• Doctors must agree to accept Medicaid as a form of payment before the state pays benefits for care.doctor image by DXfoto.com from Fotolia.com
  
  The federal Medicaid program provides health care coverage for low-income and disabled individuals. The program, though, is administered by individual states. The states set many of the rules and regulations that govern who receives coverage and the kind of coverage provided to those individuals. Georgia's program is administered by the Division of Family and Children Services. The division is a part of the Georgia Department of Human Services.
  
  

Application Process

• Georgia's Medicaid program rules require individuals to submit an application for benefits to the Georgia Department of Human Services. The Division of Family and Children Services reviews applications. Applications can be submitted at local DFCS offices by mail, phone, fax and email. Application forms are available online, too. The state requires individuals to wait a certain number of days before they are eligible for benefits. The waiting period begins with the day the application is registered, which is the day that it is received by the state agency. Pregnant women and newborns must wait 10 days before benefits can begin. Disabled applicants must wait 60 calendar days, and all other individuals must wait 45 days.
  
  

Income Requirements

• Georgia's Medicaid program limits who can qualify for benefits. Individuals must meet several requirements. The most basic requirement is that applicants must have a low income. The state defines income as all money received by a household that can be used for basic needs such as food, clothing and shelter. Financial eligibility is calculated using monthly numbers. Single individuals with no children can make no more than $235 per month. Couples with no children can earn no more than $356 per month. A family of four is allowed to earn up to $500 per month. Individuals who also receive Supplemental Security Income are allowed to earn more income, but these individuals must be elderly, blind or disabled. Income limits for single SSI recipients is $674 per month. Couples are allowed to earn $1,011 per month. If the SSI recipients are in a nursing home, they are allowed up to $2,022 per month.
  
  

Right From the Start Rules

• A special program, dubbed Right from the State Medicaid for Pregnant Women and children, provides Medicaid coverage for individuals who have low to moderate household incomes. The program allows coverage for children who are infants through 19 years of age. It also provides coverage for pregnant mothers for up to 60 days after they give birth. Coverage provides benefits for doctor visits, prescription drugs and inpatient and outpatient services. Income guidelines vary based on the ages of children and the sizes of families. Pregnant mothers are allowed to earn up to 200 percent of the federal poverty level. The program also provides coverage under the same income guidelines for infants up to 1 year in age. For 2007, the income guideline for a family of two is $2,282. The unborn infant counts as a family member in the guidelines. The limit for a family of three is $2,862. Children ages 1 to 5 qualify if a family if a family earns less than 133 percent of the federal poverty level. In 2007, Children ages 6 to 19 qualify if a family earns 100 percent of less of the federal poverty level.
  
  

Benefit Rules

• Under Medicaid rules in Georgia, covered individuals receive benefits for health care provided by a provider who accepts Medicaid as a form of payment. Medicaid recipients are eligible to participate in a managed care program called Georgia Families. The program allows members to select a health care plan to fit their needs. SSI recipients are not eligible for Georgia Families. Medicaid does not provide coverage for all medical care. If a recipient of Medicaid receives care from a provider who does not participate in the Medicaid program, Medicaid will not pay for the services.