Frequently Asked Questions

Medicaid and PeachCare for Kids® Annual Renewals

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The Renewal Process

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Authorized Representatives

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Appeals & Fair Hearings

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Gateway Website

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Other-Language Resources

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Medicaid and PeachCare for Kids® Annual Renewals

Renewal is the process that Georgia completes every 12 months to make sure current Medicaid and PeachCare for Kids® members are still eligible for coverage. Every Medicaid and PeachCare for Kids® member must go through the renewal process each year. It involves collecting and verifying information, including income and contact details, as well as other requested information or documents related to determining eligibility based on your case.  

Note: The renewal process does not guarantee any person’s eligibility for Medicaid or other available coverage.

Your coverage may change based on your individual circumstances or state law. Medicaid member eligibility is reviewed each year during the renewal process. Update your contact information in Gateway now to stay informed about your Medicaid status.

Yes. Anyone covered by Medicaid, including PeachCare for Kids®, will be reviewed for eligibility each year.

Medicaid is a program that provides health care services to individuals who meet the requirements for income, resources, and citizenship. Coverage categories include those for low-income families with children under age 19 and adults who are age 65 or over, blind, or disabled.

Basic requirements to determine eligibility under any Aged Blind Disabled (ABD) Medicaid program include:

  • Aged (65 or older), blind, or disabled
  • Application for other benefits
  • Citizenship/Qualified Alien status
  • Valid social security number
  • Residency
  • Assignment of medical benefits to the Division of Medical Assistance (DMA)

Basic requirements to determine eligibility under a Family Medicaid program include:

  • Age
  • Application for other benefits
  • Citizenship/Qualified Alien status
  • Cooperation with Child Support Service (CSS)
  • Valid social security number
  • Residency
  • Assignment of medical benefits to the Department of Community Health (DCH)
  • Living with a Specified Relative (For Parent/Caretaker with Children (P/C) Medicaid and Newborn only).
  • Cooperation with the Office of Child Support Services is a requirement of receiving certain types of Medicaid.

Basic requirements to determine eligibility under Georgia Pathways to Coverage:

  • Be a Georgia resident
  • Be a U.S. citizen or legally residing non-citizen
  • Be between 19 and 64 years of age
  • Have a household income of up to 100% of the Federal Poverty Level
  • Prove that you are doing at least 80 hours of Qualifying Activities per month
  • Not qualify for any other type of Medicaid
  • Not be incarcerated

Visit the Georgia Department of Human Services website for more information. To find out if you meet the requirements, create an account at gateway.ga.gov.

The Renewal

The State will send you a notice by letter or email when it is time for you to renew your benefits. Make sure your Gateway account has the right contact information so you get updates about your renewal. You can also find your annual renewal deadline on Gateway.

You’ll get a letter in the mail or an email about 45 days before your renewal deadline. The letter will tell you that it’s time to renew and give you instructions for submitting your documents by your deadline. This may mean you need to upload pay stubs or other materials. Follow the steps in the letter as soon as you can to help avoid a gap in your coverage. You’ll also get a reminder about 15 days before your deadline.

No, you can’t renew early. You must wait until you receive your letter or email. Only then does your renewal window open.

You will receive a notice via letter or email about 45 days before your renewal deadline saying that your annual renewal window has begun and providing instructions for updating or submitting your verification by your deadline. This may mean you need to upload pay stubs or other materials. All requested verification is due by your renewal deadline.

You have a few options. You can upload the documents, or pictures or scans of the documents, directly through gateway.ga.gov. Visit your local public library for easy Gateway access using the free self-service benefits kiosks. See a map of kiosk locations here. You can also mail, fax, or bring hard copies of your paperwork to your local Division of Family & Children Services (DFCS) office. Find your local DFCS office here.

If you are no longer eligible for Medicaid, you will be connected to other health care options. It is very important for you to update your contact information at gateway.ga.gov so you can receive this information. However, if you feel the denial decision was an error, you can appeal the decision by requesting a Fair Hearing within 30 days from the date of denial and potentially get your coverage retroactively reinstated.

You may be eligible for coverage under the Georgia Pathways to Coverage program. The program creates an opportunity for Georgians between the ages of 19 and 64, up to 100% of the Federal Poverty Level, who are not otherwise eligible for Medicaid, to gain access to affordable, quality health care. Learn more here.

If your coverage renewal is denied, the State will send you a letter explaining why. If it’s because you “failed to submit” your documents, you can still send them within 90 days after your renewal deadline to reopen your case for consideration. But remember, your Medicaid coverage will end on your renewal deadline, and you won’t have any coverage during those 90 days. If you send in your paperwork and are found eligible, your coverage will be start again. 

NOTE: There are two exceptions to this: Qualified Medicare Beneficiary (QMB) and Planning for Healthy Babies (P4HB). For these programs, coverage does not start back until the month after eligibility is actually confirmed.

Authorized Representatives  

An Authorized Representative is someone who is legally allowed to help a Medicaid or PeachCare for Kids® member during the renewal process. Providers, hospitals, family members, and friends who need to help a member must become an Authorized Representative. To do this, members should go to Gateway to “Report My Changes” and select “Add an Authorized Representative.”

To get help from someone you trust, they need to become an Authorized Representative. To do this, go to Gateway to “Report My Changes,” then choose “Add an Authorized Representative.” After you add them, they need to create their own separate Gateway account. When they visit the “create an account” screen, they should check “Yes” to the question, “Are you an Authorized Representative?” This links their account to yours so they can help you with anything.

Appeals & Fair Hearings 

If you think your denial was a mistake, you can ask for a Fair Hearing within 30 days of the denial. A Fair Hearing is handled by an independent group called the Office of State Administrative Hearings (OSAH) that helps resolve disagreements between people and state agencies. You can learn more on their website at osah.ga.gov. 

After you ask for a Fair Hearing, you’ll get a letter in the mail with the date, time, and place for the hearing. At the hearing, you can share your side of the story and show proof, like receipts or bills, to support your case. You’ll get a notice of the decision within 30 days after the hearing. For more details on the Fair Hearing process, watch this video.

Yes, if you ask for a Fair Hearing within 14 days of your denial or termination notice, you can choose to keep your coverage while you wait for the final decision.  

If you decide to pause your coverage while you wait, and the judge says the State was wrong and you still qualify, your coverage will go back to the date it stopped. This means you’ll be covered for any medical expenses during that time.

If you choose to keep your coverage while you wait, and the judge agrees with the State that you don’t qualify anymore, your coverage will stop.

If the judge says the State made a mistake in denying your Medicaid or PeachCare for Kids® coverage, your coverage will start again from the original renewal date. This means that you can get help paying for medical expenses you had during that time. 

If the judge agrees with the State that you don’t qualify for Medicaid or PeachCare for Kids® anymore, you benefits will remain terminated.

Gateway Website

Follow the instructions at the top of Gateway in the section called “HELP! I am having trouble signing in or creating an account.” If you are still having trouble with your online account, we can help you in-person at one of our offices or by phone. Visit dfcs.georgia.gov/locations to find the location and business hours for your local office. If you need help reading this information or communicating with us, call 1-877-GA-DHS-GO (1-877-423-4746). Our services, including interpreters, are free. If you are deaf, hard of hearing, deaf-blind, or have difficulty speaking, you can call us at the number above by dialing 711 (Georgia Relay).

If you entered the wrong username or password too many times, the system may temporarily lock you out. From the login page at gateway.ga.gov, select “Forgot User ID” or “Forgot Password” to receive a one-time PIN delivered to your mobile phone or email to recover your username or password. Alternatively, you can answer security questions to recover your username or password. If you need additional support, you can visit your local Division of Family and Children Services office. To find the location and business hours for your local office, visit: dfcs.georgia.gov/locations. If you need help reading this information or communicating with us, ask us or call 1-877-GA-DHS-GO (1-877-423-4746). Our services, including interpreters, are free. If you are deaf, hard of hearing, deaf-blind, or have difficulty speaking, you can call us at the number above by dialing 711 (Georgia Relay). 

If you have issues accessing gateway.ga.gov, check your internet connection first. If your internet is working correctly and you still cannot access gateway.ga.gov, it may be because the site is down for scheduled maintenance. Please visit the site again later.  

If you need additional support, you can visit your local Division of Family and Children Services office. To find the location and business hours for your local office, visit: dfcs.georgia.gov/locations. If you need help reading this information or communicating with us, ask us or call 1-877-GA-DHS-GO (1-877-423-4746). Our services, including interpreters, are free. If you are deaf, hard of hearing, deaf-blind, or have difficulty speaking, you can call us at the number above by dialing 711 (Georgia Relay). 

When you have successfully updated your information/documents at gateway.ga.gov, you will receive a confirmation “T number” (tracking number) in your customer Georgia Gateway account. Remember to write it down for later use. If needed, you can retrieve your “T number” from the “Manage My Account” page of the Georgia Gateway. 

Yes, right away! Creating an account at gateway.ga.gov is the easiest and fastest way for Medicaid representatives to contact you about your coverage.  Make sure you have completed all required fields. This may include information about your current residence, income, job, household size, etc.  

Go to Gateway to “Report My Changes” or “Renew” and select “Add an Authorized Representative.” After adding your authorized representative to your case, have them create their own separate Gateway account. Within the “create an account” screen, they must check “Yes” to the question, “Are you an Authorized Representative?” This effectively links their Gateway account to your Gateway account. They can now assist you with any actions.

If you have a Gateway account, you can reset your password in three ways.

  • Reset Your Password via Email – Gateway sends an email to the account the state has on file. This email has a one-time PIN that you will use to reset your password.  
  • Reset Your Password via Text Message – Gateway sends a text message to the phone number that the state has on file. The text message has a one-time PINthat you will use to reset your password. 
  • Reset Your Password by Answering Security Questions – You can answer the security questions you defined/answered when you created your Gateway account. You have three chances to get the answer correct. If you answer your security questions incorrectly after three tries, your account will be locked. If your account is locked, you will need to call the Customer Contact Center (1-877-423-4746) to have your account unlocked.

Other-Language Resources 

Visite nuestro sitio web en español, simeprecubierto.ga.gov, para obtener recursos en español. Además, puede visitar gateway.ga.gov y hacer un clic en una de las selecciones de idioma. También puede llamar al 1-877-GA-DHS-GO(1-877-423-4746). Nuestros servicios, incluidos los intérpretes, son gratuitos.

မြန်မာစကားနှင့် ပတ်သက်သည်များကို ဤနေရာတွင် ရှာဖွေနိုင်သည်။ နောက်ထပ် gateway.ga.gov တွင် ဘာသာစကားတစ်ခုကို နှိပ်ပါ။ 1-877-GA-DHS-GO (၁-၈၇၇-၄၂၃-၄၇၄၆) ကိုလည်း ဖုန်းခေါ်ဆိုနိုင်သည်။ စကားပြန်များအပါအဝင် ကျွန်ုပ်တို့၏ ဝန်ဆောင်မှုများသည် အခမဲ့ဖြစ်သည်။

한국어 자료는 여기에서 찾으실 수 있습니다. 또한, gateway.ga.gov 를 방문하시고 언어 선택 중 하나를 클릭하실 수 있습니다. call 1-877-GA-DHS-GO (1-877-423-4746 로 전화하시면 무료로 통역 서비스를 포함한 서비스를 제공해드립니다

तपाईंले नेपाली स्रोतहरु यहाँ पाउनु हुन्छ। यसमा थप, तपाईं  gateway.ga.gov मा गमन गर्न सक्नु हुन्छ अनि उपलब्ध कुनै एउटा भाषाको चयनमा क्लिक गर्ने। अथवा1-877-GA-DHS-GO (1-877-423-4746) अंकमा फोन लाए पनि हुन्छ। हाम्रो सेवाहरु अन्तर्बाचक लगायत सबै निशुल्क हो।    

Você pode encontrar recursos birmaneses aqui. Além disso, você pode visitar gateway.ga.gov e clicar em uma das opções de idioma. Você também pode ligar para 1-877-GA-DHS-GO (1-877-423-4746). Nossos serviços, incluindo intérpretes, são gratuitos.

Quý vị có thể tìm nguồn nguyên Tiếng Việt tại đây. Ngoài ra, quý vị có thể truy cập gateway.ga.gov và nhấp vào một trong các lựa chọn ngôn ngữ. Quý vị có thể gọi  1-877-GA-DHS-GO (1-877-423-4746). Dịch vụ của chúng tôi, kể cả thông dịch viên, đều là miễn phí.

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