Medicaid Costs and Coverage in Georgia

The question “How much is Medicaid in Georgia?” is incredibly common among low-income Georgians who need financial assistance with their medical bills. Discovering your own Medicaid cost estimates is a crucial part in establishing how much you will need to pay for healthcare in Georgia. Additionally, what services are covered by Medicaid are not necessarily applicable to all Medicaid beneficiaries. If you do not gain full coverage you may have to rely on your Medicare or private health insurance plan or be responsible for paying some of your health and medical bills out of pocket. Getting answers to “how much does Medicaid cost in GA?” and becoming familiar with the services that Medicaid covers can help low-income Georgia residents to prepare for the future.

How much does Medicaid cost in Georgia?

The biggest misconception involving Medicaid costs in Georgia is that there are always premiums and deductibles associated with Medicaid. As a government-sponsored program, GA Medicaid coverage plans often do not have explicit costs associated with them. Instead, they are simply extremely selective insurance plans that can lower the costs of your other various medical costs. Answering “how much does Medicaid cost?” in Georgia can be as simple as determining how much your medical bills and Medicare/private health insurance premiums are, and whether or not you qualify for full coverage in the state. There can occasionally be state-imposed deductibles and copayments on certain non-emergency medical events – these low and sometimes uncommon costs are further outlined below.

The biggest factor that goes into health care and Medicaid cost estimates is whether or not you qualify for Georgia’s specific maximum income limits. You cannot get Medicaid coverage at all if your household income is more than a certain percentage above the federal poverty line – therefore, it is extremely important to know the most up-to-date information. When you apply for Medicaid insurance coverage through the Georgia Department of Community Health (DCH), you will be informed of these numbers in order to ensure that you are eligible.

For more details on the costs associated with Medicaid, download our comprehensive guide.

What services are covered by Medicaid in Georgia?

After you have applied for and have met Georgia Medicaid coverage eligibility requirements, you will receive a letter in the mail that details the types of Medicaid insurance through which you are able to receive financial aid. These coverage options are many, but the majority of them simply have to do with your typical medical needs. These include helping to pay copays for doctor visits, deductibles for inpatient and outpatient hospital visits, dental care for individuals younger than 21 years of age, non-emergency ambulance use and a number of prescription drug costs.

But in determining what services are covered by Medicaid, there are also many that you may not normally expect. You can receive Medicaid benefits assistance on medical testing services, such as lab work, X-rays and other medical equipment. Also, it can cover home nursing care and hospice services for elderly or terminally ill patients. This type of assistance is useful for many different Georgia residents, and allows for low-income individuals and families can afford to pay for their medical needs.

Medicaid insurance benefits are slightly different for children that are eligible for Georgia’s PeachCare for Kids plan. Up until their 19th birthday, Georgia children can get Medicaid coverage through this program in order to cover their specific care for nearly all of the above health costs. In addition, it can cover specialized care for children, such as child mental health care and emergency room services. An application for this program can be found through the PeachCare for Kids sector of the Georgia DCH.

What does Medicaid not cover for Georgia applicants?

While a Georgia Medicaid insurance plan can be incredibly useful for covering many medical costs, it cannot cover everything. The best way to find out what Medicaid does not cover is to consult your physician or specialist. However, it is good to keep in mind that the following services are generally not covered:

  • Services that are not medically necessary, including cosmetic surgery
  • Chiropractor and massage therapy
  • Private duty nursing care or care provided by a family member
  • Experimental treatment options

Medicaid coverage can also vary depending on what state you are in – a service that is not deemed to be covered in Georgia may be considered in another state, and vice-versa. To discover the answer to “What does Medicaid not cover in Georgia?” you can ask your doctor for your own personal circumstances, or the Customer Interaction Center of the Georgia DCH.

Additional Medicaid Coverage & Cost Factors

As was previously mentioned, some Medicaid cost estimates include small premiums and copayments imposed by the state of Georgia in order to cover a portion of the insurance coverage that they are providing. Luckily for Medicaid insurance coverage recipients, these costs are generally either nonexistent or quite low. Medicaid was designed to help low-income Americans who are particularly vulnerable and need assistance with their healthcare costs. The Medicaid costs associated with PeachCare for Kids are also a factor, because they are a part of a special type of coverage. While the cost can be as low as $0 for GA children with the right qualifications, they can also be higher. Completing the PeachCare for Kids application process will give you a better idea of how much you may need to pay per month.

Download our comprehensive guide form more details on the services that Medicaid covers and the costs involved with receiving Medicaid benefits.