Medicaid is the official medical service program of Georgia's Community Health Department that makes health care accessible to low-income residents. Qualified residents will receive a member identification card which they have to show prior to receiving any health care service to accredited Medicaid doctors, hospitals or health care providers.

As soon as you receive your Medicaid card, you will be given access to a wide variety of health care services from doctors, hospitals or health care providers who are registered in Medicaid. All you have to do is to bring it with you at all times and show it to accredited doctors or hospitals before you avail of any medical service.

Basically, Medicaid allows you free services from health care providers who accept Medicaid fees such as:

• Medical or laboratory examination and treatment conducted by a physician or health care provider
• Prescribed medications
• Hospitalization and other expenses incurred during confinement
• Hospital expenses that do not require 24-hour confinement
• Special home facilities for the elderly
• Use of ambulance for emergency cases
• Dental care for children such as fillings and dental surgery
• Some urgent dental care for adults
• Fare to and from medical check-ups

However, Medicaid does not pay for:

• services that do not require medical attention
• service of private nurses, relatives or friends
• plastic surgery

A complete list of services can be found by clicking here.

You can also receive Medicaid services if you join Georgia Families. However, Medicaid will not pay for medical services that you receive from health care providers who are not enrolled in the said program.

Although Medicaid will pay for most or all of your bills, there may be some instances when you need to make a small co-payment when you receive health care. This is based on your Medicaid category.

If you have any questions or complaints regarding your Medicaid, dial the Member Contact Center at 770-325-2331 or toll free 1-866-211-0950.

Eligibility Requirements

Medicaid is available to qualified low-income individuals. Factors such as age, pregnancy, blindness, disability, earnings and other sources of income, citizenship and immigrant status are considered when reviewing your eligibility.

You can qualify for Medicaid if you fall under these categories:

• Those who have a financial limit as seen in the Medicaid Eligibility Criteria Chart
• US National or Eligible Immigrant Expectant Mother
• Children and Teenagers. Low-income parents may enroll their children and teenagers in Medicaid if they are 18 years or under, or give beneficial care to your children who are sick but can be treated at home. An independent teenager who lives outside of home may apply for Medicaid by himself.
• Those who need hospitalization due to a critical condition
• Those who are 65 years and over, legally blind or handicapped and have low income and few assets, living in nursing homes or may receive quality community care services at home.

Even if you don't think you qualify, you must still apply because some assets or conditions do not count such as:

• Need medical care although you are qualified to leave Temporary Assistance for Needy Families (TANF)
• Family with children 18 years and below with low to no salary and limited resources
• Female with breast or cervical-cancer
• Income exceeds the required limit but you have medical fees to settle, expecting a baby, below 18 or 65 years above, totally blind or handicapped

Medicaid Application Instructions

There are several ways to apply for Medicaid:

Via Mail/Walk-In Application

Fill out all the required information and sign the application form which you can download here: Get the application and submit it to the nearest Division of Family and Children Services (DFCS) office. A DFCS representative will accept your application or suggest more accessible locations such as schools, hospitals or community service centers where you can hand in your application. In case you find it hard to complete the form, ask the local representative for guidance.

Get Assitance via Phone

Dial 404-657-2700 to find a county health department. You will be connected to the nearest agency where a representative can assist you. You can also click this link for a complete list of DFCS offices, phone and fax numbers.

Online

You can also visit these websites and click on the member information button:

• DFCS: www.dfcs.georgia.gov
• DCH: https://dch.georgia.gov/
• DHR: www.dhr.georgia.gov
• Georgia Health Partnership: www.ghp.georgia.gov

IMPORTANT: As soon as you submit your application, a certified Medicaid Eligibility Specialist will review it carefully. Factors such as age, citizenship, disability and income limits will determine if can be eligible for the program. Thus, it is best to bring the documents listed below to prove your identity and source/s of income.

You may not need all of the documents listed below. They are just examples of what you need to bring.

To prove your identity:

• Birth Certificate
• Government-issued ID cards with picture (driver's license, passport, US citizen card, etc.)
• Social Security Number

To prove you meet the income limits:

• Salary stubs or recent monthly payroll record
• Documents that prove your income in SSN, Veteran's Administration, etc.
• Health/ Life insurance plans
• Bank books
• Property information such as real estate and bonds

For those who applied for SSI via the Social Security Administration: A Medicaid Eligibility Specialist will evaluate your application. Inform your specialist of any unsettled medical bills within the past quarter. Medicaid may settle a part of those bills even though you were not yet registered during that time, that is, if you are qualified for the program.

Within 45 days, a letter will be sent to inform you whether you are eligible or not. This period may extend for another 15 days if you are handicapped and it still has to be proven. A plastic Medicaid card will be included in your mail if you are eligible.

It is important to let your Medicaid Eligibility Specialist of any change in your address since all information will be sent to you via the address you provided. Equally necessary is to inform your specialist about any health care insurance.

There are certain conditions which will enable you to receive Medicaid benefits faster:

• Expectant mother- you can already avail of prenatal check-up and care as soon as you submit your application form.
• 65 years and over, legally blind or handicapped person- submit your application for the SSI program through the nearest Social Security office. Your Medicaid becomes active instantly and you will be qualified to receive supplemental income. Dial Call 1-800-772-1213 or visit www.ssa.gov to find the nearest Social Security office. DFCS will also process your application faster but you will not be given supplemental income.
• Deaf- Dial 1-800-325-077 for the Social Security Administration toll-free TTY number