Georgia Pathways to Coverage
We've served Georgia Pathways members since 2023.
Georgia Pathways is a new waiver program that gives Georgians who are not eligible for Medicaid an opportunity to gain access to healthcare coverage through Medicaid.
Georgia Pathways members are eligible to receive the same state plan benefits as other Medicaid groups, with the exception of nonemergency medical transportation (NEMT). Georgia Pathways member ages 19 to 20 who are receiving Early and Periodic Screening, Diagnostic, and Treatment services may access NEMT, dental, and vision services as part of their benefits.
Visit the Georgia Department of Community Health website to learn more about the Georgia Pathways program and other programs.
There are currently no copays for Georgia Pathways members.
For more information check out your provider manual .
To get Georgia Pathways, the member must meet income limits and:
- Be a Georgia resident.
- Be a U.S. citizen or legal resident.
- Be at least 19 years old and between the ages of 19 and 64.
- Household income up to 100% of the Federal Poverty line.
- Prove that they are doing one or more qualifying activities for at least 80 hours per month.
- Not be eligible for any other category of Medicaid.
- Not be incarcerated.
To find out more about eligibility, visit Georgia Department of Community Health website.
When applying to Georgia Pathways, members must show that they are currently engaged in at least 80 hours per month of a qualifying activity or combination of activities.
Members must provide one source of documentation for verification per qualifying activity reported. Documentation must verify hours reported for the most recent four weeks available, within the eight weeks prior to application submission date.
Qualifying activities include:
- Employment, including self-employment
- On-the-job training
- Job readiness
- Community service
- Vocational educational training
- Enrollment in an institution of higher education
- Enrollment and active engagement in the Georgia Vocational Rehabilitation Agency
Members can report qualifying hours and activities:
Your provider manual is your go-to guide for how you work with Amerigroup Community Care.
Provider tools & resources
- Log in to Availity
- Launch Provider Learning Hub Now
- Learn about Availity
- Prior Authorization Lookup Tool
- Prior Authorization Requirements
- Claims Overview
- Reimbursement Policies
- Provider Manuals, Policies & Guidelines
- Provider Training Academy
- Pharmacy Information
- Georgia Families 360°℠