Not all Medicaid coverage is the same. In Georgia, some Medicaid programs provide only limited benefits — and that can leave you with serious gaps in care.

At Mere Benefits, we help you understand what kind of Medicaid you have and, if needed, guide you toward Marketplace or Medicare plans that give you full protection at an affordable price.

What Is “Limited Medicaid”?

Limited Medicaid programs only cover certain services and do not meet the federal definition of minimum essential coverage. That means you may qualify for Marketplace subsidies (premium tax credits and cost-sharing reductions) even while on one of these programs — if you meet income requirements.

Types of Limited Medicaid in Georgia

If you’re covered by only one of these programs, you have limited benefits:

• Medicaid for Medically Needy Individuals

  • Coverage starts only after you meet a “spenddown” amount based on your medical expenses.
    

• Georgia Planning for Healthy Babies – Family Planning Demonstration

  • Covers family planning services only.

• Limited Medicaid that pays only for:

  • Family planning

  • Emergency Medicaid

  • Tuberculosis (TB) services

  • Outpatient hospital services

Why Limited Medicaid Can Be a Problem

• No full medical coverage for doctor visits, prescriptions, or inpatient hospital stays

• Higher out-of-pocket costs if you need care outside the limited benefits

• Missed access to preventive care that could help avoid bigger medical bills later

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 listed above

• 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 don’t just explain your options — we walk you through them. Our team will:

• Identify if your Medicaid is limited or full coverage

• Determine your eligibility for Marketplace subsidies or Medicare

• Compare available plans so you get better coverage without breaking your budget

• Make sure your doctors and prescriptions are included in your new plan

If you have limited Medicaid in Georgia, you may be missing out on full coverage. Call us today at 904-654-5450 and let’s fix that — #simplyforyourbenefit.