Medicaid is a program that provides health care services to individuals who meet the requirements for income, resources, and citizenship. Cooperation with Georgia Department of Human Services Division of Child Support Services is a requirement of receiving certain types of Medicaid. Individuals may apply for Medicaid at any local Division of Family and Children Services office, by mail or by telephone (1.877.423.4746).

Apply for Medicaid

Step 1: Get Prepared
Review What do I need to apply for Medicaid? You can also visit Georgia Gateway to see if you are potentially eligible for benefits.

Step Two: Complete and Submit an Application

Download the application:

English: Form 94A 

Spanish/Español: Form 94A


Request a paper application by visiting your local DFCS office or by calling the Customer Contact Center at 1.877.423.4746.

An application is considered filed when it has the name of the head of household, address, date, and signature of the head of household or another household member, and is received by the DFCS.

Additional Medicaid Information
How do I use my Medicaid Services?    
Form 508 - Food Stamp/Medicaid/TANF Renewal Form