Frequently Asked Questions
Comprehensive Health Coverage for Children and Teens Ages birth through their 19th Birthday.
Q. Why is healthcare important for kids and teens?
A: Healthy kids stay focused on learning, and are less likely to miss school days. Besides, being insured means less financial worries for the whole family.
Q: What are Medicaid and PeachCare for Kids®?
A: Right from the Start Medicaid and PeachCare for Kids® are two public health insurance programs for kids 0-19. Right from the Start Medicaid is a no-cost program. PeachCare for Kids® can be no-cost, or may require a small monthly premium ($0-$35, with a maximum of $70 for two or more children). Premiums for PeachCare for Kids® depend on your income and household size. Premiums must be paid monthly or coverage will be cancelled.
Q: What services do Medicaid and PeachCare for Kids® cover?
A: Medicaid and PeachCare for Kids® pay for doctor visits, immunizations, dental care, vision care, prescription medicines, hospital care, and much more.
Q: I have a job. Are my kids still eligible?
A: Yes, most children who are eligible for Medicaid and PeachCare for Kids®, but are not enrolled are in working families. Working parents may not have health coverage through their jobs or the health coverage they get does not cover their children or the premiums paid qualify as “unaffordable.” In some cases, if you have private health insurance, and your income is very low, you and your children may still qualify for Medicaid and receive premium assistance.
Q: When can I enroll?
A: You can enroll anytime. The process can take up to 45 days, so get started now!
Q: My kids are teenagers. Are they still covered?
A: Yes. Medicaid and PeachCare for Kids® cover kids until their 19th birthday. Eligibility is still determined by income and household size.
Q: Do non-U.S. citizens who are applying for Medicaid for their U.S.-born children have to prove citizenship or legal residency status?
A. No. If the person applying is not a U.S citizen and is applying for Medicaid for U.S. – born children, they are not required to provide proof of their citizenship status or present a Social Security card. Permanent Resident card-holder who have been in the US for 5 years or more may apply for Medicaid and PeachCare for Kids® for their children. Applying for services does not trigger any action with USCIS Immigration Service.
Q: How do I know if I am eligible?
A. Children under age 19 with a household income up to $59,904 per year for a family of four may qualify for health coverage through Medicaid or PeachCare for Kids®. It’s best to contact an enrollment assistance partner who can walk you through the process as eligibility limits may change. Whether you work or not, your kids may be eligible. Many jobs don’t offer health insurance or it’s too expensive to cover your children. Kids and teens should stay enrolled as long as they qualify. You do need to renew their coverage every year, however. Parents, grandparents and legal guardians can apply on behalf of their children.
Q: How can I apply?
A. For RSM, LIM & Pregnant Women’s Medicaid, you can apply on your own at compass.ga.gov OR you can get help applying through our enrollment assistance partner organizations. They are ready to help! If your household income qualifies for PeachCare for Kids®, the Campaign strongly recommends applying directly to PeachCare for Kids® with a paper application through our enrollment assistors. Applying first through compass.ga.gov, parents will have to wait 45 days to be screened for Medicaid and then, re-apply directly to PeachCare for Kids® for another 45-day enrollment process. Our enrollment assistors can screen your household first to make sure you are applying for the most appropriate program based on your income and household size. For children with special needs, applications must be sent to designated program offices. Please refer to information on the Medicaid for Children with Special Needs page.
Q. What documentation do I need to apply?
- Birth certificate
- Form of Government-issued Photo ID: e.g. Driver’s License, Passport (US or foreign) State issued identification card, consular identification Card.
- Social Security number for each child or proof that a card has been applied for.
- Income documents (for one month- i.e. one month’s worth of paystubs or Form 809 for cash-only income from one employer or Form 126 – 3 months for cash-only self-employed income.
For children with special needs, documentation supporting necessary but not limited to a child’s diagnosis, treatment plan and level of care. Please consult with your enrollment assister on your particular situation. For children with disabilities, please consult with the Social Security Administration list of requirements.
Q. Do I need to renew coverage?
A. Yes. You will need to renew your coverage each year and will need to provide this information along with your renewal form each year.
Q. What are Care Management Organizations?
A. CMOs or Managed care plans are a type of health insurance. They are health delivery organizations that have contracts with healthcare providers and medical facilities to provide care for members at reduced costs. These providers make up the plan’s network. Presently, PeachCare for Kids® and Georgia Medicaid health plans are managed by Peach State Health Plan, Amerigroup, and WellCare of Georgia. Go to PeachCare for Kids® or Georgia Medicaid for more detailed information.