Right from the Start Medicaid (RSM) : the RSM Medicaid Program available through the Division of Family and Children Services (DFCS)

KEITH HORTON COMMISSIONER
DFCS LEADERSHIP: Sharon Hill
Division Director Carol Christopher
Deputy Director

RIGHT FROM THE START MEDICAID (RSM)
The RSM Medicaid Program available through the Division of Family and
Children Services (DFCS)

RSM FOR PREGNANT WOMEN AND CHILDREN IN GEORGIA: Right from the Start Medicaid (RSM) for pregnant women pays for medical care for pregnant women, including labor and delivery, for up to 60 days after they give birth. Pregnant women who qualify are entitled to the full-range of Medicaid covered services. Some services include physician's visits, prescription drugs, and inpatient and outpatient hospital services. The program uses 200 percent of the federal poverty level as the ceiling for eligibility for pregnant women.

RSM for children pays for medical care for children age 0 up through the month of the 19th birthday. These children may qualify at various income levels depending on age, family size, and income. Children who qualify are entitled to the full-range of Medicaid covered services. Some services include doctor's visits, health checkups, immunizations, and dental and vision care.

HOW DOES A FAMILY APPLY FOR RSM? To apply, contact your local county Division of Family and Children Services (DFCS) office or the Right from the Start Medicaid Program, toll-free at 1-800-809-7276. You may also contact the Healthy Mothers/Healthy Babies Powerline at 1-800-822-2539. Other application options in many communities include schools, hospitals or community centers.
WHO CAN RECEIVE RSM? Pregnant women may qualify if their monthly income does not exceed 200 percent of the federal poverty level limit. A pregnant woman is counted as two people in the calculation of family size. Her husband is also counted, although husbands do not receive RSM coverage. In addition, a woman meeting the income standards may become eligible within 60 days after giving birth, even if she did not apply during pregnancy or delivery. Infants, born to women receiving Medicaid on the day the child is born, receive Medicaid until they reach their first birthday.

200 Percent Federal Poverty Level Income Limits:

Family Size

Monthly Income

2

$2,452

3

$3,089

4

$3,725

5

$4,362

Children up to age 19 may qualify at various income levels depending upon age and family size. Children up to age 1 may qualify if their family income is 185 percent of poverty or below; age 1 to 5 if their family income is 133 percent of poverty or below; and age 6 to 19 if their family income is 100 percent of poverty or below.
Car or home ownership does not affect eligibility.

Married as well as single pregnant women may qualify for RSM.

Federal Poverty Level Income Limits:

Family Size

Monthly Net Income 100% Age 6-19

1

$908

2

$1,226

3

$1,545

4

$1,863

5

$2,181

Monthly Net Income 133% Age 1-5
$1,207
$1,631
$2,054
$2,478
$2,901

Monthly Net Income 185% Age 0-1
$1,679
$2,268
$2,857
$3,446
$4,035

WHAT IS THE INTENT OF THE RSM PROGRAM? Medicaid applications are processed quickly so more eligible women may enter prenatal care earlier in their pregnancy. Eligible children are able to receive checkups and preventive care. Those needing medical treatment are more likely to receive it earlier, before their conditions become severe. The program helps to decrease infant mortality and preventable illnesses. The program allows children and pregnant women with low or moderate income to have access to health care coverage.
HOW LONG CAN A FAMILY RECEIVE RSM? A woman meeting the income standards may become eligible within 60 days after giving birth, even if she did not apply during pregnancy or delivery. Infants, born to women receiving Medicaid on the day the child is born, receive Medicaid until they reach their first birthday. Right from the Start Medicaid (RSM) for children pays for medical care for children age 0 up through the month of the 19th birthday as long as the child remains eligible. Medicaid eligibility must be renewed every 6 months.
HOW DO I RENEW MY BENEFITS? A renewal letter will be mailed to each family or recipient that gives instructions on the renewal process. Families can renew their benefits at www.compass.ga.gov. In order to use the online renewal process, the family must know the client id of the head of the household and use it to create an online account prior to going to the `renew my benefits' section.