Georgia Medicaid Income Limits for 2020

The Georgia Medicaid program provides medical coverage to low-income individuals and families. Medicaid also helps seniors and disabled people with the cost of nursing facility care and other health care expenses. In this post, we will review the eligibility standards for Medicaid in Georgia, including the Georgia Medicaid income limits.

Eligibility for Medicaid is usually based on the family’s or individual’s income. To learn more about how to qualify for Medicaid in Georgia and the income limits, please keep reading this post below.

"Georgia Medicaid Income Limits"

This article on Georgia Medicaid eligibility will cover:

  • Medicaid in Georgia
  • Who Can Get Medicaid in Georgia?
  • Georgia Medicaid Expansion
  • 2020 Georgia Medicaid Income Limit
  • What is Counted as Income for Medicaid?
  • Long Term Care Eligibility for Seniors
  • How to Apply for Medicaid in Georgia

Medicaid in Georgia

Georgia Medicaid (also known as Georgia Medical Assistance) provides healthcare coverage to almost 1.8 million Georgians including 1.3 million children.

The Medicaid program in Georgia is administered by the Georgia Department of Community Health (DCH).

However, eligibility for Medicaid in Georgia is determined either by the Georgia Division of Family and Children Services (DFCS) or the Social Security Administration (for SSI recipients).

PeachCare for Kids (PeachCare) is Georgia’s name for CHIP, which provides health insurance to children whose families earn too much to qualify for Medicaid.

Who Can Get Medicaid in Georgia?

You should apply for Medicaid if your income is low and you match one of the descriptions below:

  • You think you are pregnant
  • The parent or caretaker of a child and/or teenager under the age of 19.
  • You are a child or teenager age 18 or under.
  • An adult age 65 or older.
  • You are legally blind.
  • Living with a disability or disabled.
  • You are in need of nursing home care.

Georgia Medicaid Expansion

Georgia is one of the 14 states that have not expanded Medicaid coverage to low-income adults without dependents.

As a result, about 267,000 adults with low income who would otherwise be covered by Medicaid expansion are left without coverage.

Georgia proposes partial Medicaid expansion

Georgia enacted legislation in 2019 that allows the state to seek federal permission to expand Medicaid.

The state introduced a waiver proposal that calls for partial Medicaid expansion, effective in July 2021, that would cover adults age 19-64 with income up to 100 percent of the poverty level.

The Affordable Care Act (ACA) made Medicaid expansion available to adults who make up to 138 percent of the poverty level.

The waiver proposal will also require recipients to work at least 80 hours per month.

The video below provides a great summary of the current situation regarding the debate in Georgia about Medicaid expansion and what you can expect in the future.

2020 Georgia Medicaid Income Limit

Like most states, Georgia has multiple Medicaid programs based on categories.

To be approved for Medicaid, you have to know the income limit for the eligibility category you fall under.

Here are the main eligibility categories:

  • Children Ages 0-1
  • Children Ages 1-5
  • Children Ages 6-18
  • Children – CHIP
  • Pregnant Women
  • Parent & Caretaker Relatives
  • Seniors & People w/ Disabilities
  • Adults – Medicaid Expansion

How the Georgia Medicaid Income Limit is Calculated

The Georgia Medicaid Income limit is calculated as a Percent of the Federal Poverty Level (FPL).

In general, if your household income is at or below the current 133 percent FPL for your household size, your family is likely to be eligible for Medicaid.

Below are the Medicaid Eligibility levels for the state of Georgia as a percentage of the FPL by category.

Georgia Medicaid Eligibility Levels (as a % of Federal Poverty Level)

Children Ages 0-1 205%
Children Ages 1-5 149%
Children Ages 6-18 133%
Children – CHIP 247%
Pregnant Women 220%
Parent & Caretaker Relatives 32%
Seniors & People w/ Disabilities 74%
Adults – Medicaid Expansion No Expansion

Here is the 2020 Federal Poverty Level information, based on Household Size as released by the US Department of Health and Human Services.

Federal poverty levels in 2020
Household Size Poverty Guideline
1 $12,490
2 $16,910
3 $21,330
4 $25,750
5 $30,170
6 $34,590
7 $39,010
8 $43,430
Over 8 people Add $4,420 per extra person

The federal poverty level in Alaska ranges from $15,600 (for one person) to $54,310 (for eight people). The federal poverty level in Hawaii ranges from $14,380 (for one person) to $49,940 (for eight people).

The Georgia Medicaid Income Limit for 2020

Based on the Federal Poverty Level numbers above and the Medicaid Income Category Chart above, here are the 2020 Georgia Medicaid Income limits.

For simplicity, the chart is broken down by Children and Adults.

Georgia Medicaid for Children covers Ages 0-1, 1-5, and 6-18.

Children whose household income is too high to qualify for traditional Medicaid in Georgia may qualify for CHIP (Peachcare for Kids).

Georgia Medicaid Income Limit 2020 – Children
Children Medicaid Ages 0-1 Children Medicaid Ages 1-5 Children Medicaid Ages 6-18 Children Separate CHIP
% FPL 100% 205% 149% 133% 247%
Household Size
1 $12,490 $25,605 $18,610 $16,612 $30,850
2 $16,910 $34,666 $25,196 $22,490 $41,768
3 $21,330 $43,727 $31,782 $28,369 $52,685
4 $25,750 $52,788 $38,368 $34,248 $63,603
5 $30,170 $61,849 $44,953 $40,126 $74,520
6 $34,590 $70,910 $51,539 $46,005 $85,437
7 $39,010 $79,971 $58,125 $51,883 $96,355
8 $43,430 $89,032 $64,711 $57,762 $107,272

Here is the chart for adults, which includes Pregnant Women, Parents or Caretakers of Children under 19, Seniors, and people with Disabilities.

Note that since Georgia did not expand Medicaid to adults without dependents, that category is not populated.

Georgia Medicaid Income Limit 2020 – Adults
Pregnant Women Medicaid Adults (Medicaid) Parent/ Caretaker Seniors & People w/ Disabilities (Medicaid) Adults (Medicaid) Expansion to Adults
% FPL 100% 220% 32% 74% NO
Household Size
1 $12,490 $27,478 $3,997 $9,243 N/A
2 $16,910 $37,202 $5,411 $12,513 N/A
3 $21,330 $46,926 $6,826 $15,784 N/A
4 $25,750 $56,650 $8,240 $19,055 N/A
5 $30,170 $66,374 $9,654 $22,326 N/A
6 $34,590 $76,098 $11,069 $25,597 N/A
7 $39,010 $85,822 $12,483 $28,867 N/A
8 $43,430 $95,546 $13,898 $32,138 N/A

What is Counted as Income for Medicaid?

For Medicaid application purposes, income is all money, earned or unearned, cash or any type of support received from any source by you or your household that can be used to meet basic needs for food, clothing or shelter.

Income eligibility is determined by your modified adjusted gross income (MAGI), which is your taxable income, plus certain deductions.

However, for most people, MAGI is identical or very close to your adjusted taxable income, which you can find on your tax return.

Non-taxable income is excluded in the eligibility determination based on federal rules.

Excluded Income

Some examples of excluded income are adoption assistance payments, earnings from the Census Bureau, Child Support, Veteran’s Benefits, and Supplement Security Income (SSI).

In addition, Earned Income Tax Credits, Disaster relief assistance, and TANF (formerly AFDC) benefits are also excluded.

Also, Income is considered on a monthly basis and is used to determine financial eligibility and benefit level.

Whether your income level qualifies you or your family for Medicaid depends on the size of your family and the Medicaid program for which you are applying.

How Can I Verify My Income?

Income verification can be provided in a variety of ways, including:

  • Pay stubs covering at least the past four weeks.
  • Copy of check reflecting gross income.
  • Form 809 – Wage Verification form.

How to Calculate MAGI for Medicaid Eligibility

Follow the steps below, to calculate your MAGI for Medicaid Eligibility. Please note that this includes estimating any future income that may impact your MAGI.

Step 1

Calculate your household’s adjusted gross income (AGI) by using your most recent federal income tax return. Additionally, you can find your AGI on line 7 of IRS Form 1040.

Step 2

Second, add the following types of income (if applicable) to your AGI:

  • Tax-exempt foreign income
  • Eligible Tax-exempt Social Security benefits (including tier 1 railroad retirement benefits)
  • Any Tax-exempt interest

Do not include Supplemental Security Income (SSI).

Step 3

Lastly, adjust your estimate for any changes you expect.

Be sure to consider things future changes or adjustments for all members of your household, such as:

  • Expected raises
  • New jobs or other employment changes, including changes to your work schedule or self-employment income
  • Include changes to income from other sources, like Social Security or investments
  • Changes in your household, like gaining or losing dependents. Gaining or losing a dependent can have a big impact on your savings.

In conclusion, you now have successfully calculated your MAGI. Additionally, you should have an estimate of your expected income.

Exemptions from Income Limits

Not all Medicaid applications are required to meet the income limit. The following groups do not have to meet the Medicaid Income limit:

  • Supplemental Security Recipients (SSI)
  • Breast and cervical cancer treatment and prevention program beneficiaries
  • Children for whom an adoption assistance agreement is in effect under title IV-E of the Social Security Act are automatically eligible.
  • Young adults who meet the requirements for eligibility as a former foster care recipient are also eligible at any income level.

2020 Georgia Medicaid Long Term Care Eligibility for Seniors

Your assets come into play when it comes to Long-Term Services and Supports (LTSS), the part of Medicaid that pays for long-term care and nursing home for Seniors.

Here are the income and asset (resources) limits for the Seniors applying for long-term care under Medicaid in Georgia.

Single Person Applying for Georgia Medicaid Benefits

Type of Medicaid Single
Income Limit Asset Limit Level of Care Required
Institutional / Nursing Home Medicaid $2,349 / month $2,000 Nursing Home
Medicaid Waivers / Home and Community-Based Services $2,349 / month $2,000 Help w/ 2 Activities of Daily Living (ADLs)
Regular Medicaid / Aged Blind and Disabled $783 / month $2,000 None

Married Couple if Both are Applying for Georgia Medicaid Benefits

Type of Medicaid Married (both spouses applying)
Income Limit Asset Limit Level of Care Required
Institutional / Nursing Home Medicaid $4,698 / month (Each spouse can have income up to $2,349 / month) $3,000 Nursing Home
Medicaid Waivers / Home and Community-Based Services $4,698 / month (Each spouse can have income up to $2,349 / month) $3,000 Help w/ 2 Activities of Daily Living (ADLs)
Regular Medicaid / Aged Blind and Disabled $1,175 / month $3,000 None

Married Couple if Only One Needs to Apply for Georgia Medicaid Benefits

Type of Medicaid Married (one spouse applying)
Income Limit Asset Limit Level of Care Required
Institutional / Nursing Home Medicaid $2,349 / month for applicant $2,000 for applicant & $128,640 for non-applicant Nursing Home
Medicaid Waivers / Home and Community-Based Services $2,349 / month for applicant $2,000 for applicant & $128,640 for non-applicant Help w/ 2 Activities of Daily Living (ADLs)
Regular Medicaid / Aged Blind and Disabled $1,175 / month $3,000 None

Here is a list of assets counted during eligibility determination:

  • Cash
  • Checking accounts
  • Savings accounts and certificates
  • Christmas or vacation clubs
  • Stocks and bonds
  • Some trust funds
  • Life insurance
  • Vehicles
  • Revocable burial funds
  • Non-resident property

Examples of resources not counted in determining eligibility include:

  • Your home
  • Revocable and irrevocable burial reserves subject to specified limits
  • Burial space and marker
  • One motor vehicle

How to Apply for Medicaid in Georgia

There are 3 ways you can apply for Medicaid in Georgia.

Option 1 – Apply online

To apply online, please visit the Georgia Gateway online application portal.

You may also find out if you qualify and apply online through the Healthcare.gov Marketplace.

Option 2 – Apply at DFCS Office Near You

You can apply in person at the Georgia Division of Family and Children Services (DFCS) office near you. Click here to locate a DFCS office.

Option 3 – Download Georgia Medicaid Application

You can download an application, complete it and mail it to your county DFCS office or submit it in person.

If you are pregnant or have breast or cervical cancer, you may apply for Presumptive Medicaid at your local health department or call 404-657-2700.

Documents you need to apply

Here are the documents you are going to need to apply for Medicaid in Georgia:

    • A copy of your birth certificate or other proof of identity and citizenship or immigration status
    • ID cards issued by federal, state or local government agencies or entities either containing a picture or identifying information, such as name, date of birth, sex, height, eye color and address to confirm identity
    • Social Security numbers, for each person requesting Medical Assistance
    • Paycheck stubs, payroll records or recent W-2 forms covering at least the past four weeks
    • Letters or forms that show your income from Social Security, SSI, Veterans Administration, retirement, pensions, unemployment, worker’s compensation or all sources of income
    • Current health insurance policies, health insurance cards, or other health insurance information
    • Life insurance policies
    • Recent bank statements or bank books, and/or most recent tax return
    • Information about property you own (such as land, or stocks and bonds)

Georgia Medicaid Income Limits Summary

We hope this post on the Georgia Medicaid Eligibility was helpful.

If you have further questions about Georgia Medicaid benefits, please let us know in the comments section below.

Be sure to check out our other articles on Georgia Benefits, including how to get 50% OFF Amazon Prime Membership with Georgia EBT Card and FREE Museums for EBT Cardholders and how to check Georgia EBT Card Balance.  

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