Georgia Medicaid

Enrollment

  • In the 2011 fiscal year, males made up 42% of Medicaid enrollees while females accounted for 58%.

CHIP

  • In October 2014, child enrollment in Medicaid/CHIP was 1,218,048.
  • Children made up 70.3% of total enrollees in Medicaid/CHIP for October 2014.

Costs Covered

  • The distribution of Medicaid spending by service in 2012 was 68.9% acute care, 26.2% long-term care and 4.9% disproportionate share hospital payments.
  • Medicaid spending per enrollment group in 2011 was 18% for the aged, 36% for the disabled, 16% for adults and 30% for children.

Medicaid Expansion

  • Georgia was one of 23 states to not approve the Medicaid expansion in 2014.
  • Before the Affordable Care Act, Georgia’s monthly Medicaid enrollment average was 1,535,090.
  • Monthly Medicaid enrollment in Georgia after the Affordable Care Act’s Medicaid expansion was 1,733,367, a 12.9% increase.

1) What is Medicaid?

For those individuals and families who required medical assistance and have low incomes, Medicaid is the program they need to apply for. Medicaid, which is a state and federal program, provides low-cost or free health care to all applicants who qualify for the benefits. This includes American citizens and immigrants who are living in the United States legally. In the entire country, there are approximately 60 million people who are covered by the program.

The services available when your Medicaid application is accepted vary and include everything from immunizations to treatment and surgeries, and both children and adults receive this medical assistance. One reason Medicaid is very important today is because of the Affordable Care Act. With its establishment came the individual mandate, which states that everyone who is a citizen of the United States needs to have health insurance. Anyone who chooses not to follow this law will be penalized and have to pay a substantial fine.

So if you do not qualify for the medical benefits of the GA Medicaid program, then it is your responsibility to purchase health coverage from the federal Health Insurance Marketplace. Those who do have Medicaid do not have to worry about purchasing additional coverage to meet the individual mandate requirement.

2) How do I apply for Medicaid in Georgia?

There are few ways that you should learn how to apply for Medicaid if you live in the state of Georgia. After you have learned about all of your options, then you will be able to choose which one is the most convenient for you. The first option that you have, which is often seen as the easiest method of filing for Medicaid, is to apply online. By submitting a GA Medicaid application online, you will be able to see if you qualify for the program in just a few easy steps. If you do, you will be given quick access to all of the benefits of the medical program. If this option suits you, apply online here.

If you would rather not apply online, another choice you have is to call 877-423-4746 and request a Medicaid application be sent to you. Then, after filling it out, you can mail it to the address that is listed on the form. You can also decide to take this form to a local Division of Family and Children Services office. In addition, applicants can also choose to apply by phone or by email, as long as they provide all of the necessary personal information, such as:

  • Names and addresses of everyone you are applying for
  • Social Security numbers
  • Income information (paystubs, W2 forms)

3) What does GA Medicaid cover?

Those who apply for Medicaid in Georgia and receive the medical benefits of the program will enjoy a wide variety of services that are covered. These services and treatments are designed to maintain the health of all beneficiaries while not forcing them to spend much if any money. Some of the most important services included in the Medicaid GA program are:

  • Visits to the physician.
  • Prescription medication.
  • Inpatient hospital services.
  • Outpatient hospital services.
  • Lab exams.
  • X-rays.
  • Hospice services.
  • Home health services.
  • Durable medical equipment or DME.
  • Medical supplies.
  • Dental care, if you are 21 years old or younger.
  • Transport to medical appointments, if not considered an emergency.

Although all of the above services are available to Georgia recipients of Medicaid, there is also a variety of services, treatments and surgeries that will not be covered by the medical assistance program. The Georgia Medicaid will not provide care if a service is deemed not medically necessary. But because of all of the savings you receive while a part of the medical assistance program, other costly procedures that are not covered are not as hard on your budget. To begin receiving all of the above benefits as soon as possible, apply for Medicaid here.

4) Who is eligible for Georgia Medicaid?

There is a variety of groups of people who are eligible to receive Medicaid in the state of Georgia. But each of these groups must meet certain requirements before they are accepted into the medical assistance program. The requirements can include age, pregnancy status, whether or not you are disabled, blind or aged and the level of your income.

Income is the most important factor that determines eligibility, as you cannot receive any of Medicaid’s benefits if your earnings exceed the financial limits set by the program, regardless of whether you are a U.S. citizen or a legal resident. Determining a child’s status is different. Their eligibility is based on their own situation, not that of their parents.

Review the 2015 Georgia Medicaid income requirements below:

  • 1 person = $11,770
  • 2 family members = $15,930
  • 3 family members = $20,090
  • 4 family members = $24,250
  • 5 family members = $28,410
  • 6 family members = $32,570
  • 7 family members = $36,730
  • 8 family members = $40,890
  • Add $4,160 for each additional person for families with more than eight family members.

If your income meets the financial requirements of the program, you should apply for Medicaid GA if you belong to any of the following groups:

  • Pregnant women
  • Women with breast or cervical cancer
  • The aged (over 65)
  • The blind
  • The disabled
  • Children 18 years of age or younger
  • Those in need of nursing home care
  • Children in foster care or adopted

Even if you do not belong in any of the above groups, it is recommended that you apply for medical assistance through Georgia Medicaid if you or anyone in your family needs health care and you do not believe you can afford it.

5) What are the consequences if Georgia does not elect Medicaid expansion?

Georgia was part of the minority of the country that chose not to approve the Medicaid expansion in 2014. They, along with 22 other states, chose to keep their medical assistance program the same size that it was for fear that their state government would not be able to afford the medical bill in the coming years when they would be required to pay a portion of the Medicaid expansion bill. Twenty-seven other states and the District of Columbia chose to expand their medical programs, accepting free funds from the government to insure more American citizen and legal immigrants.

The immediate consequences of not augmenting the Medicaid program in Georgia is that an estimated 682,000 people will not gain access to medical assistance in the state. Furthermore, these individuals are expected to remain uninsured for the year.

Meanwhile, the states that elected to expand their medical assistance programs can now offer care to more individuals and families than ever before, and the services and treatments featured under GA Medicaid come at low or no cost. This was accomplished because the expansion allowed states to accept applicants with income up to 133 percent of the federal poverty level, as well as children of families with similar earnings.

6) How do I contact Georgia Medicaid?

There are two main ways that a resident of Georgia can get in touch with a representative from the Medicaid program. You can either call a specific hot line, which will vary based on your needs, or you can visit a local Division of Family and Children Services’ Medicaid office. There are centers scattered throughout the state for your convenience. But if you would like to save time and get an answer to your question as soon as possible, it is recommended that you contact a representative on their specific Georgia Medicaid phone number.

If you want to get in touch with an official of Peachcare for Kids, you must call 877-427-3224. To learn more about eligibility requirements and see if you qualify, dial 404-651-9982. For other services provided by the DFCS, call one of the numbers listed below:

  • Member Services: 866-211-0950
  • Provider Services: 800-766-4456
  • Customer Service: 404-657-5468
  • Hospital Services: 404-651-9606
  • Long-Term Care : 404-656-6862
  • Medical Policy: 404-651-9606

If your problem relates to any of the above help lines, then you should not hesitate to call and have your issue resolved by a professional representative. Whether you are trying to find out if you are eligible or would like to learn more about the services provided by Medicaid GA, call a Medicaid phone number today.

Close Bitnami banner
Bitnami