Peach State Health Plan (Peach State) is a health plan participating in Georgia Families® (GF). It is a managed care program for Medicaid and PeachCare for Kids® members. We offer our members local healthcare programs and services. Peach State Health Plan helps our members grow healthy and stay healthy. We provide access to quality healthcare.
Centene Corporation is the parent company of Peach State Health Plan. To find out more visit their site at www.centene.com.
The Georgia Families® program delivers healthcare services to members of Medicaid and PeachCare for Kids®. The program is a partnership between the Department of Community Health (DCH), Peach State Health Plan and three other health plans. Learn about Georgia Families®.
The Georgia Department of Community Health (DCH) is one of Georgia’s health agencies. DCH’s programs provide access to health care services for one in four Georgians. Learn about Georgia Department of Community Health.
PeachCare for Kids® offers free or low-cost health insurance. This program is for children through the age of 18. Learn about PeachCare for Kids®.
Planning for Healthy Babies® (P4HB) covers family planning services for women ages 18-44. Learn about Planning for Healthy Babies.
Peach State Health Plan wants you to have a doctor who will meet your medical needs. You can see if your PCP is in our network by searching our provider directory.
Members may change their PCP if they are not satisfied. Members may change their PCP once a month during the first 90 days of enrollment in Peach State Health. After 90 days, members can change their PCP once every six months. They may also get services from any Peach State Health Plan participating Primary Care Provider at any time regardless of assignment.
Yes, as long as your current doctor accepts Peach State Health Plan. Remember that because you are pregnant you will have 2 doctors. One doctor is your PCP. The second doctor is your OB/Gyn. Your OB/Gyn will not appear on your Peach State Health Plan ID card. Only your PCP will appear on your Peach State Health Plan ID card. You can keep your current OB/Gyn as long as they accept Peach State Health Plan.
If you have had a major change in your life, your caseworker needs to know. This could be a change in your:
- Telephone Number
- Family Size
Please call your local caseworker at the Department of Family and Children Services (DFCS). To speak with an agent (8 a.m. to 5 p.m. M-F) regarding Food Stamps, TANF, Childcare or Medicaid: Call 1-877-423-4746. Applications for Childcare, Medicaid and Food stamps as well as renewals and case status information for all programs can be accessed at www.gateway.ga.gov.
Peach State Health Plan staff will help you:
- Change your PCP
- Teach you how to use your benefits
- Identify special needs
- Refer you to programs or resources
Peach State Health Plan offers the same benefits covered by Medicaid and PeachCare for Kids®. We also offer enhanced benefits that extend your coverage.
- Choose your own doctor from over 20,000 providers and 40,000 locations.
- Free Dental & Vision Services for adults and children.
- Mental Health & Substance Abuse Services
- Extra Incentives for completing prenatal and postpartum visits.
- Nurse Advice Line: Free 24/7 bilingual health phone line
- START SMART for Your Baby: Program for pregnant women
- Community Health Services (formerly Member Connections): Outreach program that includes home visits
- FREE transportation. This includes doctor appointments.
- Healthy Solutions: Asthma Program
- Free Translation services.
- Script Assist-help line to assist members with questions about their medication and the side effects and risks.
- Membership for Boys and Girls Clubs with no annual fee for members age 6-18 at participating clubs only
You must review your eligibility with the Department of Family and Children Services (DFCS) or PeachCare for Kids®. You must complete the requested information. Go see your caseworker if needed. Tell your caseworker if you have had any major change in your life. This change could be:
- Telephone Number
- Family size
Your eligibility must be renewed through DFCS or PeachCare for Kids®.
How do you complete the review process?
- Online at Gateway
Medicaid members should contact their county DFCS office for questions about the review process. PeachCare for Kids® members should call 1-877-427-3224. They can give instructions on how to complete the process. Each county office is different.
Please contact your county caseworker when it is time for your review.
What happens if you don’t renew your Medicaid?
You can lose your Medicaid coverage. This will cause a break in your health coverage.
United States citizens and nationals must provide proof of U.S. citizenship. Every member of the family that is a U.S. citizen or national must provide proof. These items can prove citizen status:
- Birth Certificate
- Social Security Card
- Green Card
- Certificate of U.S. Naturalization
- School Records
- State Issued Picture ID
- Confirmation of Birth
You can call Peach State Health Plan Member Services if you have any questions about our services. Call us at 1-800-704-1484 or TTY/TDD 1-800-255-0056. Our staff is here Monday through Friday, between 7 a.m. to 7 p.m. We are closed on holidays.
What is the Georgia Health Information Network (GaHIN)?
It’s a way for your health care providers to share electronic versions of your health records with each other.
What kind of information will my providers share with each other?
Your PCP and other providers can share information such as:
- Your notes
- Medical history
- X-rays and lab reports
- Lists of medications and allergies
The providers share this and other important health information with each other and Peach State Health Plan. They will do this with your permission.
What are benefits of using GaHIN?
The network makes it easier for your health care providers to access your health information. Electronic records also change the way that your PCP and other doctors see your health history. They can see graphs and charts and easily note trends in your health.
Do I have to give my permission first?
Yes. Your providers must tell you before they share your electronic records. You can opt out at any time if you don’t want your health information shared on the exchange. Just ask your provider for the opt-out form. Complete the form and return it to your provider. And if you change your mind, you can always tell your doctor that you’d like to participate again.