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GA Medicaid Financial Eligibility

SSI Recipients

SSI Recipients are automatically eligible for Medicaid coverage as long as they remain eligible for SSI Cash Benefits. If SSI Cash Benefits go to zero because of earnings, then Medicaid eligibility continues under a work incentive called 1619(b) as long as earnings are below the State threshold – or below an Individualized Threshold if one has been established.

The income limits for many of the various programs shown below are a percentage of the Federal Poverty Guidelines (also referred to as Federal Poverty Level [FPL]). These guidelines for the current and previous years may be found in the topic "Poverty Guidelines - Federal ". Other income limits are a multiple of the Federal Benefit Rate (FBR). A rate table showing current and previous years may be found in the Federal Benefit Rate - SSI topic.

Eligibility Tables

Click on the link below for the year you are interested in:
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·          Eligibility Table for Calendar Year 2010

·          Eligibility Table for Calendar Year 2009

·          Eligibility Table for Calendar Year 2008

·          Eligibility Table for Calendar Year 2007

·          Eligibility Table for Calendar Year 2006

·          Eligibility Table for Calendar Year 2005

·          Eligibility Table for Calendar Year 2004

·          Eligibility Table for Calendar Year 2003

·          Eligibility Table for Calendar Year 2002

Countable Assets and Income

In determining Medicaid eligibility, your local office of the Department of Family and Children's Services (DFCS) must consider the total gross monthly income of an individual from all sources. This includes Social Security benefits, any pensions, retirement, interest, dividends, etc. If the applicant is living with a spouse, DFCS must also consider the income of the spouse.

If the applicant is living with a spouse, DFCS must count the assets of both the husband and the wife. Countable assets do not include the individual's home and one automobile.

Countable assets do include any real property other than the home, saving and checking accounts, investments such as certificates of deposit, stocks, bonds, mortgages and promissory notes, life insurance, inherited property, and jointly owned assets. An asset counts against the Medicaid limit if the individual has legal ownership and the legal right to sell the asset, even if the person does not have physical access to it, or if there is no market for it.

In addition to the $2000 limit, Medicaid also provides for a burial allowance. An individual is allowed $1500 or $5000 (depending on the type of Medicaid) to pay for funeral expenses. This money must be in a separate account and cannot be used for any other purpose. Cemetery lots are not counted for Medicaid. An individual can also own a pre-need funeral contract with a funeral home that will not be counted.

The cash value of life insurance may or may not be considered a countable asset, depending on the face value of the life insurance and the type of Medicaid. The caseworker in the county DFCS office can explain the life insurance regulations.

NOTE: Information for this topic was drawn from the Georgia Department of Community Health website at:
http://www.communityhealth.state.ga.us

Additional information was provided by DCH Medical Assistance Plans, Eligibility Policy Office.

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Medicaid Overview

GA Benefit Information System Overview

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