How SSDI Payments Affect Your Medicaid Coverage in Georgia

SSDI income counts toward Medicaid's income limit in Georgia, but the rules are different depending on which Medicaid program you're in

If you receive Social Security Disability Insurance (SSDI) payments, Georgia counts that money as income when you explore for or renew Medicaid. However, whether those payments push you over the income limit depends on which Medicaid category you're trying to enter. Some programs have higher income limits than others, and some have special rules that let you keep Medicaid even when your SSDI goes up.

The most important thing to know: you do not automatically lose Medicaid when you start receiving SSDI, but you may need to report the income and your coverage might change. Georgia's Medicaid program is called Georgia Medicaid, and it handles these cases through its income verification system.

Key Takeaways

Georgia counts your full SSDI payment as income when determining Medicaid coverage, with no special deduction for disability benefits.
The income limit that matters depends on which Medicaid category you fall into—aged, blind, disabled, or another group—and limits vary by category.
If you lose Medicaid because your SSDI pushed you over the limit, you may be able to get it back through a work incentive program called Plan to Achieve Self-Support (PASS).
You must report changes in SSDI income to Georgia Medicaid within 30 days, or your coverage could be terminated for not reporting.
Some people can stay on Medicaid even after their income exceeds the limit through a program called Medicaid Buy-In for Working People with Disabilities.

Georgia's income limits for Medicaid and where SSDI fits

Georgia Medicaid has different income limits depending on which category you fall into. For people who are aged, blind, or disabled, the income limit is based on a percentage of the Federal Benefit Rate (FBR)—the base amount Social Security uses to calculate payments. In Georgia, the limit for this category is 100% of the FBR, which changes each year when Social Security adjusts payments for inflation.

Your SSDI payment is counted as unearned income, meaning Georgia does not subtract anything from it before comparing it to the limit. If you receive $1,200 per month in SSDI and the income limit is $1,150, you would be $50 over and would not meet the income requirement for that category of Medicaid. However, Georgia also runs other Medicaid programs with different rules, so being over the limit in one category does not mean you have no options.

The income limit changes every January when the Social Security cost-of-living adjustment (COLA) takes effect. If your SSDI payment increases because of the COLA, you should check with Georgia Medicaid to see whether your coverage is affected. You can contact Georgia Medicaid through the state's website or by calling the number on your Medicaid card.

What happens if your SSDI income puts you over the limit

If your SSDI payment is higher than Georgia's income limit for your category, you have several options. The first is to check whether you may have access to for a different Medicaid category with a higher income limit. Georgia runs programs for working people, parents and caretakers, and pregnant people, each with its own income rules. You might not fit into any of these, but it is worth asking Georgia Medicaid directly.

The second option is Plan to Achieve Self-Support (PASS), a federal work incentive program that lets you set aside part of your income for a specific work goal. If you are working or planning to work, you can exclude money you are saving for education, training, or a business from your Medicaid income calculation. This can bring your countable income below the limit and restore your coverage. PASS is run by Social Security, not Georgia Medicaid, so you explore through your local Social Security office.

The third option is the Medicaid Buy-In for Working People with Disabilities, a Georgia program that lets people with disabilities stay on Medicaid even when their income exceeds the normal limit, as long as they are working. If you are employed and your SSDI plus work income is above the limit, you may be able to buy into Medicaid by paying a small monthly premium. This program is designed to help people keep health coverage while they work.

Reporting SSDI income changes to Georgia Medicaid

When you start receiving SSDI, you must report it to Georgia Medicaid. If you already have Medicaid, you should report the new income within 30 days. You can report changes online through the Georgia Medicaid website, by phone, by mail, or in person at your local county office. Failing to report within 30 days can result in your Medicaid being terminated, even if you would have remained covered if you had reported on time.

If your SSDI payment changes—because of a cost-of-living adjustment, a medical review, or a change in your work history—you should report that change as well. Georgia Medicaid may automatically receive information from Social Security about your SSDI, but you should not assume they have it. It is safer to report it yourself and keep a record of when you reported it.

When you report income, Georgia Medicaid will send you a notice explaining whether your coverage continues, changes, or ends. Read this notice carefully. If you disagree with the decision, you have the right to request a hearing. The notice will explain how to ask for a hearing and what important date you have to request one.

How SSDI and Medicaid work together in Georgia

Many people in Georgia receive both SSDI and Medicaid at the same time. SSDI is a cash benefit that replaces lost wages, while Medicaid is health insurance. They are separate programs with separate rules, but they are linked through income. Having both means you have a monthly income from Social Security and health coverage through Georgia Medicaid.

If you are receiving SSDI and lose Medicaid because your income is too high, you may be able to get coverage through your employer if you are working, or through the health insurance marketplace. However, if you have a disability and your income is low, staying on Medicaid is usually cheaper than buying insurance on your own. This is why the work incentive programs—PASS and the Medicaid Buy-In—exist: they help people keep Medicaid while they work or prepare for work.

Georgia also has a program called Medicaid for Employed People with Disabilities (MEPD), though this is less common. Ask Georgia Medicaid whether you might may have access to for this or any other program that could help you keep coverage.

What to do if you are denied Medicaid because of SSDI income

If Georgia Medicaid denies your process or terminates your coverage because your SSDI income is too high, you have the right to appeal. The denial notice will explain how to request a hearing. You have 30 days from the date on the notice to ask for one. At the hearing, you can explain your situation to a hearing officer and present documents or witnesses to support your case.

Before you request a hearing, contact Georgia Medicaid and ask whether you might may have access to for PASS, the Medicaid Buy-In, or another program. Sometimes a phone call can solve the problem faster than a hearing. If you need help understanding your options, you can contact a Protection and Advocacy agency or a legal aid organization in Georgia. These organizations help people with disabilities understand their rights and can sometimes represent you at a hearing.

Frequently Asked Questions

If I get a raise in my SSDI payment, will I lose Medicaid?

Not automatically. Georgia will recalculate your income when you report the raise, and your coverage will continue if you are still under the income limit for your category. If the raise pushes you over the limit, you may may have access to for PASS or the Medicaid Buy-In. Report the change within 30 days to avoid your coverage being terminated for not reporting.

Can I have SSDI and Medicaid at the same time in Georgia?

Yes. Many people receive both. SSDI is income, and Medicaid is health insurance. As long as your SSDI income is at or below Georgia's limit for your category, you can have both. If your income is above the limit, you may still may have access to through PASS or the Medicaid Buy-In.

What is the income limit for Medicaid in Georgia for someone receiving SSDI?

The limit depends on your category. For aged, blind, or disabled people, it is 100% of the Federal Benefit Rate, which changes each January. In 2024, this is approximately $1,150 per month, but you should contact Georgia Medicaid to confirm the current limit, as it changes yearly.

Do I need to report my SSDI to Georgia Medicaid if I already told Social Security?

Yes. Social Security and Georgia Medicaid are separate agencies. Georgia Medicaid may eventually receive information from Social Security, but you should report your SSDI income directly to Georgia Medicaid within 30 days to make sure there is no delay or termination of your coverage.

What is PASS and how does it help me keep Medicaid?

PASS lets you set aside part of your income for a work goal—like education, training, or starting a business—and exclude that money from your Medicaid income calculation. This can bring your countable income below the limit and restore coverage. You explore through Social Security, not Georgia Medicaid.

This guide is for general information only and is not medical, financial, legal, or other professional advice. For decisions specific to your situation, consult a qualified professional. See our Editorial Policy.