What You Pay

If you have Georgia Pathways to Coverage Medicaid, you don’t have to pay a monthly premium. You only have to make payments when you need medical care.

If you are 21 years or older, you may have to make small copayments when you use certain medical services that Medicaid covers. Prescription medications have small copayments of $3 or less.

You do not need to make copayments if you:

• Are under 21 years old
• Are pregnant
• Are an American Indian in a federally recognized tribe
• Are in hospice care
• Live in a nursing facility, or
• Have breast cancer or cervical cancer.

Compared to Private Insurance

Medicaid’s copayments are much lower than the copayments required by private insurance plans. For example, many private insurance plans can have annual deductibles that require you to pay thousands of dollars before the plan will cover most services. Even after the deductible is paid, many private insurance plans require copayments of $50 or more for services.

Note: If you have the option of employer-sponsored coverage, either through your work or your spouse's or parent's work, Pathways Medicaid may require you to sign up for it, and Medicaid will pay your monthly premium, deductible, coinsurance, and copayments.