Georgia Pathways to Coverage™ Eligibility Changes
What You Need to Know About Upcoming Medicaid Eligibility Changes
Medicaid eligibility rules are changing, and this will impact some requirements to enroll in Georgia Pathways to Coverage. For current Pathways members, no requirements will change until your renewal period on or after January 1, 2027.
What’s the New Work Requirement?
If the requirement applies to you, you must spend at least 80 hours each month on one or more of these activities:
- Working (or earning at least $580 a month).
- Doing volunteer or community service.
- Participating in certain job-training programs.
- Participating in an educational program (like college, technical programs, or General Educational Development (GED) programs). If you’re enrolled in school at least half-time (as defined by your school), you likely meet the new requirement. If you’re enrolled less than half-time, your school hours can count toward your 80 hours.
You can combine different activities to reach your 80 hours.
If you have questions about how the changes impact you, visit pathways.georgia.gov.
What You Should Do
- Update your contact information. Make sure Georgia Pathways to Coverage has your current information (like address, phone number, and email address) so they can contact you about these eligibility changes.
- Check your mail and email. Georgia Pathways to Coverage will send you a letter or email in the next few months if the eligibility changes apply to you.
- Track your activities. Keep track of any work, volunteer, job training, or school hours you complete each month. Start now so you’ll be ready to show you meet the new requirement when it’s time to renew your coverage.
- Follow-up with your state. Contact your state Medicaid office to find out what else you can do or provide to keep your coverage.
- Gather documents. Gather important medical or legal documents in case you need to show Georgia Pathways to Coverage you qualify for an exclusion.
What If You Don’t Meet the New Work Requirement?
If the new requirement applies to you and you don’t meet it, your state might end your Medicaid coverage or deny your application.
If this happens:
- You can apply again at any time. Visit Medicaid.gov/about-us/where-can-people-get-help-medicaid-chip to get started if you lose coverage.
- You might be able to get health coverage through Georgia Access, but you might not qualify for financial help to lower your monthly premium. Visit GeorgiaAccess.gov to find or enroll in a health plan or call 1-888-687-1503 (TTY: 711).
More Information
Have more questions? Find organizations and other resources that can help.
By selecting links in the “Georgia Pathways to Coverage” and “Public Resources” sections below, you will be leaving the CMS.gov website. These external links are not the responsibility of, or under the control of, the Centers for Medicare & Medicaid Services (CMS). Some of these links may be to non-federal government websites (.gov). CMS disclaims responsibility for the content and privacy policies of non-.gov websites.
Georgia Pathways to Coverage
Get more information about eligibility and coverage through Georgia Pathways to Coverage.
Public Resources
Use these public resources to find organizations that can help you take steps to keep your coverage.