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Georgia’s Medicaid Benefits

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/
Email 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

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