Programs

Eligible Parties: Children, Disabled 

This program provides coverage for Autism Spectrum Disorders (ASD) services for individuals under the age of 21. ASD coverage is provided for assessment and treatment services according to severity and is based on medical necessity.

Eligible Parties: Children

Georgia Medicaid provides behavioral health services to eligible children through several different programs. The chart included here outlines the specific Medicaid Program categories that offer behavioral health services for children by program name, service type, eligibility of the Medicaid member, and provider requirements.

Eligible Parties: Children 

In 2010, the Georgia Department of Community Health (DCH) implemented the country’s first CHIPRA Premium Assistance Program.

Eligible Parties: All Medicaid Members

Electronic Visit Verification (EVV) is a technology that automates the gathering of service information by capturing time, attendance and care plan information entered by a home care worker at the point of care.

Eligible Parties: Children, Families

Georgia Families® is a program that delivers health care services to members of Medicaid and PeachCare for Kids®.

Eligible Parties: All Children

Georgia Families 360° Managed Care for foster care, adoption assistance and juvenile justice members.

Eligible Parties: Elderly, Disabled

The Long-Term Care Partnership Program (Partnership), administered by the Department of Community Health in collaboration with the Office of the Commissioner of Insurance and the Department of Human Resources, Division of Aging Services, provides an alternative to spending down or transferring assets by forming a partnership between Medicaid and private long-term care insurers.

Eligible Parties: Elderly, Disabled

The project’s goal is to transition more than 2,600 Medicaid long-term care Georgians by December 2018 from institutional settings to the community primarily through use of Georgia’s Medicaid waiver programs – the Independent Care Waiver Program (ICWP). 

Eligible Parties: Adults

Georgia Pathways to Coverage™ is a new program to help low-income Georgians qualify for Medicaid who otherwise would not be eligible for traditional Medicaid.

Eligible Parties: Adults

Georgia Medicaid members who are employed may be eligible for health insurance premium assistance through a Medicaid program called the Health Insurance Premium Payment Program (HIPP).

Eligible Parties: Children

Information on Infant and Early Childhood Behavioral Health Services, including Medicaid Funded Behavioral Health Services, Ages 0-6 , and DC:0-5 Crosswalk & Case Studies .

Eligible Parties: Elderly, Disabled

Medicaid Long-Term Services amenable eligible Georgians to live in the setting most appropriate for their needs – nursing facilities, their own home or a caregiver’s home.

Eligible Parties: Elderly

Estate recovery is a program, required by federal law, whereby Medicaid members with qualified assets reimburse the taxpayers for long term care and home and community-based services provided through Medicaid. Funds are recovered from the member's estate, after death, for the cost of these services.

Eligible Parties: All Medicaid Members

Georgia Medicaid’s Subrogation, Estate Recovery and Special Needs Trust programs are administered by Health Management System (HMS).

Eligible Parties: All Medicaid Members

The Non-Emergency Medical Transportation (NEMT) program provides eligible members transportation needed to get to their medical appointments.

Eligible Parties: All Medicaid Members

Governor Brian P. Kemp signed The Patients First Act into law on March 27, 2019. The Act authorizes the Georgia Department of Community Health to submit a Section 1115 Medicaid Waiver request to the Centers for Medicare and Medicaid Services and also authorizes the Governor to submit a Section 1332 waiver to identify innovative health insurance coverage solutions for the commercial health insurance marketplace.

Eligible Parties: Children

In Georgia, PeachCare for Kids® began covering children in 1998 and provides comprehensive coverage to uninsured children.

Eligible Parties: Women Ages 18-44

The Georgia Department of Community Health (DCH) offers Planning for Healthy Babies to reduce Georgia’s low birth weight rate. P4HB® fills a critical gap in health care for underinsured and uninsured women by expanding Medicaid eligibility to those who qualify for family planning services.

Eligible Parties: Adults

The Postpartum Extension Demonstration waiver was developed from the passage of HB 1114 during Georgia’s 2020 legislative session. It was created by the Department of Community Health (DCH) in partnership with the Department of Public Health (DPH) to extend Medicaid coverage from 60 days to six months to allow extended access to quality care and ensure continuity of care, and care coordination during the postpartum period, and became effective July 1, 2021.

Eligible Parties: All Medicaid Members

Right from the Start Medical Assistance Group is a doorway for certain people in need of health care coverage.The mission of the Right from the Start Medical Assistance Group (RSM) is to enable children under age 19, pregnant women, low income families and women with breast or cervical cancer to receive comprehensive health services through Medicaid and related programs. RSM eligibility specialists help these working and low-income families obtain access to no cost and low-cost health care coverage.

Eligible Parties: Children, Disabled 

Provides Medicaid benefits to eligible children through the TEFRA/ Katie Beckett Medicaid program under §134 of the Tax Equity and Fiscal Responsibility Act (TEFRA) of 1982.

Eligible Parties: Elderly, Disabled

Waiver programs help people who are elderly or have disabilities and need help to live in their home or community instead of an institution such as a nursing home or ICF-MR.