Georgia Medicaid Updates
What you need to know about Medicaid
Changes to Medicaid are coming in 2027. We can help you understand what to expect.
Call 800-888-3081.
Take steps now to help protect your coverage
Beginning in 2027, some Medicaid members may be asked to complete additional eligibility reviews, provide updated information or meet new requirements to keep their coverage. If any action is needed, your state Medicaid agency will contact you directly with instructions.
Expected changes include:
- New work and community engagement requirements for some adults ages 19-64, with exemptions for certain individuals, including those with disabilities or medical frailty. Understanding whether you qualify for an exemption can help you protect your coverage.
- More frequent eligibility reviews, with some Medicaid members required to verify eligibility every six months instead of annually.
- Additional documentation or verification requirements from state Medicaid agencies.
Some patients may lose Medicaid coverage if they miss renewal deadlines or do not respond to requests from their state.
What you can do now
These changes are expected to begin in 2027, so now is the time to stay informed, keep your information up to date, and know where to turn for help.
- Keep your contact information current Make sure Medicaid has your current mailing address, phone number
and email address.
- Update your current account or create an account on www.gateway.ga.gov or call 877-423-4746.
- Watch for important notices Pay attention to mail, email, text messages, and other communications from Medicaid.
- Respond quickly If your state Medicaid agency asks for information or documentation, respond as soon as possible to avoid delays or interruptions in coverage.
- Ask for help if needed If you have questions about your Medicaid coverage or need help understanding next steps, resources are available to assist you.
To find out if you are eligible or to apply, visit medicaid.georgia.gov.
What if I no longer qualify for Medicaid?
If you're no longer eligible to receive Medicaid coverage, you can select a health plan through the Affordable Care Act's Health Insurance Marketplace. Learn more about the Marketplace at healthcare.gov.
These are the health insurance plans offered through the health care marketplace that include Atrium Health Navicent:
- Alliant Health Plans - SoloCare plans
- Ambetter
- Anthem Blue Cross Blue Shield of Ga Blue Value plans - excluding AHN Peach
- Anthem Blue Cross Blue Shield of Ga Pathway plans - AHN Baldwin only
- Oscar Health
See Atrium Health Navicent's Marketplace resources
You may also be eligible for Georgia Pathways to Coverage™. See our frequently asked questions below for more information.
Our financial advocates can help
If you have questions about Medicaid changes, call 800-888-3081.
If you have questions about Marketplace enrollment, our certified application counselors can help. Please call 866-988-0520.
How do I apply for Medicaid?
You have flexible options when applying for Medicaid. Choose the method that works best for you.
Online
Visit Gateway.ga.gov and log in or create an account to apply.
By 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.
Learn more about how to apply for GA Medicaid.
Need more help?
Contact your state Medicaid agency to update your information or learn more about your coverage requirements. Learn more at Medicaid.gov.
Frequently asked questions about Medicaid renewals
Medicaid covers mandatory benefits plus additional health services Georgia has added for eligible beneficiaries. Benefits may be different depending on age, income and health care needs. In general, Medicaid may cover the following services:
- Doctor visits, including OB/GYNs, health departments and rural health clinics
- Emergency care
- Lab tests and X-rays
- Hospital/surgical center services, including anesthesia
- Prescriptions
- Vision and hearing
- Dental services
- Mental and behavioral health
- Medical equipment, such as wheelchairs
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.
Atrium Health Navicent doctors and hospitals are in network for the following Georgia Medicaid health insurance plans:
If you have any questions, please contact your health plan.
Important: If you have a medical emergency, go to the closest hospital emergency room. Atrium Health Navicent hospitals provide services to all patients seeking treatment for an emergency medical condition, regardless of what health insurance plan you have or if you can pay for emergency services.
Georgia Pathways to Coverage™ or Pathways offers Medicaid coverage to Georgia residents who meet program requirements.
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.
- If you move or change your address
- If you are pregnant or your household size has changed
- If you have a new job or change in income
If there have been no changes to your personal information, you don't need to do anything.
Learn more www.staycovered.ga.gov.
When you enroll in a health plan, you can change your health plan once for any reason within 90 days of initial enrollment. After that, you can change your health plan:
- At your Medicaid renewal date
- If you're 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.
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 within your current health plan's provider network, please contact your health plan.