What to Know about Georgia Medicaid
The Georgia Medicaid Program provides free or low-cost health coverage to needy persons. If you are currently applying for Medicaid in Georgia or are currently a recipient and have questions, you’ve come to the right place.
In this post, we are going to explain everything you need to know to successfully apply for Medicaid.
If you are a recipient, we will answer the most common question people have about Georgia Medicaid and how you can get the most out of your Medicaid benefits.
In this article, we will cover:
- What is Medicaid?
- Who is eligible for Medicaid in GA?
- What is the income limit for Medicaid?
- How Do I Apply for Medicaid in Georgia?
- What does Medicaid cover in Georgia?
- How do I apply for Georgia Medicaid?
- Does GA Medicaid cover dental for adults?
- Does Georgia Medicaid cover transportation?
- How do I contact Georgia Medicaid customer service?
- Georgia Medicaid FAQs
What is Medicaid?
Medicaid is a federal and state health insurance program for people with a low income.
It provides free or low-cost health coverage to millions of Americans, including families and children, pregnant women, the elderly, and people with disabilities.
The Children’s Health Insurance Program (CHIP) offers health coverage to children in families with incomes too high to qualify for Medicaid, but who can’t afford private coverage.
Medicaid in Georgia
Georgia Medicaid provides healthcare coverage to almost 1.8 million Georgians including 1.3 million children, and 500,000 seniors and people with disabilities.
The program is managed by the GA Department of Community Health (DCH).
PeachCare for Kids (PeachCare) is Georgia’s name for the Child Health Insurance Program (also called CHIP), which provides health insurance to children whose families earn too much to qualify for Medicaid.
For eligibility or help applying for PeachCare, check out our guide here.
Facts about GA Medicaid
Here are facts about the impact of GA Medicaid.
50% + of all Births – Georgia Medicaid covers more than half of all births in the state.
75% Nursing Home Stays – For 75% of all nursing home stays in GA, Medicaid is the primary payer.
168,000 low-income Georgia Seniors – Medicaid pays the premiums and other costs of Medicare for 168,000 low-income Georgian seniors.
50% Georgia children – Half of all Georgia children, including all current and former foster children, are covered by Medicaid and PeachCare for Kids.
2:1 Ratio – Federal to State Funding – The federal government provides the bulk of the state’s Medicaid funding. For every $1 Georgia spends on Medicaid benefits, the state receives more than $2 in federal funds.
Medicaid Expansion In Georgia
Georgia is one of the 14 states that have not expanded Medicaid coverage to low-income adults without dependents.
As a result, about 726,000 adults with low income who would otherwise be covered by Medicaid expansion are left without coverage.
Given that Georgia has one of the highest uninsured rates in the nation, this leaves many people without the coverage they need.
What does Georgia Medicaid cover?
The GA Medicaid program covers a variety of healthcare and medical services treat illnesses and help keep households healthy. Currently, the following services are covered:
- Doctor Visits
- Inpatient & Outpatient Hospital Care
- Lab Tests
- Home Health Care
- Hospice Care
- Medical Equipment & Supplies
- Non-Emergency Medical Transportation Services
- Dental Care (up to the age of 21)
Who is eligible for Medicaid in GA?
You may be eligible for Medicaid if your income is low and you meet one of the descriptions listed below.
You should apply for Medicaid in GA if you are:
- Pregnant or think you may be
- A child or teenager
- Age 65 or older
- Legally blind
- Disabled or have a disability
- In need of nursing home care
Please note that if you are pregnant or think you may be pregnant, there are specific eligibility requirements to receive Medicaid benefits. Please refer to our Pregnancy Eligibility guide here.
You may be automatically eligible for Medicaid if you receive any of the following:
- Supplemental Security Income (SSI)
- Cash Assistance
- State/County Special Assistance for the Aged or Disabled
When you apply for benefits, your application will be carefully reviewed by a caseworker and a determination will be made if you qualify or not.
GA Medicaid Eligibility Criteria
Whether you qualify for GA Medicaid or not depends on a variety of factors, the most important is the Income Limit, which we explain below.
In addition, you must meet the following eligibility rules:
- Be a resident of the state of Georgia
- Be a U.S. citizen or a qualifying noncitizen
- Provide a Social Security number for each person requesting coverage, unless an exception is met
- Meet income and asset limit
- Meet any other program rules set by the DCH for GA Medicaid.
For more on eligibility guidelines, see our Georgia Medicaid Eligibility post.
What is the income limit for Georgia Medicaid?
The GA Medicaid income limit is based on a percentage of the Federal Poverty Levels.
The state of Georgia has four categories for Medicaid recipients. Each of these categories has it’s income limit based on the Federal Poverty Level.
The four categories are:
- Infants and Children
- Families with Dependent Children
- Pregnant Women
- Aged, Blind, and Disabled
For income limits for each of these categories and resource limits, see our detailed Georgia Medicaid Income limits post.
Generally, in order to qualify for GA Medicaid, you must have an annual household income (before taxes) that is less than or equal to the following amounts:
|Household Size*||Maximum Income Level (Per Year)|
How do I apply for Georgia Medicaid?
If you would like to apply for Medicaid benefits online, you will need to use the Georgia Gateway online portal.
For a complete step-by-step process on how to apply for Medicaid, see our How to Apply Guide.
In order to successfully apply for the Medicaid benefits in Georgia, there are a number of documents you will need to provide.
You 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.
If you have already started your online Medicaid application, but need help accessing it your information, check out our Medicaid Login Help Guide for assistance completing your application.
Does Georgia Medicaid cover dental?
The short answer is Yes.
The state of Georgia is required under federal law to provide dental benefits to children covered by Medicaid and the Children’s Health Insurance Program (CHIP).
This dental services for children must include:
- Relief of pain and infections
- Restoration of teeth
- Maintenance of dental health
Therefore, If your child has Medicaid dental coverage, many of your child’s necessary dental care treatments may be covered. This includes:
- Annual dental exams
- Regular dental checkups
- Fluoride treatments
However, when it comes to dental coverage for adults, states choose whether to provide dental benefits for adults or not.
While Medicaid covers children for Dental Care, coverage for Adults is only limited to emergencies.
See our post – Georgia Medicaid Dental Coverage (including how to find a Medicaid Dentist) for more details on dental coverage.
Does Medicaid cover transportation?
The answer is yes, but there are rules you have to follow.
Georgia Medicaid Transportation covers non-emergency medical transport (NEMT) services for eligible recipients who have no other means of transportation to get to Medicaid covered services. Medicaid also covers medically necessary emergency ground or air ambulance transportation.
You can request GA Medicaid transportation for the following covered Medicaid services:
- Medical treatment
- Medical evaluations
- Obtaining prescription drugs
- Obtaining medical equipment
How to Request a Ride with GA Medicaid Transportation
There are currently two (2) brokers that provide NEMT services to Georgia’s 159 Counties. They are LogistiCare and Southeastrans.
For the purposes of GA Medicaid Transportation, the state is divided into five (5) regions by county – Central Region, East Region, Southwest Region, Atlanta Region, and North Region.
For details about the four regions, and which region your county falls under, see our Georgia Medicaid Transportation post.
How do I contact Georgia Medicaid customer service?
If you are trying to get in contact with someone about Georgia Medicaid, you will need to contact the GA Department of Community Health (DCH).
The DCH is responsible for administering the Medicaid program, as well as PeachCare for Kids. Here are the phone numbers to call. See the link to the complete list below.
DCH has specific phone numbers to call for different questions and situations.
For a full list, see our Contact Number for Georgia Medicaid post.
Georgia Medicaid Frequently Asked Questions (FAQs)
Get answers to some of the most frequently asked questions about the GA Medicaid program.
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 benefits 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.
We hope you found this guide on Georgia Medicaid was helpful. If you still need help completing your application for GA Medicaid, contact the GA Medicaid Help Center phone number at 1-877-423-4746.
If you have more questions about the Medicaid program, leave those in the comments section below. We are happy to help answer them for you.