Georgia handles adult Medicaid differently from most states. In 2025, low-income adults can qualify only through Georgia Pathways to Coverage, a limited pathway tied to 100% of the Federal Poverty Level (FPL) and at least 80 hours/month of qualifying activities.
Children often qualify at much higher incomes through PeachCare for Kids® (CHIP), and pregnant people have their own rules.
Key Takeaways
- Adults (19–64): Georgia uses Pathways (not full expansion). Income must be ≤ 100% FPL, and you must complete 80 qualifying hours/month.
- Children: Many qualify under PeachCare for Kids® with income caps set at ~247% FPL.
- Pregnancy & kids: Higher limits than adults; check PeachCare/Medicaid category charts.
- Numbers update annually: In 2025, the FPL is $15,650 for one person and $26,650 for three.
Georgia at a Glance: Why It’s Different
Most states expanded Medicaid to 138% FPL for adults. Georgia did not. Instead, the Pathways program covers certain adults up to 100% FPL who also meet an 80-hour monthly engagement requirement.
For example, the state lists $15,650/year for one person and $26,650/year for a family of three as 2025 limits. Meanwhile, kids can qualify at far higher incomes via PeachCare for Kids®, making it common for a child to be insured even if the parent isn’t.
Income Limits (2025): Adults vs. Kids
A) Pathways (Adults 19–64, Non-disabled)
Financial test: ≤ 100% FPL; Activity test: ≥ 80 hours/month.
Examples (2025 FPL):
| Household | 100% FPL (Annual) | 100% FPL (Monthly) |
| 1 | $15,65 | ~$1,304 |
| 2 | $21,150 | ~$1,763 |
| 3 | $26,650 | ~$2,221 |
| 4 | $32,150 | ~$2,679 |
These figures come directly from the Georgia Pathways eligibility chart, which ties financial eligibility to the activity requirement.
In practice: A single adult earning ~$1,300/month must also log 80 hours of qualifying activities (work, classes, training, or community service) to keep coverage.
B) PeachCare for Kids® (CHIP)
Georgia sets PeachCare at about 247% FPL. Here are the 2025 examples from the Georgia DCH PeachCare income guidelines:
| Family Size | Monthly Limit | Annual Limit |
| 1 | $3,100 | $37,200 |
| 2 | $4,208 | $50,496 |
| 3 | $5,315 | $63,780 |
| 4 | $6,422 | $77,064 |
The Pathways Activity Rule
To qualify, Pathways members must show at least 80 hours per month of accepted activities. According to the state’s official guidance, this can include:
- Employment (part-time or full-time)
- Higher-ed coursework (credit hours are converted to monthly equivalents)
- Job training or vocational rehabilitation
- Community service
Exceptions exist for caregivers, people with medical barriers, or those who qualify under special “good cause” rules.
How to Apply for Georgia Medicaid (Step-by-Step)
- Check your category: Adults apply through Pathways; children through PeachCare.
- Apply online: Use the Georgia Gateway portal.
- Gather documents:
- ID and proof of residency
- Income proof (pay stubs, tax returns)
- For Pathways, proof of 80 hours/month activities
- Submit your application and check messages/mail for follow-up requests.
- Renew annually watch deadlines to avoid losing coverage.
Required Documents
- Georgia ID or driver’s license
- Social Security number (if applicable)
- Proof of income (stubs or W-2s)
- Residency proof (lease, bill)
- For Pathways: logs or documents proving 80 hours of qualifying activity
If You Don’t Qualify, You Can Check These Other Programs
- Children’s coverage: Kids may still get PeachCare up to 247% FPL.
- ACA Marketplace plans: Adults over 100% FPL may qualify for tax credits at HealthCare.gov.
- Community health centers: Offer sliding-scale care regardless of Medicaid eligibility.
FAQs
1) Do adults get Medicaid up to 138% FPL in Georgia?
No, Georgia only covers up to 100% FPL through Pathways with an 80-hour rule.
2) What is the 2025 FPL for one person?
$15,650 annually, per the HHS poverty guidelines.
3) What counts toward 80 hours?
Work, education, training, or community service, per Georgia Pathways guidance.
4) Why do children qualify but parents don’t?
Kids can qualify up to 247% FPL under PeachCare for Kids®, while parents/adults face lower limits.
5) Where can I apply?
On the Georgia Gateway portal.
6) What happens if I miss activity reporting?
You risk losing Pathways coverage even if your income is within limits.
Conclusion
Georgia’s Medicaid in 2025 remains restrictive for adults limited to 100% FPL under Pathways, with an added 80-hour activity rule. Children, however, benefit from PeachCare for Kids®, which expands eligibility up to 247% FPL.
If you believe you qualify, start your application at the Georgia Gateway and check Pathways rules or PeachCare guidelines for details. Even if you don’t qualify, kids’ programs and ACA marketplace subsidies can help bridge the gap.
