Table of Contents
Georgia Medicaid provides health coverage to low-income residents, including children, pregnant women, parents, seniors, and individuals with disabilities.
Program Name | Georgia Medicaid |
Expanded Medicaid | No |
Website | https://medicaid.georgia.gov/ |
https://dch.georgia.gov/contact-dch | |
Phone | 877-423-4746 |
Apply Online | https://medicaid.georgia.gov/how-apply |
Appeal a Denial | File an Appeal |
Find a Local Office | https://dfcs.georgia.gov/locations |
Eligibility Requirements
To be eligible for Georgia Medicaid, you must be a resident of the state of Georgia, a U.S. national, citizen, permanent resident, or legal alien, in need of health care/insurance assistance, whose financial situation would be characterized as low income or very low income.
You must also be one of the following:
- Pregnant
- Be responsible for a child 18 years of age or younger
- Blind
- Have a disability or a family member in your household with a disability
- Be 65 years of age or older
Annual Household Income Limits (before taxes)
Household Size* | Maximum Income Level (Per Year) |
1 | $31,814 |
2 | $43,028 |
3 | $54,242 |
4 | $65,456 |
5 | $76,669 |
6 | $87,883 |
7 | $99,097 |
8 | $110,311 |
*For households with more than eight people, add $11,214 per additional person.
Available Services Include:
Certain emergency dental care for adults | Laboratory services |
Diagnostic and screening services | Medical equipment and supplies |
Doctor and nurse office visits | Mental health clinic services |
Emergency ambulance services | Non-emergency transportation |
Exams and vaccines for children | Nurse midwife |
Family planning services | Nursing facilities |
Hearing services for children | Prescription drugs |
Hospice care services | Preventive dental care for children |
Hospital services | Vision care for children (limited for adults) |
Copayments
Ambulatory surgical centers/birthing | $3.00 |
Durable medical equipment | $2.00 |
Federally Qualified Health Centers | $2.00 |
Free-Standing Rural Health Clinic | $2.00 |
Home health services | $3.00 |
Hospital-Based Rural Health Center | $2.00 |
Inpatient hospital services | $12.50 |
Oral maxillofacial surgery | Cost-Based |
Orthotics and prosthetics | $3.00 |
Outpatient hospital services | $3.00 |
Pharmacy – preferred drugs | $0.50 |
Pharmacy – non-preferred drugs | Cost-Based |
Physician assistant services | Cost-Based |
Physician services | Cost-Based |
Podiatry | Cost-Based |
Eye care | Cost-Based |
Cost-Based Copayment Schedule | |
Cost of Service | Copayment (Amount Member Pays) |
$10.00 or less | $0.50 |
$10.01 to $25.00 | $1.00 |
$25.01 to $50.00 | $2.00 |
$50.01 or more | $3.00 |
The following Georgia Medicaid members do not have to pay copayments:
- Medicaid members under age 21
- Pregnant women
- Members with breast and/or cervical cancer
- Members in nursing homes
- Members in hospice care
- American Indians
- Alaskan natives