Does Medicaid in Georgia Provide Full Coverage for Emergency Room Visits?


Quick Answer

Medicaid in Georgia covers treatment received in a hospital, even if the person is not admitted to the hospital, according to government information site Disability.gov, but full coverage is only available for emergency services. Non-emergency services performed in an emergency room may be subject to copayments.

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Full Answer

Federal Medicaid laws allow states to impose copayments on those enrolled in Medicaid for emergency room visits if it is determined that the emergency room visit is for a non-emergency purpose. This requires that the doctors in the emergency room to determine that the Medicaid patient does not require emergency services and that there is an alternative non-emergency practitioner available to perform the services needed in a timely manner. The hospital must also inform the patient that the copayment is charged before the service is performed and about alternative non-emergency practitioners. It must also offer a referral to coordinate scheduling an appointment with the non-emergency practitioner. The hospital is not authorized to impose a copayment If these conditions are not met,

In addition, Georgia's Medicare law exempts some classes of patients from copayments entirely. These include persons on Medicaid under the age of 21, women with breast or cervical cancer or who are pregnant, residents of nursing homes and Native Americans.

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