicable) to your AGI:
- Tax-exempt foreign income
- Eligible Tax-exempt Social Security benefits (including tier 1 railroad retirement benefits)
- Any Tax-exempt interest
Do not include Supplemental Security Income (SSI).
Lastly, adjust your estimate for any changes you expect.
Be sure to consider things future changes or adjustments for all members of your household, such as:
- Expected raises
- New jobs or other employment changes, including changes to your work schedule or self-employment income
- Include changes to income from other sources, like Social Security or investments
- Changes in your household, like gaining or losing dependents. Gaining or losing a dependent can have a big impact on your savings.
In conclusion, you now have successfully calculated your MAGI. Additionally, you should have an estimate of your expected income.
If you cannot calculate your modified adjusted gross income, Georgia Medicaid eligibility can also be determined by using resource limits.
When determining your eligibility you must meet a set of resource limit criteria. For example, here is a list of resources counted during eligibility determination:
- Checking accounts
- Savings accounts and certificates
- Christmas or vacation clubs
- Stocks and bonds
- Some trust funds
- Life insurance
- Revocable burial funds
- Non-resident property
Examples of resources not counted in determining eligibility include:
- Your home
- Revocable and irrevocable burial reserves subject to specified limits
- Burial space and marker
- One motor vehicle
If you have any questions about Medicaid in the state of Georgia, you can ask us in the comments section below.
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