What is Georgia Families?
Georgia Families is the program for people in Medicaid and
PeachCare for Kids® that guides them in choosing a health plan and a Primary Care Provider. Most Medicaid and PeachCare for Kids members must enroll in Georgia Families and join a health plan and choose a provider.
What
is a health plan?
A health plan is a group of doctors, nurses, other staff, hospitals, and clinics that provide health services and coordinate patient care.
What
is a Primary Care Provider (PCP)?
Your PCP is your main doctor (or other practitioner). Your
PCP will give you checkups, see you when
you are sick, and refer you to specialists when needed. Your PCP will get to know you and will keep track of your health records.
When must you join?
Shortly after you are approved for Medicaid or PeachCare for Kids®you will be enrolled into a health plan in Georgia Families. Georgia Families will mail you a welcome letter with information about your health plan. If you do not want the health plan we chose for you, you can change to another health plan. You will have 90 days from the start date of your health plan to change to a new health plan.
Who must join?
Most Medicaid and all PeachCare for Kids members must join in a
Georgia Families health plan.
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Who
should not join?
Medicaid members who are:
- blind,
- disabled,
- children in foster care,
- children with special health care needs,
- or are members who can get Medicare.
See a complete list of Health Plan Exclusions for Medicaid members who should not join on the Public Portal.
You cannot join if you are not in Medicaid or PeachCare for Kids.
How do
you join?
There are three ways you can join:
- Online: Go to Log In or Register link and follow the steps.
- By phone: Call 1-888-GA-Enroll (1-888-423-6765). An enrollment counselor can help you during business hours, or you can use the automated phone system anytime, day or night. Business hours are 7 a.m. to 7 p.m., Monday through Friday.
- On paper: Use the form you get in the mail from Georgia Families. Mail or fax it to Georgia Families.
Do you
get to choose the health plan you want?
Yes. You can choose between three health plans in your
area. Health plans that work with Georgia Families are:
- Amerigroup Community Care
- CareSource Georgia
- Peach State Health Plan
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Do all
family members have to choose the same health plan?
No. Each member of the household may have a different plan and PCP.
Can you
keep seeing the doctor you go to now?
If your doctor works with a Georgia Families health plan in your region, you can choose him or her.
Specialists cannot be PCPs.
Can you change doctors anytime?
Yes.
Call your health plan and say you want to change your PCP.
What happens if you choose a plan and a doctor who don't work with each other?
You will join that plan, then ask the plan to help you choose a doctor.
Is there a list of PCPs?
Yes, you can Search for a Doctor (PCP) on this site to see providers and plans near you. You can also call us and we can help you find doctors near or send you a copy of the Provider Directory that has a list of the PCPs.
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Do you have to choose a doctor when you join?
No. A doctor (PCP) will be chosen for you, but you can change your doctor anytime.
When can you change health plans?
- During your first 90 days in a plan, you can switch to a different plan.
- After 90 days, you cannot change plans unless you have a special reason and get permission from Georgia Families.
- When you have been in your plan for a year, you can change plans. Georgia Families will mail you information about changing plans at that time. If you want to stay in your plan for another year, you do not have to do anything.
Can you change PCPs when you are in a health plan?
Yes. To change PCPs, call your health plan.
What if your PCP leaves your health plan?
Call your plan to choose a new doctor.
What if you want someone else (an authorized representative) to speak for you about your health plan?
You may choose an authorized representative. Contact your DFCS office.
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Can you get extra copies of brochures, charts and directories?
Yes, you can get copies on this website or by phone:
- Call Georgia Families at 1-888-GA-Enroll
(1-888-423-6765). Use the recorded system to ask for the materials you want.
- Go to Public Portal. Download the materials you want.
Where
can you get more information about Georgia Families?
- Call Georgia Families at 1-888-GA-Enroll
(1-888-423-6765), Monday to Friday from 7 a.m. until 7 p.m.., or
- Use this website
(www.georgia-families.com).
What about name changes or lost ID cards?
- If you have a new name, call your local Medicaid or PeachCare for Kids® office to let them know.
- For new Medicaid or PeachCare for Kids cards, also call a Medicaid or PeachCare for Kids office.
- For new health plan cards, call your health plan.
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