Georgia Medicaid: What It Covers, Who Qualifies, and What to Do If You Lose Coverage
If you’re in Georgia and worried about affording health insurance, Medicaid can be a lifeline—but it’s not the only path to coverage. And if you’ve recently lost Medicaid, been denied, or have a type of Medicaid that doesn’t count as “minimum essential coverage,” you still have options.
At Mere Benefits, we help you figure out exactly where you stand—whether that means getting re-enrolled, transitioning to Medicare, or finding a Marketplace plan that works for your budget.
Understanding Georgia Medicaid
Georgia Medicaid offers different programs depending on your age, income, health, and family situation. You may qualify if you are:
Pregnant
A child or teen under 19
65 or older
Living with a disability or blindness
A parent or caretaker of children under 19
In need of nursing home care
Georgia also offers Pathways to Coverage for adults ages 19–64 with incomes up to 100% of the Federal Poverty Level who work or participate in qualifying activities.
And for kids whose families earn too much for Medicaid, there’s PeachCare for Kids®, covering everything from routine checkups to hospital stays for a small monthly premium.
When Medicaid Isn’t “Minimum Essential Coverage” in Georgia
Some Medicaid programs in Georgia are limited and do not meet federal requirements for “minimum essential coverage.” This means you may qualify for Marketplace subsidies even while enrolled in these programs, if your income meets the criteria.
This includes:
Medicaid for medically needy individuals who only get full benefits after meeting a spenddown amount
Georgia Planning for Healthy Babies Family Planning Demonstration
Limited coverage that only pays for:
Family planning
Emergency Medicaid
Tuberculosis services
Outpatient hospital services
If you or someone in your household is only covered by one of these programs, you can still apply for a Marketplace plan with potential premium tax credits and cost-sharing reductions.
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:
Call our office: 📞 904-654-5450
We check if you qualify for Marketplace or Medicare coverage
We help you apply — No cost. No obligation.
Mere Benefits #simplyforyourbenefit
“We help Georgia residents keep the coverage they need—whether it’s Medicaid, Marketplace, or Medicare.”
