Adult Medicaid Programs

Medical Treatment Facility (MTF)
This includes nursing homes, hospice care, hospital stays of 30 days of more, and Community Care Services. The income limit for MTF's is adjusted annually.

Supplemental Security Income (SSI)
This is a financial assistance program administered by Social Security. If an individual is eligible for SSI, he or she qualifies for Medicaid automatically. Any person who may be potentially eligible for SSI will be referred to Social Security before a Medicaid application will be taken. The income maximum for SSI is adjusted annually.

Qualified Medicare Beneficiaries (QMB)
This coverage pays an individual's Medicare CO-insurance and deductibles. It does not pay prescription drugs. The income maximum for QMB is adjusted periodically.

Public Laws
Through the years, Congress has passed six public laws, which provide for Medicaid coverage for people who have been terminated for SSI. Each public law has different financial criteria that the county office can explain.

Adult Medically Needy
This is the one Medicaid program that has no income maximum. An individual can qualify for Medicaid if his or her medical bills exceed a certain percentage of their monthly income, which is known as the spenddown. Medically Needy is limited to one month, and it only pays for bills incurred after the spenddown is met.

Requirements:

• Age 65 or older, or be totally disabled, or be blind.
• Residing in a Medicaid approved nursing home.
• A citizen of the U.S. or a qualified alien.
• A resident of Georgia (there is no time limit for establishing residency, only the intent to live in Georgia).