Georgia Medicaid updates

If you are no longer eligible to receive Medicaid benefits, you can enroll in a health plan through the Affordable Care Act’s Health Insurance Marketplace. Choosing a plan can protect you from high, unexpected medical costs.

That’s why Atrium Health Floyd is proud to work with affordable Health Insurance Marketplace plans – like Aliant SoloCare, Ambetter and Anthem (limited markets only) – to provide quality coverage with access to a level of care you won’t find anywhere else.

Take time to compare your options and make sure to choose a plan that includes Atrium Health Floyd doctors and hospitals.

Visit Healthcare.gov

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Georgia Pathways to Coverage™

Georgia Pathways to Coverage™ is a new pathway to Medicaid coverage and healthier communities. Pathways introduces a new Medicaid eligibility category in Georgia, increasing access to affordable, quality health care coverage for those in the state who don’t have it today.

To be eligible for Pathways, you should:

• Be a Georgia resident
• Be a U.S. citizen or legally residing non-citizen
• Be between 19 and 64 years of age
• Have a household income of up to 100% of the Federal Poverty Level
• Prove that you are doing at least 80 hours of qualifying activities per month
• Not qualify for any other type of Medicaid
• Not be incarcerated

To learn more about the program, and to see if you or someone you know may qualify, visit dch.georgia.gov/georgiapathways.

Georgia residents can apply through the Gateway Customer Portal online at gateway.ga.gov. You can also apply:

In-person at your local Division of Family & Children Services (DFCS) office. To find the location and business hours for a DFCS office, visit: dfcs.ga.gov/locations.

By mail to your local DFCS office.

By phone at 1-877-423-4746 or 711 for those who are deaf, hard of hearing, deafblind or have difficulty speaking.

The 2023 Consolidated Appropriations Act (Omnibus Bill) was signed into law on Dec. 29, 2022. It included an important change to the federal COVID-19 Public Health Emergency (PHE) period.

Starting April 1, 2023, Medicaid programs are no longer required to provide continuous coverage for beneficiaries. (According to the to the Office of Management and Budget, the COVID-19 PHE will end May 11, 2023.)

Recertifications (renewals) will be completed over the next 12 months as beneficiaries are up for renewal. Recertification could result in termination or reduction of benefits.

There are three ways to apply:

• Online: Apply at Gateway.ga.gov
• Mail: Mail a paper application to:
• Division of Family and Children Services (DFCS)
• Customer Contact Center
• P.O. Box 4190
• Albany, GA 31706
• In person: Schedule an appointment at your local DFCS office.

Learn more about how to apply for Georgia Medicaid.

Gateway is a way to apply for benefits and services, view case details and renew your Medicaid online.

You can manage or create an account online.

• A recent move or change of address
• If you are pregnant or your household size has changed
• A new job or a change in income

If there have been no changes to your personal information, no action is needed.

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Most people can change their health plan within 90 days of health plan enrollment.

When you enroll in a health plan, you can change your health plan for any reason within 90 days. After that, you can change your health plan:

• At your Medicaid recertification date
• If you are required to change health plans
• If you have a special or “with cause” reason, such as:
  • You moved out of your health plan’s service area
  • You have a family member in a different health plan
  • You cannot get all the related services you need from providers in your health plan, and there is a risk to getting the services separately
  • A different health plan may be better for your complex medical conditions
  • Your Long-Term Services and Supports (LTSS) provider is not in your health plan
  • Your health plan does not cover a service you need for moral or religious reasons
  • Other reasons (poor quality of care, lack of access to covered services, lack of access to providers experienced in dealing with your health care needs)

You can change your health plan at any time for these reasons:

• You need services to address a mental health disorder, substance use disorder, intellectual/developmental disability (I/DD) or traumatic brain injury (TBI)
• You are a federally recognized tribal member or qualify for services through Indian Health Service (IHS)

To change your primary care provider (PCP) within your current health plan’s provider network, please contact your health plan. Below are the health plans and their contact information:

• Amerigroup
• CareSource
• Centene (Peach State)
• Georgia Medicaid