Medicaid Costs and Coverage in Georgia


Finding out how much is Medicaid in Georgia is important for applicants who need affordable medical coverage. Knowing what services are covered by Medicaid insurance for approved applicants is equally as important since coverage can influence the cost. Medicaid is a state and federal government funded program that helps qualifying applicants with low incomes receive low or no cost health insurance coverage. Medicaid cost estimates are typically determined on an applicant-by-applicant basis since many factors determine eligibility and benefit amount. To find how much does Medicaid cost beneficiaries, read the outlined topics below.

Georgia Medicaid Coverage Cost

Georgia Medicaid coverage and the cost associated can vary by enrollee. The types of Medicaid insurance beneficiaries have influence which health care services are covered and which will have out-of-pocket costs. In most cases, the beneficiary will not have to pay a premium. However, a small monthly premium may be required in some cases. Like Medicaid eligibility, officials consider the applicants income to determine future Medicaid cost estimates. Enrollees may be subject to monthly premiums to share in the cost of medical coverage.

The percentage of cost covered by Medicaid also depends on the type of service. Most preventative services are free of charge. Other services may require a small portion to be paid by the beneficiary in the form of a copayment or deductible. Again, the household income will affect the percentage or flat fee the beneficiary is required to pay for health care services. By means of example, those with higher incomes will pay a higher percentage or costs while lower income enrollees may have a nominal fee.

Find out more about the how income influences the cost of medical services for Medicaid participants in our comprehensive guide.

Services Covered by Medicaid in Georgia

Learning what services are covered by Medicaid in Georgia helps petitioners plan and prepare for medical expenses. Costs occurred from rendered services not covered by Medicaid will be the responsibility of the patient. Since there are several types of Medicaid insurance, a variety of service can be covered by these different plans. The list below details the types of medical services that are covered by most Medicaid options:

  • Doctor’s visits and immunizations
  • Hospitalizations and emergency services
  • Dental care (for those younger than 21 years of age)
  • Vision care
  • Mental health services
  • Medical equipment such as inhalers

Those who have a disability or a covered illness will be able to get other services covered by Georgia Medicaid like nonemergency transport. Women with breast or cervical cancer will usually get all their treatments pertaining to their illness covered by Medicaid. One of the types of Georgia Medicaid insurance is Long Term Care, which is an option for those who need long-lasting medical care in a nursing home or hospice environment. Medicaid officials will have to evaluate an applicant’s situation before granting them access to Long Term Medicaid.

While there are different types of insurance by Medicaid, most types will have limits on the amount of times in a certain period you can get a particular service. For example, you may be only able to get one vision or hearing exam per year. If you want or need an additional exam, then you will have to pay for the service without Medicaid’s coverage.

Services Not Covered By Medicaid in Georgia

What does Medicaid not cover for Georgia enrollees? Medicaid coverage will not be provided for services rendered by a health care provider who does not accept Medicaid insurance. Before seeing a doctor or any other type of medical provider, it is important to check to see if he or she accepts your Medicaid plan. If you see an out-of-network provider, then you will have to pay for the services you received without the help of Medicaid, in most cases.

Medicaid does not provide coverage for treatments that have not been scientifically proven to be effective. While some services like acupuncture are known to help certain conditions, there is no scientific data that proves that this type of medical treatment is effective and it will not be covered. Medicaid cost estimates for treatments will not include non-medically necessary treatments like cosmetic surgery.

Download our detail guide for information on services Medicaid covers.

Getting Georgia Medicaid Coverage

While you may be wondering, “How much does Medicaid cost?” it is crucial to learn if you meet the eligibility requirements for Medicaid coverage first. The type of Medicaid insurance you qualify for will directly affect the cost and coverage available. For instance, those who are eligible for Medicaid and Medicare coverage will have the lowest medical costs. Likewise, Medicaid services for children and the elderly tend to be less restrictive than services for able-bodied adults.

While some states do allow adults without dependents to be on Medicaid, Georgia does not. If you have determined that you are able to get Medicaid, then you will have to follow the application process and provide all the details that the Medicaid program will ask of you. You will then find out what exact services are covered by GA Medicaid once you hear of your acceptance into the program. The costs of Medicaid approved services will still be billed to you if you received care before your official enrollment in the program.

Please note: While Medicaid is available for many people, some applicants may not qualify for certain reasons. However, other medical benefits programs may be an option for them. If you have been denied Medicaid benefits, then you may still qualify for other types of programs managed by the state of Georgia.

What Health Services Are Available in Georgia?

From Obamacare health insurance plans to Medicaid and Medicare, there are various types of health coverage available in Georgia. Each type of insurance can be accessed through a different application method. To learn about the easiest ways to apply for affordable health care in GA, download our comprehensive guide on health services.

Who Is Eligible for Affordable Health Services in Georgia?

Affordable and free health services are often limited to Georgia residents who meet all established eligibility requirements. Income, age and household size are often key factors taken into consideration when determining an applicant’s qualifications. Discover if you qualify for free or reduced-cost health insurance by reviewing the in-depth information on all program eligibility requirements within our comprehensive guide.