Medicaid Unwinding in Georgia: What You Need to Know If You Lose Coverage
Key takeaways:
Medicaid renewal in Georgia is changing because of the end of the COVID-19 public health emergency (PHE) on May 11, 2023. This is being called the unwinding of Medicaid, and some people will lose coverage during this process.
During the PHE, Medicaid renewals were automatic and enrollees had continuous coverage. As part of the unwinding, automatic renewals for Medicaid and the Children’s Health Insurance Program (CHIP) ended nationwide on March 31, 2023.
Georgia has started to determine who is currently eligible for Medicaid. Make sure the Georgia Department of Human Services (DHS) has your current contact information. If you can't be reached or you no longer qualify for Medicaid or Georgia’s CHIP program — which is known as PeachCare for Kids — you risk losing coverage as early as May 1, 2023.
If you lose your Medicaid coverage, DHS will notify you of other low-cost insurance options for you and your children.
The U.S. Department of Health and Human Services declared a public health emergency (PHE) for COVID-19 in January 2020, which was renewed a dozen times through February 2023.
If you were enrolled in Medicaid at any point during the COVID PHE, you kept your health insurance without eligibility reviews. That’s because all states, including Georgia, were required to provide continuous coverage during the pandemic.
The PHE will end on May 11, 2023, and automatic Medicaid renewals stopped in March 2023.
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Georgia is resuming reviews of enrollees in Medicaid and the Children’s Health Insurance Program — known as PeachCare for Kids (PCK) in the state — to decide who is eligible to continue enrollment. This process is called redetermination. If you or your family members no longer qualify for Medicaid or PCK, you could lose coverage as early as May 1, 2023.
Here’s how to prepare for Medicaid changes in Georgia and what to do if you lose coverage.
Why is Medicaid changing nationwide?
After the PHE ends, COVID-19 will remain a public health priority — but not an emergency. As part of this process, Medicaid renewals will no longer be automatic. This is being referred to as the unwinding of Medicaid, and millions of people nationwide risk losing Medicaid coverage.
The unwinding will affect Medicaid in every state, the District of Columbia, and five U.S. territories.
What’s happening with Medicaid renewal in Georgia?
The Georgia Department of Human Services (DHS) and the Georgia Department of Community Health (DCH) are jointly evaluating about 2.7 million Medicaid renewal cases. Georgia’s redetermination plan explains how the state intends to handle Medicaid’s unwinding.
During this process, about 545,000 Georgians may lose Medicaid or PCK, according to the Georgia Budget and Policy Institute.
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The state wants to reduce the number of current Medicaid enrollees who take no action about their renewal or end up without another form of health insurance. It aims to hire about 500 additional eligibility caseworkers. The state has also created a Stay Informed. Stay Covered. website to address questions and help Medicaid enrollees. These efforts are in addition to billboards, radio announcements, and other paid media. DHS is also installing self-service kiosks in more than 400 public library locations across the state to ensure people in underserved areas have internet access.
How to prepare for your Medicaid renewal
DHS and DCH are asking Medicaid members to update their contact information — including mailing addresses, email addresses, and cell numbers. You can also confirm and update other household changes. You can provide this information by:
Logging in to your account on the Georgia Gateway web portal
Visiting a local Division of Family and Children Services office in person
Calling 1-877-423-4746 or 711 within the state for the hearing impaired
Starting April 17, 2023, all Medicaid enrollees will be assigned a renewal date that will appear in their Georgia Gateway accounts.
DHS will contact Medicaid enrollees about their Medicaid status from April 2023 through May 2024. Every person in your household currently receiving Medicaid will be notified about their eligibility. You’ll receive a letter in the mail with instructions on how to respond to your renewal review.
You will also receive email notices about your eligibility if you've signed up for them. You may also get text messages about Medicaid renewal.
It’s important that you respond to state Medicaid notifications and provide all requested information. You could lose Medicaid if you do not meet your renewal deadline.
If you need to reach DHS by phone about your Medicaid coverage, call 877-423-4746.
What should I do if I lose my Medicaid coverage in Georgia?
Through May 2024, the Georgia DHS will review eligibility for Medicaid recipients. You can receive Medicaid in Georgia if you meet the following criteria:
You are a Georgia resident.
You are a U.S. citizen, permanent resident, or legal resident.
You need healthcare or insurance assistance.
Your annual household income before taxes meets the limits for your household size.
And you are one of the following:
Pregnant
Child or teenager
In charge of caring for a child 18 years old or younger
Blind
65 years old or older (under certain conditions)
Person with a disability, or a family member in your household has a disability
In a nursing home
If you no longer meet the eligibility guidelines, your Medicaid in Georgia won’t be renewed. This means you will no longer have Medicaid coverage.
If you lose Medicaid coverage, the DHS will use the contact information in your Georgia Gateway account to send you other healthcare options.
If you lose coverage but believe you still qualify, you should reapply for Medicaid in Georgia. You may be uninsured for a while if you reapply for Medicaid and wait to be approved again. In that case, you can consider free and low-cost healthcare options. You can also use free GoodRx coupons to save on your prescription medications.
You should see if you qualify for coverage elsewhere if you don’t plan to reapply for Medicaid and aren’t eligible for another government healthcare program. Depending on your circumstances, you may be able to find health insurance with one of these options:
Affordable Care Act (ACA) marketplace: Through the ACA marketplace, you may be able to find coverage for $10 or less per month if you qualify for a premium subsidy. If you lose your Medicaid coverage, you’ll be able to purchase a plan on the ACA marketplace during an unwinding special enrollment period from March 31, 2023 to July 31, 2024.
Employer plan: You may now have a job that offers health insurance.
Medicare: If you have a qualifying disability or condition — such as end-stage renal disease or ALS (amyotrophic lateral sclerosis), commonly referred to as Lou Gehrig’s disease — you can enroll in Medicare at any age.
Partner’s plan: If you have a spouse or domestic partner who has insurance, you may be able to join their plan during an open enrollment or special enrollment period.
Special plans: Short-term insurance can be a great choice if you anticipate a better option, like job-based health insurance, to be available soon. You may also consider alternative and limited-benefit plans, such as fixed indemnity, accident, cost-sharing, and catastrophic insurance plans.
Student health plan: If you’re enrolled in a college or university, you may be eligible for a campus health plan.
U.S. Department of Veterans Affairs (VA): If you are an active-duty service member or a veteran, you may qualify for TRICARE coverage or VA benefits and services.
Georgia Medicaid resources
Here are some sites where you can learn more about Medicaid in Georgia and upcoming changes related to the end of the public health emergency:
Georgia Medicaid offices: The Georgia Department of Human Services and the Georgia Department of Community Health are jointly evaluating the state’s Medicaid cases for renewal.
Georgia Medicaid self-service portal: You can log in to your Medicaid account 24/7 through the Georgia Gateway portal to make sure your mailing address, email, and other contact information is correct.
Georgia Medicaid redetermination: This site provides details about the Georgia Medicaid redetermination plan, including the timeline of changes.
Email and text notifications: For the fastest alerts, learn how to receive your Georgia Medicaid notifications via emails or text messages.
The bottom line
Automatic Medicaid renewals stopped on March 31, 2023 in advance of the COVID-19 public health emergency’s conclusion on May 11, 2023.
Georgia will review Medicaid eligibility for enrollees from April 2023 through May 2024. During that time, the DHS will reach out to you by mail about your Medicaid renewal. You may receive text messages and email notifications if you’ve signed up for them.
It’s important to update your information in your Georgia Gateway account. This will allow you to receive your notifications so you can respond to requests and prevent a gap in coverage if you’re still eligible.
If you lose your Medicaid coverage, you may still qualify for health insurance elsewhere. Your options may include ACA marketplace plans, Medicare, or job-based insurance.
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References
Centers for Medicare & Medicaid Services. (2023). Unwinding and returning to regular operations after COVID-19.
Chan, L. (2022). Keeping Georgians covered: Tools for minimizing the harm of the Medicaid unwinding. Georgia Budget & Policy Institute.
Georgia Department of Human Services. (n.d.). Basic eligibility.
Georgia Department of Human Services. (n.d.). Medicaid redetermination is coming soon.
Georgia Department of Human Services. (2022). Look out for text message requests to prepare for Medicaid eligibility redeterminations.
Georgia Department of Human Services. (2023). DHS and DCH urge 2.7 million Medicaid members to keep contact information updated as redetermination begins.
Georgia Department of Human Services. (2023). Medicaid has started.
Georgia Department of Human Services. (2023). Plan for Medicaid redetermination.
Griffin, G. S., et al. (2022). Medicaid unwinding: Status of state efforts to prepare for the end of continuous coverage. Georgia Department of Audits and Accounts.
Tolbert, J., et al. (2023). 10 things to know about the unwinding of the Medicaid continuous enrollment provision. Kaiser Family Foundation.
U.S. Administration for Strategic Response and Preparedness. (2020). Determination that a public health emergency exists.
U.S. Administration for Strategic Response and Preparedness. (2023). Renewal of determination that a public health emergency exists.
U.S. Department of Veterans Affairs. (2022). VA & TRICARE information.
