Medicaid Redetermination: What You Need to Know
Starting on April 1, 2023, the state of Georgia began the process of Medicaid redetermination due to Federal Law unwinding COVID-19 era Medicaid regulations. Approximately 2.7 million Medicaid and PeachCare for Kids members are required to redetermine eligibility. On May 31, 2024, the redetermination window ended, disenrolling some Georgians who were otherwise eligible. It’s important to ensure you’re still covered. Here’s what you need to know:
Implication:
In light of redetermination, individuals can access resources for Medicaid reassessment or re-enrollment to sustain healthcare coverage and gain support.
The Specifics:
Redetermination began on April 1, 2023, and ended on May 31, 2024.
Georgia used ex parte renewal for some individuals, meaning the state may have completed the redetermination on your behalf. However, for varying reasons (such as incomplete income verification or not being enrolled in other benefit programs), not all individuals were eligible for ex parte renewal.
If you weren’t eligible for ex parte renewal and didn’t renew manually, your Medicaid coverage may have lapsed, meaning you aren’t currently covered.
It’s important to double-check that you’re covered and enroll again if your coverage has lapsed. You can check your enrollment status here. You can also make sure you’re eligible by looking at the eligibility criteria here.
If your enrollment is wrongfully denied, you have the right to appeal that ruling, and you can reach out to the resources below who will help you navigate that process.
Resources:
The state of Georgia created Stay Covered after redetermination began. It has resources to help make this process easier for you.
The Georgia Division of Family & Children Services has county offices where a state employee can help you through the process. These offices can be found here or be contacted at (877) 423-4746.
Georgia Access is a program set up by the Insurance Commissioner, and on its website, you can find resources here and connect with a free local assistant here.
Georgians for a Healthy Future (GHF) is a nonprofit and advocacy organization dedicated to helping Georgia’s families live safe and prosperous lives. Fill out the form here for help from a GHF Health Insurance Navigator.
Mercy Care is a Federally Qualified Health Center (FQHC) that accepts Medicaid. It also provides enrollment assistance—just call 678-843-8527.
The Georgia Primary Care Association is an association of FQHCs in Georgia, and it provides enrollment assistance—just fill out the form here.
The Healthy Mothers, Healthy Babies Coalition of Georgia can help you navigate Medicaid enrollment and connect you to additional resources. Contact it at 1-888-457-4769 or fill out the form here.
Pickles & Ice Cream is a project by Healthy Mothers, Healthy Babies Coalition of Georgia that educates mothers about all things maternity. Follow its Instagram, sign up for its newsletter, and explore its blogs and infographics to learn about your Medicaid enrollment and maternal health.
Legal aid groups can help you appeal an eligibility decision. A list of such groups can be found here and below.
Atlanta/Fulton County — (404) 524-5811
South Fulton/Clayton Counties — (404) 669-0233
Cobb County — (770) 528-2565
DeKalb County — (404) 377-0701
Gwinnett County — (678) 376-4545
Outside the Metro Area — 1-833-GLSPLAW | (1-833-457-7529)
Advocacy:
GHF created the Cover Georgia Coalition, bringing together community groups and advocacy organizations, to advocate for full Medicaid expansion in the state of Georgia. Sign up for action alerts here and get involved if you want Medicaid expansion—which positively impacts maternal health—to be a reality.
Voices for Georgia’s Children is an organization dedicated to advocating for policies that help Georgia families, including ensuring mothers and children have health insurance. Information on legislative developments and guides to advocacy are available on its website here.
The Healthy Mothers, Healthy Babies Coalition of Georgia engages in advocacy, working to improve Doula access under Medicaid, maternal mental health care, and expanding coverage. Each of these reforms would improve Georgia mothers' maternal health outcomes. Information on legislation and how to get involved is available here.