Georgia Medicaid Presumptive Eligibility (2026): Hospital PE, Right from the Start, 60-Day Coverage

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heading: "Georgia Medicaid Presumptive Eligibility" subheading: "Presumptive eligibility lets hospitals, clinics, and other qualified entities make immediate Medicaid eligibility determinations for pregnant women, children, parents, former foster care youth, and breast and cervical cancer patients. The presumptive period runs approximately 60 days and provides full Medicaid coverage while the formal application is processed. In Georgia, two programs operate side by side: Right from the Start Medicaid for pregnant women and the federally-mandated hospital presumptive eligibility option for additional populations."

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• Hospital presumptive eligibility is federally mandatory. Under 42 USC 1396a(a)(47)(B) and 42 CFR 435.1110, every Medicaid state must permit qualified hospitals to make presumptive eligibility determinations.
• Georgia operates Right from the Start Medicaid (RSM) for pregnant women. Under O.C.G.A. §49-4-159, designated WIC offices, county health departments, FQHCs, and obstetric practices make immediate presumptive determinations for pregnant women at or below 220 percent FPL.
• The presumptive period runs about 60 days. Coverage begins at the qualified entity determination date and ends on the earlier of the formal application decision or the last day of the month following the presumptive determination month.
• Coverage is full Medicaid during the presumptive period. For pregnant women, this means ambulatory prenatal care. For children and other populations, it means the full Medicaid benefit package.
• One presumptive period per pregnancy. Under 42 CFR 435.1102, a pregnant woman is limited to one presumptive period per pregnancy. She must file a formal application during that period to maintain coverage. ::

Presumptive eligibility is a fast-track Medicaid enrollment mechanism that solves a fundamental problem in the safety-net system: someone shows up needing immediate medical care, the formal Medicaid application takes up to 45 days to process, and care cannot wait. The federal Medicaid statute at 42 USC 1396a(a)(47) authorizes state-approved qualified entities (hospitals, clinics, FQHCs, WIC offices, county health departments) to make immediate presumptive eligibility determinations. ACA §2202 made hospital presumptive eligibility a mandatory option in every Medicaid state, regardless of whether the state has elected the broader state-option presumptive program. The presumptive period runs from the date of qualified entity determination until the formal application is decided, or for approximately 60 days if no formal application is filed.

In Georgia, presumptive eligibility operates through several intersecting programs. The state's longest-running presumptive program is Right from the Start Medicaid (RSM), codified at O.C.G.A. §49-4-159, which enables WIC offices, county health departments, FQHCs, and designated obstetric practices to make presumptive determinations for pregnant women. The state also operates the ACA-mandatory hospital presumptive eligibility program, expanded by State Plan Amendments to include children, parents, former foster care youth, and breast and cervical cancer patients. The Georgia Breast and Cervical Cancer Program provides presumptive eligibility for NBCCEDP-screened women diagnosed with cancer. The Planning for Healthy Babies (P4HB) Family Planning Waiver provides presumptive eligibility for family planning services.

This article is the canonical Georgia presumptive eligibility playbook. It walks through the federal statutory and regulatory framework at 42 CFR 435.1100-1110, the qualified entity certification process, the 60-day presumptive period mechanics, the coverage scope during the presumptive period, the income standards used at presumptive determination, the limit of one presumptive period per pregnancy, the interactions with retroactive eligibility and the 12-month postpartum coverage, and the practical steps families take to use presumptive eligibility to bridge to full Medicaid enrollment. Six worked examples drawn from common Georgia scenarios show how the rules apply, followed by a 15-item common mistakes list, a 5-question FAQ, and a directory of qualified entities and phone numbers.

The federal statutory and regulatory foundation

By Brevy Care Team · Last verified May 12, 2026

42 USC 1396a(a)(47): the federal authorization

Presumptive eligibility was originally a state option authorized by 42 USC 1396a(a)(47)(A) starting in the 1980s for pregnant women and expanded in the 1990s for children. States that elected the option could designate qualified entities to make immediate presumptive determinations. States that declined had no presumptive eligibility program.

ACA §2202 added subsection (B): "the State shall provide for permitting hospitals that are participating providers under the State plan to make presumptive eligibility determinations." This shifted hospital presumptive eligibility from state option to federal requirement. Every Medicaid state, including non-expansion states like Georgia, must offer hospital presumptive eligibility.

The covered populations under hospital presumptive eligibility (42 CFR 435.1110) are:

• Children under 19
• Pregnant women
• Parents and caretaker relatives (LIM and Transitional Medical Assistance categories)
• Former foster care youth under 26
• Breast and cervical cancer screening and treatment recipients
• Individuals needing family planning services
• Adults at or below 133 percent FPL in Medicaid expansion states (NOT applicable to Georgia, which has not expanded Medicaid)

42 CFR 435.1100: the general framework

42 CFR 435.1100 establishes general rules applicable to all presumptive eligibility:

• States may permit qualified entities to determine presumptive eligibility
• QEs must be approved by the state agency and complete training
• QEs use simplified income and other criteria established by the state
• The presumptive period runs from QE determination until the agency makes a final eligibility determination on the formal application, OR if no application is filed, the last day of the month following the month of presumptive determination
• Limit of one presumptive period per pregnancy (for pregnancy) or per period (for other categories) as the state policy specifies

42 CFR 435.1101 through 1103: category-specific rules

42 CFR 435.1101 governs children under 19 presumptive eligibility. Coverage during the presumptive period is full Medicaid equivalent to a fully-eligible child. Children may have multiple presumptive periods if circumstances change.

42 CFR 435.1102 governs pregnant women presumptive eligibility. Coverage during the presumptive period covers ambulatory prenatal care: OB visits, ultrasounds, lab work, prenatal vitamins, gestational diabetes management, mental health services, and emergency prenatal services. The presumptive period runs from QE determination until the last day of the month following the month of presumptive determination, unless a formal application is filed and decided sooner. Each pregnancy generates only one presumptive period.

42 CFR 435.1103 governs parents and caretaker relatives presumptive eligibility. Coverage is full Medicaid for the presumptive period for LIM and TMA categories.

42 CFR 435.1110: hospital presumptive eligibility implementation

42 CFR 435.1110 implements the ACA §2202 hospital presumptive eligibility mandate. Hospital qualifications include:

• Participation in Medicaid
• Compliance with state training requirements
• Agreement to make presumptive eligibility determinations consistent with state policies and procedures
• Agreement to refer presumptively-eligible individuals to file a full Medicaid application

State performance standards include:

• Percentage of individuals presumptively determined who file full applications (per federal performance floor)
• Percentage of those who are subsequently determined fully eligible
• Training and compliance metrics

Hospitals that fail to meet performance standards may have their authority to make presumptive determinations revoked.

CHIPRA 2009 §211 expansion

The Children's Health Insurance Program Reauthorization Act of 2009 §211 expanded presumptive eligibility to additional populations, clarified Express Lane Eligibility coordination under 42 USC 1396a(e)(13)(C), and permitted states to use simplified data sources (SNAP, WIC, school lunch program) for presumptive determinations. Georgia uses WIC enrollment as a presumptive eligibility data source for pregnant women and infants.

Georgia's presumptive eligibility programs

Right from the Start Medicaid (RSM)

RSM is Georgia's longest-running presumptive eligibility program. Codified at O.C.G.A. §49-4-159, RSM permits designated qualified entities to make immediate presumptive determinations for pregnant women.

RSM qualified entities include:

• WIC clinics across Georgia
• County health departments
• Designated FQHCs (Federally Qualified Health Centers)
• Designated obstetric practices
• Designated hospitals with prenatal clinics

RSM eligibility criteria for presumptive determination:

• Self-reported income at or below 220 percent FPL
• Household size counts the unborn child
• Georgia residency (self-attested)
• Citizenship or qualified immigration status (self-attested at presumptive determination; verified at formal application)

RSM coverage scope during the presumptive period:

• Prenatal OB visits at any Medicaid-enrolled obstetric provider
• Ultrasounds and prenatal lab work
• Prenatal vitamins
• Gestational diabetes management
• Mental health services
• Substance use disorder treatment
• Emergency prenatal services

Hospital presumptive eligibility (HPE) in Georgia

Georgia's State Plan Amendment implements the ACA-mandatory hospital presumptive eligibility option. Under HPE, all Georgia hospitals that participate in Medicaid and complete state training can make presumptive determinations for:

• Pregnant women (in addition to the RSM pathway)
• Children under 19
• Parents and caretaker relatives (LIM, TMA)
• Former foster care youth under 26
• Breast and cervical cancer screening and treatment recipients

Hospital eligibility specialists complete annual training, use the state's standardized screening tool, submit presumptive determinations to DCH within state-required timelines, and refer individuals to file full applications through Gateway or DFCS.

Georgia Breast and Cervical Cancer Program (BCCP) presumptive eligibility

GA BCCP provides presumptive Medicaid eligibility for women diagnosed with breast or cervical cancer through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Coverage during the presumptive period covers cancer treatment, surgery, chemotherapy, and radiation. The presumptive period bridges to full BCCP Medicaid pending application processing.

Planning for Healthy Babies (P4HB) Family Planning Waiver

Georgia's P4HB Family Planning Waiver under §1115 demonstration permits presumptive eligibility for family planning services for women with income at or below 220 percent FPL. Coverage scope is limited to family planning services: contraception (all FDA-approved methods), sterilization, family planning visits, related lab work, and STI screening at family planning visits.

The 60-day presumptive period mechanics

Start date

The presumptive period begins on the date the qualified entity makes the presumptive determination. The QE provides the individual with a written notice of presumptive eligibility including the start date and information about filing a full application through Gateway or DFCS.

End date

The presumptive period ends on the earlier of:

• The day the agency makes a final determination on the formal Medicaid application (approval or denial)
• The last day of the month following the month of presumptive determination IF no formal application has been filed

In practice, the presumptive period runs approximately 45 to 60 days. If the individual files a formal application promptly and DFCS makes a decision within the standard 45-day window under 42 CFR 435.911, the presumptive period may be shorter.

Coverage scope

Coverage during the presumptive period is full Medicaid for the specific category. For pregnant women under RSM, this means ambulatory prenatal care. For children under 19 under hospital presumptive, this means the full Medicaid benefit package including EPSDT, primary care, hospital admission, ED visits, prescriptions, behavioral health, dental, and vision. For former foster care youth, this means full Medicaid with no income limit.

Income standard at presumptive determination

The qualified entity uses a simplified screening tool with the same income thresholds as the underlying Medicaid category:

The QE relies on self-reported income at presumptive determination. Documentation is verified during the formal application process. The QE makes a good-faith determination based on the applicant's statement and any readily-available data such as WIC enrollment or prior Medicaid history.

One presumptive period per pregnancy

For pregnant women, federal regulation under 42 CFR 435.1102 strictly limits presumptive eligibility to one period per pregnancy. If the presumptive period ends without a formal application being approved, a second presumptive period for the same pregnancy is not available. She can still apply formally for pregnancy Medicaid; presumptive is just the fast-track entry.

For children, parents, and former foster care youth, federal regulation does not strictly limit the number of presumptive periods. Georgia policy under hospital presumptive eligibility under 42 CFR 435.1110 typically permits one presumptive period per 12-month period for non-pregnancy populations.

Qualified entity certification

Approved QE list

Georgia's qualified entity list as of 2026 includes:

• Right from the Start Medicaid providers: All county WIC clinics, county health departments, designated FQHCs, designated obstetric practices, and designated hospital prenatal clinics
• Hospital presumptive entities: All Georgia hospitals participating in Medicaid that have completed state training. This includes Grady Memorial Hospital (Atlanta), Emory Healthcare (Atlanta), Piedmont Healthcare (Atlanta and statewide), Northside Hospital, Children's Healthcare of Atlanta, Memorial Health (Savannah), AU Medical Center (Augusta), WellStar Health System (statewide), Coliseum Health System (Macon), Phoebe Putney Health (Albany), Houston Healthcare (Warner Robins), and many others
• Breast and Cervical Cancer Program providers: NBCCEDP-participating screening facilities including AU Medical Center, Grady Cancer Center, Emory Cancer Network, Piedmont Cancer Institute, and others
• Planning for Healthy Babies (P4HB) providers: P4HB-enrolled clinics including county health departments and participating FQHCs

Training requirements

DCH requires QE staff to complete training on:

• Eligibility categories and income thresholds
• Screening tool operation
• Notice requirements (presumptive determination, denial, full application referral)
• Documentation and reporting to DCH
• Civil rights and language access requirements
• HIPAA and confidentiality

Training is typically conducted annually with refresher requirements for staff changes. Training is delivered through DCH Provider Services Section.

Performance standards under 42 CFR 435.1110(d)

DCH monitors QE performance. The federal regulation requires that a significant share of presumptive determinations result in full applications being filed, per the performance floor in 42 CFR 435.1110(d). QEs with poor performance may have certification revoked. Hospital eligibility specialists generally meet this benchmark by integrating Medicaid screening into the admission workflow.

Interaction with retroactive eligibility and postpartum coverage

Presumptive eligibility, retroactive eligibility, and 12-month postpartum coverage are complementary mechanisms. Together, they can provide continuous Medicaid coverage spanning more than a year.

Retroactive eligibility: backward 3 months

Under 42 USC 1396a(a)(34) and 42 CFR 435.915, Medicaid covers services received during the 3 months immediately before the formal application month, if the applicant would have been eligible during those months. Georgia preserves the full 3-month retroactive window.

Presumptive eligibility: forward 60 days

Under 42 CFR 435.1100-1110, presumptive coverage runs from QE determination until the formal application decision or the last day of the month following presumptive determination.

12-month postpartum coverage

Under 42 USC 1396a(e)(16) and ACA §2202 (the same statute that made hospital presumptive eligibility mandatory), states must provide 12 months of continuous postpartum coverage from the end of pregnancy. Georgia has adopted this extension.

Stacked coverage example

A woman who learns she is pregnant in November 2025, receives an RSM presumptive determination at her county health department in November, files her formal Gateway application in December, delivers in February 2026, and would have:

• Retroactive eligibility: August through October 2025 (if she had medical services and met eligibility during those months)
• Presumptive eligibility: November 2025 (QE determination) through December 2025 (formal eligibility decision)
• Pregnancy Medicaid: December 2025 through end of pregnancy in February 2026
• 12-month postpartum: February 2026 through February 2027

Total continuous Medicaid coverage: August 2025 through February 2027, approximately 18 months.

Worked examples

Example 1: Maria, 28, Atlanta (Grady Hospital, undocumented, pregnant)

Maria is undocumented, 24 weeks pregnant, and presents at Grady Memorial Hospital ED with preterm contractions. The hospital eligibility specialist screens her under both Emergency Medicaid for L&D and RSM presumptive eligibility for prenatal care.

Under 42 USC 1396b(v) Emergency Medicaid, Maria's labor and delivery admission will be covered when she delivers. For undocumented immigrants, RSM presumptive operates as a state-funded prenatal care program in Georgia (Georgia uses CHIPRA §214 unborn child option to cover the fetus, providing prenatal services regardless of mother's immigration status).

Grady provides Maria with a presumptive determination notice. She receives prenatal visits at the Grady OB clinic, two ultrasounds, lab work, gestational diabetes screening, and prenatal vitamins. She delivers at Grady seven weeks later under Emergency Medicaid coverage.

Example 2: Jasmine, 10, Macon (asthma admission, hospital presumptive)

Jasmine is admitted to Coliseum Health System Macon with status asthmaticus requiring ICU-level care. Her mother is uninsured and has no Medicaid record on file. The hospital's eligibility specialist screens Jasmine under hospital presumptive eligibility for children under 19.

Jasmine's household income: $2,400 per month (mother working part-time, household of 3 including Jasmine and a younger sibling). The hospital eligibility specialist confirms she is within the Georgia child Medicaid income threshold for age 6-18, making Jasmine income-eligible.

The hospital makes a presumptive determination same day. Coverage starts immediately. The mother completes the Gateway application within 7 days. DFCS approves full Medicaid in 28 days. Jasmine's full asthma admission, ICU stay, and discharge medications are covered. The mother experiences no surprise hospital bill.

Example 3: Roberto, 22, Atlanta (former foster care, FQHC primary care)

Roberto aged out of Georgia foster care at age 21 in September 2025. Under 42 USC 1396a(a)(10)(A)(i)(IX) and ACA §2004, former foster care youth are eligible for Medicaid until age 26 with no income limit. Roberto did not enroll at exit because his caseworker did not facilitate enrollment.

In May 2026, Roberto presents at an Atlanta FQHC for primary care (annual physical, behavioral health follow-up for ADHD medication). The FQHC eligibility specialist screens him under former foster care presumptive eligibility. Roberto provides his foster care exit verification (letter from his prior caseworker).

The FQHC makes a presumptive determination same day. Roberto receives full Medicaid coverage. He files his Gateway application that week. DFCS approves former foster care Medicaid within 14 days. Coverage continues to age 26 with no income limit.

Example 4: Ana, 19, Savannah (postpartum after RSM presumptive)

Ana enrolled in RSM presumptive at 22 weeks pregnant in October 2025 at a Savannah WIC clinic. She filed her formal Gateway application in November and was approved for pregnancy Medicaid effective November 1. She delivered February 20, 2026, at Memorial Health Savannah.

Coverage timeline:

• RSM presumptive: October 2025 (QE determination at WIC) through October 31, 2025
• Pregnancy Medicaid (formal): November 1, 2025 through February 20, 2026 (end of pregnancy)
• Retroactive eligibility: August through September 2025 (if she had qualifying prenatal services)
• 12-month postpartum: February 20, 2026 through February 19, 2027

Ana's coverage continues for 12 months postpartum regardless of changes in income, marital status, or household composition. The 12-month postpartum coverage is an extension Georgia adopted under ACA §2202.

Example 5: Tyler, 7, Athens (renewal gap, hospital presumptive bridge)

Tyler had been enrolled in MAGI Medicaid since age 2. His mother missed a renewal deadline in February 2026, and Tyler was procedurally disenrolled. In April 2026, Tyler is brought to Children's Healthcare of Atlanta for a sick visit (ear infection with hearing concern).

Children's Healthcare eligibility specialist checks Tyler's Medicaid status, sees he was procedurally disenrolled, and offers hospital presumptive eligibility. Income screening: mother earns $2,800 per month, household of 4 (mother, Tyler, 2 siblings), within the Georgia child Medicaid income threshold for ages 6-18.

Presumptive determination same day; coverage starts immediately. The mother files a new Gateway application that night. She also notices she is still within the reconsideration window under 42 CFR 435.916 from her February termination, so she requests reconsideration. DFCS reinstates Tyler's prior eligibility retroactive to the termination date. Tyler's coverage is restored with no gap.

Example 6: Lisa, 52, Augusta (breast cancer, BCCP presumptive)

Lisa received a screening mammogram at the AU Medical Center NBCCEDP program in March 2026. Diagnostic workup revealed invasive ductal carcinoma. The NBCCEDP coordinator referred Lisa for treatment, but Lisa had no health insurance.

Under the Georgia Breast and Cervical Cancer Program, NBCCEDP-screened women with cancer diagnosis are eligible for full Medicaid for cancer treatment. The BCCP coordinator makes a presumptive determination same day. Coverage starts immediately.

Lisa begins chemotherapy at AU within 10 days of diagnosis. She files her formal Medicaid application during the presumptive period. DFCS approves full BCCP Medicaid within 30 days. Treatment continues throughout the cancer treatment course (chemotherapy, surgery, radiation, follow-up). Coverage continues as long as Lisa is actively in treatment for the qualifying cancer.

Common mistakes (15)

1. Not asking about presumptive eligibility at hospital admission. Hospital eligibility specialists are required to screen for presumptive eligibility, but families must sometimes initiate the conversation, especially in EDs.
2. Assuming hospital presumptive only applies to pregnant women. It applies to children, parents, former foster care youth, and breast and cervical cancer patients in addition to pregnant women.
3. Failing to file a formal application during the presumptive period. Without a formal application, coverage ends at the last day of the month following presumptive determination.
4. Filing the formal application but failing to provide documentation. Income verification, citizenship, residency documentation are still required for the formal eligibility decision even after presumptive determination.
5. Believing presumptive coverage extends back retroactively. Presumptive coverage starts at QE determination and runs forward. Retroactive coverage runs backward from formal application date. These are separate mechanisms.
6. Missing the one-presumptive-period-per-pregnancy limit. A pregnant woman cannot receive a second presumptive period for the same pregnancy; she must apply formally if the first period ends.
7. Confusing presumptive eligibility with Emergency Medicaid. Emergency Medicaid (under 42 USC 1396b(v)) covers emergency-only services for non-citizens. Presumptive eligibility is a fast-track for citizens and qualified immigrants to bridge to full Medicaid.
8. Receiving services from non-Medicaid providers during the presumptive period. Coverage applies only to Medicaid-enrolled providers, just like any other Medicaid coverage.
9. Not transitioning from RSM presumptive to formal pregnancy Medicaid before the presumptive period ends. The formal application must be filed and approved before the end of the month following presumptive determination, or coverage ends.
10. Failing to use Gateway for the formal application. Gateway is the primary application portal; paper applications add processing time.
11. Believing former foster care youth presumptive has an income limit. Former foster care youth under 26 have NO income limit under 42 USC 1396a(a)(10)(A)(i)(IX).
12. Not enrolling at foster care exit. Foster care caseworkers are required to facilitate Medicaid enrollment at exit; if missed, presumptive eligibility provides a bridge that should be used immediately.
13. Missing the BCCP eligibility window. BCCP presumptive requires NBCCEDP screening; women diagnosed outside the program may need a different Medicaid pathway.
14. Failing to notify the QE if income changes during the presumptive period. Income changes between presumptive determination and formal eligibility decision can affect both presumptive coverage and the full eligibility outcome.
15. Assuming presumptive determinations from out-of-state QEs are recognized. Each state's presumptive eligibility program is separate; a Florida hospital presumptive determination does not transfer to Georgia.

Frequently asked questions

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items:

• title: "What is presumptive Medicaid eligibility?" body: "Presumptive eligibility is a fast-track Medicaid enrollment mechanism that lets qualified entities (hospitals, FQHCs, WIC offices, county health departments, designated obstetric practices) make immediate eligibility determinations based on simplified income screening. The presumptive period provides full Medicaid coverage for approximately 60 days while the formal application is processed. The federal authority is 42 USC 1396a(a)(47) and 42 CFR 435.1100-1110."
• title: "How does Right from the Start Medicaid work?" body: "Right from the Start Medicaid (RSM) is Georgia's presumptive eligibility program for pregnant women, codified at O.C.G.A. §49-4-159. Designated WIC offices, county health departments, FQHCs, and obstetric practices make immediate presumptive determinations for pregnant women with income at or below 220 percent FPL. Coverage starts the day of determination and covers ambulatory prenatal care. The pregnant woman must file a formal Medicaid application through Gateway during the presumptive period to continue coverage."
• title: "How long does presumptive coverage last?" body: "The presumptive period runs from the qualified entity determination date until the earlier of: (1) the formal Medicaid application decision date, or (2) the last day of the month following the month of presumptive determination. In practice, the period typically runs approximately 45 to 60 days depending on when the formal application is filed and decided."
• title: "Do I still need to file a formal Medicaid application?" body: "Yes. The presumptive determination is a fast-track entry point, not a substitute for the formal application. You must file a full Medicaid application through gateway.ga.gov or with DFCS during the presumptive period. If you do not file, coverage ends at the end of the month following the presumptive determination month. If you file and are approved, full Medicaid coverage continues without a gap."
• title: "What about former foster care youth?" body: "Former foster care youth under 26 are eligible for Medicaid with NO income limit under 42 USC 1396a(a)(10)(A)(i)(IX), as added by ACA §2004. Georgia's State Plan Amendment added former foster care youth to the hospital presumptive eligibility list. If you aged out of Georgia foster care and were not enrolled at exit, you can receive a presumptive determination at any Medicaid hospital or FQHC."

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Brevy is here to help

Presumptive eligibility is one of the most powerful tools in the Medicaid safety net, and one of the least understood. A pregnant woman who walks into a WIC clinic with no insurance can leave the same day with active Medicaid coverage. A child admitted to a hospital with asthma can have the entire admission covered through the eligibility specialist's same-day presumptive determination. A 22-year-old who aged out of foster care without enrollment can walk into an FQHC and bridge into Medicaid that day.

Find personalized help understanding Georgia Medicaid presumptive eligibility at brevy.com.

::cta{type="phone-list" heading="Georgia Medicaid Presumptive Eligibility: Where to Get Determined"}

contacts:

• label: "Department of Community Health (DCH)" phone: "1-866-211-0950" description: "Medicaid Member Services, presumptive eligibility questions, RSM provider directory"
• label: "Division of Family and Children Services (DFCS)" phone: "1-877-423-4746" description: "Formal application processing after presumptive determination"
• label: "Gateway online portal" phone: "gateway.ga.gov" description: "Online formal application, document upload"
• label: "Right from the Start Medicaid (RSM)" phone: "Local WIC clinics, county health departments, designated FQHCs" description: "Presumptive eligibility for pregnant women under O.C.G.A. §49-4-159"
• label: "Grady Memorial Hospital" phone: "1-404-616-1000" description: "Hospital presumptive eligibility (Atlanta)"
• label: "Emory Healthcare" phone: "1-404-712-2000" description: "Hospital presumptive eligibility (Atlanta and metro)"
• label: "Piedmont Healthcare" phone: "1-404-605-5000" description: "Hospital presumptive eligibility (statewide)"
• label: "Children's Healthcare of Atlanta" phone: "1-404-785-5437" description: "Hospital presumptive eligibility for children"
• label: "Memorial Health Savannah" phone: "1-912-350-8000" description: "Hospital presumptive eligibility (Savannah)"
• label: "AU Medical Center" phone: "1-706-721-2273" description: "Hospital presumptive eligibility (Augusta) and BCCP"
• label: "WellStar Health System" phone: "1-770-956-7827" description: "Hospital presumptive eligibility (metro Atlanta and Northwest Georgia)"
• label: "Georgia Breast and Cervical Cancer Program (BCCP)" phone: "1-404-657-6611" description: "Presumptive eligibility for NBCCEDP-screened women diagnosed with cancer"
• label: "Planning for Healthy Babies (P4HB)" phone: "1-877-792-2660" description: "Family Planning Waiver presumptive eligibility"
• label: "Atlanta Legal Aid Society" phone: "1-404-524-5811" description: "Free legal help for Medicaid applications in metro Atlanta"
• label: "Georgia Legal Services Program (GLSP)" phone: "1-800-498-9469" description: "Free legal aid throughout Georgia outside metro Atlanta"

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Disclaimer: This article is intended as a general informational resource on Georgia Medicaid presumptive eligibility. It does not constitute legal advice. Eligibility categories, income thresholds, and qualified entity certification status change over time. Consult an attorney licensed in Georgia, a legal aid organization, or your Medicaid agency for advice on a specific case. Statutory citations and procedural rules in this article reflect the law as of May 12, 2026, and are subject to amendment.