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GA Right from the Start Medicaid

The Right from the Start Medicaid (RSM) Project began in July 1993 as a response to Georgia's high infant mortality rate and to provide a medical safety net for Georgia's working families through Medicaid. This endeavor also was created to address the need to improve health care access for all children and pregnant women.

The Department of Medical Assistance (DMA) and the Department of Human Resources (DHR) entered into an agreement to place eligibility workers in community settings. RSM staff currently has offices in health departments, hospitals, clinics, schools, community action agencies and other convenient locations. A major feature of the program is the availability of staff during non-traditional work hours each week so that work, school and childcare arrangements are not a barrier for families.

The RSM program provides Medicaid coverage for pregnant women and children under the age of 19. Income limits are higher than those of the Temporary Assistance to Needy Families (TANF) and Medically Needy programs. (See: Medicaid Financial Eligibility.)

Right from the Start Medicaid (RSM) for pregnant women pays for medical care for pregnant women, including labor and delivery, for up to 60 days after they give birth. Pregnant women who qualify are entitled to the full-range coverage of Medicaid services. Services covered include doctor visits, prescription drugs, and inpatient and outpatient hospital services.

Right from the Start Medicaid (RSM) for children pays for medical care for children age 0 up to 19. These children may qualify at various income levels depending on age, family size and income. Children who qualify are entitled to the full-range of Medicaid covered services. These include doctor visits, health checkups, immunizations, dental and vision care, and prescription drugs.

The application process is fast and easy. There is no assets test. Working families may be eligible even if both parents live in the home or if other insurance coverage is in place.

Pregnant women may qualify if their monthly income does not exceed 200 percent of the federal poverty level limit. A pregnant woman is counted as two people in the calculation of family size. Her husband is also counted, although husbands do not receive RSM coverage. In addition, a woman meeting the income standards may become eligible within 60 days after giving birth, even if she did not apply during pregnancy or delivery.

Infants born to women receiving Medicaid on the day the child is born receive Medicaid until they reach their first birthday.

Children up to age 19 may qualify at various income levels depending upon age and family size. Children up to age 1 may qualify if their family income is at or below 185 percent of the federal poverty level limit; age 1 to 5 if their family income is at or below 133 percent of the federal poverty level limit; and age 6 to 19 if their family income is at or below 100 percent of the federal poverty level limit.

To apply, contact your local county Department of Family and Children Services (DFCS) or the Right from the Start Medicaid Project office at (770) 603-4788 or toll-free 1-800-809-7276. You may also contact the Powerline at 1-800-822-2539.

Workers and supervisory staff make presentations regularly to community groups, medical providers and employers. Staff has utilized creative techniques for distributing information to the public. Some examples include: flyers to homes with school children; program information in women's and children's shoe boxes and visits to churches, schools and daycare centers. Employer contacts have resulted in opportunities to distribute literature and to accept applications at job sites.

In its efforts to serve all Georgians, the RSM Project joined with the Georgia Partnership for Caring Foundation, Inc. (GPCF), to address the needs of those persons who are ineligible for Medicaid or other coverage. GPCF is a private, non-profit organization that provides limited voluntary services of physicians, hospitals, pharmacists and other health provider agencies. These volunteers are not compensated for their time or services. The RSM Project is the contact for applications and referrals into the program.

The RSM Project also works closely with the PeachCare for Kids program (Georgia's Child Health Insurance Program -CHIP). This program was designed for working, self-supporting Georgia families who cannot afford private insurance and are not eligible for Medicaid. The RSM outreach workers help enroll PeachCare eligible children and help spread the word to healthcare providers and throughout the community.

Georgia has made a serious commitment to improving the quality of health for children and pregnant women. RSM Project workers have received over 270,000 applications since the Project has been in operation, over 15,000 referrals and applications for GPCF during the past fiscal year. Recently the RSM Project gained attention from southeastern states and others developing outreach strategies. RSM allows families to have medical coverage that is often unavailable or inadequate to protect Georgia's working families.

NOTE: Some information for this topic was drawn from the Right from the Start website at: http://www.dhr.state.ga.us/DHR/DHR_FactSheets/FS_RSM_06a.pdf.

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Medicaid Overview

Medicaid Financial Eligibility

Georgia Benefit Information System (GABIS) Overview

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