Georgia - Calendar Year 2009
Eligibility for major coverage groups within Medicaid

The following guidelines provide general income criteria that are used in part to determine a person’s eligibility for Medicaid programs and services. To become eligible, please visit your local county Department of Family and Children Services office.

SSI Recipients - 100 % FBR

Aged, blind or disabled individuals who receive Supplemental Security Income (SSI)

Income Limits
Resource Limits
  • Individual - $674 per month ($8,088 per year)
  • Couple - $1,011 per month ($12,132 per year)
  • Individual - $2,000
  • Couple - $3,000

Nursing Homes - 300 % FBR

Aged, blind or disabled individuals who live in nursing homes and have low income and limited assets.

Income Limits
Resource Limits
  • Individual - $2,000
  • Couple - $3,000
  • $2,022 per month ($24,264 per year)

Community Care - 300 % FBR

Aged, blind or disabled individuals who need regular nursing care and personal services but can stay at home with special community care services.

Income Limits
Resource Limits
  • Individual - $2,000
  • Couple - $3,000
  • $2,022 per month ($24,264 per year)

Qualified Medicare Beneficiaries (QMB) - 100 % FPL

Aged, blind or disabled individuals who have Medicare Part A (hospital) insurance, and have income less than 100 percent of the federal poverty level and limited resources. Medicaid will pay the Medicare premiums (A&B), coinsurance and deductibles only.

Income Limits
Resource Limits
  • Individual - $923 per month ($11,076 per year)
  • Couple - $1,235 per month ($14,840 per year)
  • Individual - $4,000
  • Couple - $6,000

Hospice - 300 % FBR

Terminally ill individuals who are not expected to live more than six months may be eligible for coverage. Recipients must agree to receive hospice services through a Medicaid participating hospice care provider.

Income Limits
Resource Limits
  • Individual - $2,000
  • Couple - $3,000
  • $2,022 per month ($24,264 per year)

Low-Income Medicaid (LIM) - Set by Statute, Fixed

Adults and children who meet the standards of the old AFDC (Aid to Families with Dependent Children) program.

Family Size
Income Limits
1 $235 per month ($2,820 per year)
2 $356 per month ($4,272 per year)
3 $424 per month ($5,088 per year)
4 $500 per month ($6,000 per year)

Right from the Start Medicaid for Pregnant Women and their Infants (RSM Adults and Newborns) - 200 % FPL

Pregnant women and their infants with family income at or below 200 percent of the federal poverty level.

Family Size
Income Limits
1 $1,805 per month ($21,660 per year)
2 $2,429 per month ($29,148 per year)
3 $3,052 per month ($36,624 per year)
4 $3,675 per month ($44,100 per year)

Each additional person: $624 per month ($7,488 per year)

Right from the Start Medicaid (RSM Children) - 185 % FPL

Children under 1 whose family income is at or below 185 percent of the federal poverty level

Family Size
Income Limits
1 $1,670 per month ($20,040 per year)
2 $2,247 per month ($26,964 per year)
3 $2,823 per month ($33,876 per year)
4 $3,400 per month ($40,800 per year)

Each additional family member: $578 per month ($6,936 per year)

Right from the Start Medicaid (RSM Children) - 133 % FPL

Children between 1 and 6 whose family income is at or below 133 percent of the federal poverty level.

Family Size
Income Limits
1 $1,201 per month ($14,412 per year)
2 $1,615 per month ($19,380 per year)
3 $2,030 per month ($24,360 per year)
4 $2,444 per month ($29,328 per year)

Each additional family member: $415 per month ($4,980 per year)

Right from the Start Medicaid (RSM Children) - 100 % FPL

Children between 6 and 19 whose family income is at or below 100 percent of the federal poverty level.

Family Size
Income Limits
1 $903 per month ($10,836 per year)
2 $1,215 per month ($14,580 per year)
3 $1,526 per month ($18,312 per year)
4 $1,838 per month ($22,056 per year)

Each additional family member: $312 per month ($3,744 per year)

Medically Needy - Set by Statute, Fixed

Pregnant women, children, aged, blind, and disabled individuals whose family income exceeds the established income limit may be eligible under the Medically Needy program. The Medically Needy program allows a person to use incurred/unpaid medical bills to "spend down" the difference between their income and the income limit to become eligible.


Pregnant Women and Children

Income Limits Resource Limits
Family Size
1 $208 per month ($2,496 per year)
2 $317 per month ($3,804 per year)
3 $375 per month ($4,500 per year)
4 $442 per month ($5,304 per year)
Family Size
1 $2,000
2 $4,000

(Add $100 per additional family member)

Aged, Blind and Disabled

Income Limits
Resource Limits
  • Individual: $317 per month ($3,804 per year)
  • Couple: $375 per month ($4,500 per year)
  • Individual: $2,000
  • Couple: $4,000

SOURCE: Georgia Department of Community Health Website
http://dch.georgia.gov/00/channel_title/0,2094,31446711_31945377,00.html