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Georgia Pathways to Coverage

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    Georgia Pathways to Coverage

    Frequently Asked Questions

    Georgia Pathways to Coverage is a way of qualifying for Medicaid that is for adults with low income, whether or not they have a disability.

    To qualify for Pathways, you must:

    To qualify for Pathways, a person must also do a qualifying activity, which could include working, going to college, getting other training, taking care of a child under six years old, or doing vocational rehabilitation with the Georgia Vocational Rehabilitation Agency (GVRA). Learn more about Georgia Pathways to Coverage Medicaid.

    It depends on how you qualified for Medicaid. Georgia Pathways to Coverage Medicaid has no resource limit. PeachCare for Kids and Medicaid for pregnant women also do not have resource limits. However, if you have a disability and get Medicaid through a program that is linked to your disability, such as Supplemental Security Income (SSI), SSI's 1619(b) provision, or a Medicaid waiver program, there are resource limits.

    If you need more help in understanding Medicaid, you can:

    There are different ways to apply for Medicaid:

    You can also apply for Medicaid online using Georgia Access, Georgia's health insurance marketplace. Georgia Access will check to see if you qualify for Medicaid or subsidized individual coverage. If you may be eligible for Medicaid, Georgia Access will send your information to your local Division of Family and Children Services (DFCS) office, and they will contact you about enrolling.

    Note: If you get Supplemental Security Income (SSI) or used to and now are on SSI 1619(b), you automatically get Medicaid coverage. You do not need to apply for Medicaid.

    No, Medicaid is also available to people who do not have disabilities. Adults under 65 may qualify for Medicaid through Georgia Pathways to Coverage if their income is at or below 100% of the Federal Poverty Guidelines (FPG) ($1,305 per month). Children under 19 and pregnant women can have higher family incomes.

    There are other ways of getting Medicaid that are linked to having a disability. The most common way is getting Medicaid automatically through Supplemental Security Income (SSI) benefits.

    Note: Some people who do not qualify for most Medicaid benefits, such as undocumented immigrants, may qualify for coverage in emergencies only.

    To get Medicaid through Georgia Pathways to Coverage, you must do 80 hours or more of qualifying activities each month. Qualifying activities can include:

    • Working full-time or part-time
    • Volunteering
    • Going to college
    • Getting job training or vocational education training
    • Doing vocational rehabilitation with the Georgia Vocational Rehabilitation Agency (GVRA)
    • Taking care of a child under six years old

    You don't have to do 80 hours of the same activity. For example, you could work 60 hours each month and volunteer for 20 hours. Or, you could be a part-time student and work part time. If you are getting SNAP (Food Stamps) benefits through the Able-Bodied Adults Without Dependents (ABAWD) program, you meet the qualifying activity requirement.

    If you have a disability and need help doing 80 hours of activities per month, you can get help from the Georgia Vocational Rehabilitation Agency (GVRA). You can do vocational rehabilitation with GVRA instead of doing 80 hours of other activities, and your vocational counselor will take care of confirming your qualifying activities to Pathways.

    Learn more about the Qualifying Activities requirement for Pathways Medicaid.

    In most cases, it does not matter how you qualify for Medicaid, because the actual medical coverage you get from Medicaid will be very similar.

    DB101 has two articles that explain the different ways you may be able to get Medicaid:

    If you are not sure how you qualified for Medicaid, you can ask your local Division of Family and Children Services (DFCS) office.

    Yes, if your family’s income is low enough for you to qualify for Medicaid, you may do so even if your job offers insurance.

    If you qualify for Medicaid through Georgia Pathways to Coverage and you can get coverage through your employer, Medicaid will either pay your employer-sponsored coverage costs, like your premiums, deductible, and copayments, or give you Medicaid coverage through a managed care plan. Medicaid will determine which coverage option to offer you after you apply, based on which option is more cost-effective for the state of Georgia; you do not get to choose.

    No matter which option you qualify for, Pathways will always be a better choice than paying for your own employer-sponsored coverage, because it is much less expensive.

    You can usually get Georgia Pathways to Coverage Medicaid if your family’s income is at or below 100% of the Federal Poverty Guidelines (FPG) ($1,305 per month for an individual in 2025, $2,679 for a family of four).

    Children 18 years old or younger can get PeachCare for Kids coverage if their family's income is 252% of FPG or less ($6,752 per month or less for a family of four). Pregnant women can get Medicaid if their family's income is 225% of FPG or less. (For the purposes of calculating a pregnant woman’s family income, the unborn baby is counted as a family member.)

    Note: You may see the income limit for PeachCare for Kids listed as 247% of FPG in some places, and the income limit for pregnant women listed as 220%. However, if you make more than these income limits, Medicaid will knock 5% of FPG off of your income when they count it. That's why we show the limits as 252% and 225%, because they more accurately show how much you could make and still get Medicaid.

    Pathways Medicaid counts most types of earned and unearned income you have. However, some income is not counted, including Supplemental Security Income (SSI) benefits and some contributions to retirement accounts. Learn more about what types of income affect income-based Medicaid eligibility.

    Note: The income limits may be different if you have a disability. Read DB101’s article about disability-based Medicaid.

    Health Coverage Income Limits for Your Family

    If you make more than the income limit for Medicaid, the government may help you pay for a private insurance plan though Georgia Access. This option is only available if you can’t get affordable health coverage through your job.

    You can read more about this option in DB101’s article about Buying Coverage on Georgia Access.

    You must be a U.S. citizen or meet specific noncitizen requirements to be eligible for Medicaid:

    • Immigrants who have been lawfully present for five years or longer and some other noncitizens who meet specific noncitizen requirements qualify for the same programs that U.S. citizens can get, including Medicaid.
    • Most immigrants who have been lawfully present for less than five years do not qualify for Medicaid. However, they may qualify to get private coverage subsidized by the government through Georgia Access.
    • Undocumented immigrants cannot qualify for regular Medicaid, although some people, like children, pregnant women, and people with disabilities, may be able to get Medicaid coverage in an emergency (called Emergency Medical Assistance) if they meet all other Medicaid requirements. To learn more about Emergency Medical Assistance, contact your local Division of Family and Children Services (DFCS) office.

    Learn more

    Finding the Right Health Coverage For You

    Try this interactive guide to see your health coverage options.

    Disability-Based Medicaid

    There are several ways to qualify for Medicaid if you have a disability.

    Buying Health Coverage on Georgia Access

    You can get private health coverage on Georgia Access. The government may help you pay for it.