The BasicsIs It Right for You?What It CoversWhat You PayHow to Sign UpFAQsPitfallsNext Steps

Disability-Based Medicaid

Try It

    updated September 10, 2025
    Disability-Based Medicaid

    The Basics

    Medicaid is a public program that helps pay medical expenses for people with low income. How you may qualify depends on your family’s situation, including things like whether you have a disability, how much you have in income, whether you are pregnant, or if you are a child.

    If you have a disability, you may qualify for Medicaid through rules that aren't related to your disability, such as Georgia Pathways to Coverage. Or, you may qualify for Medicaid through a way that is based on your disability, such as:

    • By getting Supplemental Security Income (SSI), a Social Security program that helps people with disabilities who have low income and low resources.
    • By qualifying through SSI's 1619(b) rule if you used to get SSI, but stopped getting it because work caused your income to go over SSI's income limit.
    • By qualifying for a Medicaid waiver program that helps people with disabilities who need extra care to be able to live in their own home.
    • By qualifying for Medicaid with a spenddown, which is a way for you to get Medicaid coverage after you spend some of your own income every month. Note: Medicaid with a spenddown can be very expensive. In some cases, private insurance is a more affordable option.

    This article introduces these ways of getting disability-based Medicaid and helps you figure out if they might be right for you.

    Another way to qualify for Medicaid

    Disability-based Medicaid is not the only way to qualify for Medicaid. Some people get Medicaid through Georgia Pathways to Coverage, which has different rules and does not require you to have a disability.

    Note: If you qualify for any of the disability-based Medicaid programs explained in this article, you cannot qualify for Pathways. If you have a disability, read this article first to see if you qualify for disability-based Medicaid. Then, read DB101's article on Georgia Pathways to Coverage.

    This article is about disability-based Medicaid and will help you understand:

    • If it is right for you
    • Other ways you may qualify for Medicaid
    • What services it covers
    • How much you will have to pay, and
    • How to sign up.

    If, after reading this article, you need more help in understanding disability-based Medicaid, we recommend you talk to trained experts who can help you. Here are some good resources:

    Highlights
    • There are several disability-based ways to get Medicaid in Georgia, including getting Medicaid automatically through SSI benefits.
    • You can get Medicaid and Medicare at the same time, if you qualify. If you have both, Medicaid will help pay your Part B premium.
    • If your disability does not qualify you for Medicaid, you may be able to qualify for Medicaid through Georgia Pathways to Coverage, which has no disability requirement.
    • Medicaid with a spenddown can be very expensive. If you qualify for Medicaid with a spenddown, you may be able to get more affordable health coverage in other ways, including private insurance.

    Note: DB101 keeps track of changes to health coverage and related laws. DB101 has been and will continue to be updated to reflect any changes. Visit KFF for news related to health coverage.


    Learn more

    Medicaid Waiver Programs

    Medicaid waiver programs help people with disabilities live in the community.

    Long-Term Services and Supports Programs

    Learn about programs that can help you live in a home in the community.

    Personal Assistance Services

    Personal Care Assistants offer services that help you with daily life.