If you’re a Georgia Medicaid member, the rules have changed — and you could lose coverage if you don’t take action. Every year, Georgia checks to see if you still qualify for Medicaid, but in 2025 this process is catching many people off guard.

At Mere Benefits, we help Georgia residents understand their renewal letters, avoid gaps in care, and find affordable options if Medicaid is no longer available.

Why Are People Losing Medicaid in Georgia?

Medicaid coverage is not automatic. Each year, the state’s Division of Family & Children Services (DFCS) reviews your eligibility, looking at:

• Income and household size

• Age or disability status

• Pregnancy status

• Other coverage options available to you

If the state doesn’t get the information they need — or if your income is now too high — you can lose coverage, even if you still need it.

How to Avoid Losing Coverage

1. Open and read every Medicaid renewal notice you get in the mail or by email.

2. Respond to any requests for proof of income, residency, or other eligibility details.

3. Update your contact information with DFCS so you don’t miss important notices.

What If You Get a Denial or Termination Letter?

Don’t panic — you still have options. If your Medicaid coverage ends:

• You may qualify for a Special Enrollment Period (SEP) to get a Marketplace plan with subsidies to lower your premium.

• If you’re turning 65 or qualify for disability Medicare, we can help you transition without a gap in coverage.

• If you qualify for limited Medicaid benefits only, you may still be eligible for Marketplace savings.

Limited Medicaid Programs That Don’t Count as Full Coverage

If you’re only on one of these programs in Georgia, you may qualify for Marketplace subsidies right now:

• Medicaid for medically needy individuals (spenddown programs)

• Georgia Planning for Healthy Babies – Family Planning Demonstration

• Coverage limited to family planning, emergency Medicaid, TB services, or outpatient hospital services

Medicaid to Marketplace Quick Guide

Do You Have Full Georgia Medicaid… or Just Limited Benefits? (Knowing the difference could save you money on health insurance.)

Full Medicaid – You’re Covered

• Covers doctor visits, hospital, prescriptions, preventive care

• No monthly premium (for most)

• Not eligible for Marketplace subsidy

Limited Medicaid – You May Qualify for Marketplace Savings ⚠

• Only covers specific services:

  • Family Planning

  • Emergency Medicaid

  • Tuberculosis Services

  • Outpatient Hospital Services

  • Medically Needy Spenddown

• No full benefits

• You may be eligible for subsidies & lower costs on a Marketplace plan

What To Do Next:

1. Call our office: 📞 904-654-5450

2. We check if you qualify for Marketplace or Medicare coverage

3. We help you apply — No cost. No obligation.

How Mere Benefits Can Help

We know how stressful it is to get a Medicaid denial. Our licensed team will:

• Review your Medicaid status and determine your eligibility for Marketplace subsidies or Medicare

• Help you apply for the right plan with no-cost, no-obligation support

• Make sure your doctors and prescriptions are covered

• Explain your plan in plain language — so you know exactly how it works

If you’ve lost Medicaid or have limited coverage in Georgia, call 904-654-5450 or request an appointment. We’ll help you get the right coverage in place — #simplyforyourbenefit.