- Here is a great place to start when it comes to understanding Pregnancy Medicaid!
- You'll learn where to start applying, your eligibility, and all the steps that follow.
- Stay up-to-date with us as we continue to watch for Medicaid updates!
As soon as you find out you are pregnant, you can apply to see if you are eligible for Medicaid to help cover your costs even the ones not related to your pregnancy. Costs like provider visits, prescription medicines, labor & delivery, and inpatient and outpatient hospital services are covered!
To help you with the application process, we have put together some resources for you throughout this blog post. Here are the departments you’ll be going through based on which stage of the application process you are on.
- The Division of Family and Children’s Services (DFCS) handles Medicaid applications. They will be your go-to for application related questions or concerns. Their customer contact number is (877) 423-4746.
- Once approved, Care Management Organizations (CMOs) like Amerigroup, CareSource, Peach State, and WellCare will be your source for all things Pregnancy Medicaid related like network providers, coverage and much more.
Am I Eligible?
Over 50% of Georgia’s pregnancies and births are covered by Medicaid. You must be pregnant, meet income requirements, and be a U.S. citizen or meet certain immigration status requirements.
The income requirements change depending on how many people are in your household. For Medicaid purposes, the baby in your tummy is counted as a member of your household. You can see all the income eligibility limits for 2020 below:
|Family Size||2020 Income Limit (225% of the Federal Poverty Level)|
|1||$2,394 per month|
|2||$2,874 per month|
|3||$3,620 per month|
|4||$4,367 per month|
|5||$5,114 per month|
|6||$5,860 per month|
|7||$6,607 per month|
How Can I Apply?
You can apply for Medicaid by visiting www.gateway.ga.gov. Follow these steps:
- Choose the option to “Apply for Benefits.”
- Create an account with Gateway (share email for notices and updates).
- Select programs you would like to apply for like Pregnancy Medicaid and SNAP (food stamps).
- Start the program application and fill it out honestly and to the best of your ability!
Quick Tips for Applying:
- DFCS should accommodate you if you need an application in another language, need an interpreter for future interviews, or any other requests to complete the application process.
- You can list someone as your authorized representative during the application. This should be someone you trust with your most personal information.
- DFCS will not report any information you share with them about members of your household who are not applying for benefits, regardless of immigration status.
- The more information you give, the better for you and the process.
- Remember the time and date you submitted your application. If you can, take a picture of the web-page showing you submitted the application.
- If you receive pregnancy care through your county health department or another qualified provider or hospital, you may be eligible for Presumptive Eligibility. You should ask your provider if they are qualified to determine Medicaid Eligibility.
What Should I Expect Once I’ve Applied?
After you submit your application, a caseworker from DFCS may contact you to conduct a required phone interview. Afterwards, the caseworker may request additional verifying information such as pay-stubs or proof of residency. You can scan or take a picture of these and upload them to your Gateway account.
Keep tabs on whom you spoke to, the date and time of the conversation, note documents you’ve submitted, and take pictures of the web-page where you submitted your documents.
DFCS must make a decision about your Pregnancy Medicaid application within 10 days of your submission. If you do not hear back within 10 days or you are denied when you think you are eligible, call the resource below.
- In Fulton, DeKalb, Gwinnett, Cobb, and Clayton, call Atlanta Legal Aid at 404-524-5811 or visit www.atlantalegalaid.org
- In all 154 additional counties, call Georgia Legal Services Program at 833-GLSPLAW (457-7529) or visit www.glsp.org
What Should I Expect Once I’ve Been Approved?
Once your Pregnancy Medicaid application is approved, you’ll be contacted to choose a CMO. Keep these things in mind before choosing a CMO.
- CMOs all provide the same core benefits but offer different incentives and have different provider networks.
- If you already have a provider, you can call that provider to check if they are in the CMO’s network.
- Call the providers listed as in-network for each CMO and make sure they are accepting new patients.
- Call each CMO and see which one is the easiest to reach in case you have future questions or concerns.
You can start using your Medicaid benefits right after you are approved!
What Happens After I Give Birth?
After you give birth, your baby will automatically be eligible for Newborn Medicaid. Newborn Medicaid lasts until your baby turns 1. At that time, you will have to renew your baby’s Medicaid on your Gateway account. Your Pregnancy Medicaid will last until 60 days after you give birth. However, it may last longer due to the COVID-19 pandemic (see below).
During the Public Health Emergency declared due to the COVID-19 Pandemic, your Medicaid cannot be terminated. You should not be terminated from Medicaid, even if it has been over 60 days since you gave birth. If you or your child’s Medicaid is terminated during the Public Health Emergency, call your civil legal aid office mentioned in the blog post.
You may have heard on the news that Medicaid was extended for women up to 6 months postpartum. While the legislature has passed a bill that says the state intends to extend Medicaid for women up to 6 months postpartum, Georgia must still receive approval from the federal government. At this time, the federal government has not issued that approval.