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What should I know about PeachCare for Kids?

Authored By: GeorgiaLegalAid.org
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PeachCare for Kids in Georgia

What should I know? +

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What is PeachCare for Kids?

PeachCare for Kids is a health care program for uninsured kids in Georgia. If your child does not qualify for Medicaid benefits, they may be eligible for PeachCare.

 

PeachCare covers:

  • Primary care,

  • Preventative care,

  • Specialists,

  • Dental care,

  • Vision care,

  • Hospitalization,

  • Emergency room services,

  • Prescription medications, and 

  • Mental health care.

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Who is eligible for PeachCare for Kids?

PeachCare for Kids is for kids who:

  • Are under 19 years old,

  • Are U.S. Citizens or eligible legal immigrants,

  • Live in Georgia,

  • Have guardians who meet monthly and annual income levels,

  • Do not have current health care coverage and are not eligible for Medicaid.

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Does PeachCare cost money?

There are no premiums or co-payments charged for children:

  • Under six years old,

  • In foster care, or

  • Who are American Indians or Alaskan Natives.

 

For all other children covered under PeachCare, there is a monthly cost. As of February 2020, the monthly cost for coverage is $11-$36. 

 

There may also be a co-payment for some medical services. As of February 2020, the co-pay ranges from $0.50-$12.50. 

 

There is no co-pay for:

  • Emergency services,

  • Routine check-ups,

  • Immunizations,

  • Routine dental services.

 

You will not have to pay more than 5 percent of your yearly income for premiums and co-pays. If you reach that amount, you will not have to make any more payments for the year. 

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What are my rights and responsibilities if my child gets PeachCare?

If your child meets the eligibility requirements, they have a right to PeachCare for Kids. You cannot be denied eligibility or benefits based on your:

  • Race,

  • Age,

  • Sex

  • Disability,

  • National origin, or

  • Political or religious beliefs. 

 

You are responsible for paying any required monthly premium and co-pays.

 

If you do not agree with a decision about whether your child is eligible, you have the right to request an appeal. You are responsible for starting the appeal within 45 days. 

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What can I do? +

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How do I apply for PeachCare for Kids?

When you apply for Medicaid, you are also applying for PeachCare for Kids. If you are ineligible for Medicaid, your child may still be enrolled in PeachCare. There is one application for medical assistance, which covers both Medicaid and PeachCare for Kids.

 

You can apply:

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Can I appeal a PeachCare decision?

You can appeal a decision on whether your child is eligible for PeachCare. You must request an appeal within 45 days of the decision.

 

To appeal the decision, you must include your:

  • Name and case number,

  • Contact information, and 

  • Reason for filing an appeal.

 

If your case is still open, file an appeal by:

Right from Start Medical Assistance Group

Attn: Eligibility Hearings Coordinator

426 West 12th St., Alma, GA 31510

 

If your case has been closed, you must go to the Customer Portal at Georgia Gateway.

 

If you have other issues with the PeachCare for Kids program, you can file a complaint online.

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Forms

Resources

Last Review and Update: Feb 18, 2020