Contacting Georgia Families

Members can visit www.georgia-families.com or call 888-423-6765 to speak to a representative who can give them information about the CMOs and the health care providers.

The three CMOs have toll-free numbers available for health care providers to find out more about enrolling with Georgia Families:

Program Overview

Georgia Families is a program that delivers health care services to members of Medicaid and PeachCare for Kids. The program is a partnership between the Department of Community Health and private care management organizations (CMOs). By providing a choice of health plans, Georgia Families allows members to select a health care plan that fits their needs.

Eligibility and Enrollment

Children enrolled in PeachCare and children, pregnant women and women with breast or cervical cancer on Medicaid are eligible to participate in Georgia Families. Members will continue to maintain eligibility and enrollment through Medicaid or PeachCare.

June 1, 2006 marks the beginning for members living in the Atlanta and Central region; those living in the East, North, Southeast and Southwest regions will be able to obtain services as of September 1, 2006. Health plans and primary care providers can be selected by calling a Georgia Families representative at 1-888-GA-ENROLL (423-6765) or by visiting the www.georgia-families.com.

Benefits

Medicaid and PeachCare members will continue to be eligible for the same services they receive today as well as new services. Members will not have to pay more than they are currently paying for Medicaid co-payments or PeachCare premiums. With a focus on health and wellness, many CMOs will provide members with health education and prevention programs as well as expanded access to plans and providers, giving them the tools needed to live healthier lives. Providers participating in Georgia Families will have the added assistance of the CMOs to educate members about accessing care, referrals to specialists, member benefits, and health and wellness education.

Collaboration and partnership between CMOs and the Department of Community Health provides a more efficient delivery of health care services, better care for members and accountability to taxpayers while at the same time maintaining predictable and sustainable growth for the Department.

Who must enroll

Almost everyone who is in Medicaid or PeachCare for Kids must enroll in Georgia Families. If you don’t enroll, a health plan and PCP will be assigned to you.

Exceptions. Some people are excluded from joining (do not need to join) a health plan. Read about exclusions to see if you might be excluded because of your medical condition, heritage, or where you live.

If you think you should be excluded, talk with your eligibility worker at your DFCS office.

• DFCS offices: Department of Family and Children Services

When you should enroll

As soon as you are eligible for Medicaid or Peachcare for Kids, you will be mailed an enrollment packet from Georgia Families.  Once you get your packet, you can mail or fax your enrollment form.

Although you will be mailed your enrollment packet quickly, you don’t have to wait until your packet arrives to enroll in Georgia Families.  You can also enroll by phone (1-888-GA-ENROLL) or your can enroll in your community with a Georgia Families staff member.  Click here to find a community enrollment session near you.

You will have at least 30 days to enroll in Georgia Families and choose a health plan.  If you have not enrolled within 30 days, a health plan and PCP will be chosen for you.

When your coverage starts

Once you enroll in Georgia Families, your coverage will generally begin on the 1st of the following month.  At this time, your health plan will send you a welcome packet that contains your membership card, as well as a list of PCPs in your health plan’s network.  You will call your PCP to get most of your medical care.

Frequently Asked Questions (FAQ)

What is Georgia Families?
Georgia Families is a program just for members in Medicaid and PeachCare for Kids. Medicaid and PeachCare for Kids members must enroll in Georgia Families to choose a health plan and Primary Care Provider, or PCP. If you don’t enroll, a health plan and PCP will be chosen for you.

What is a health plan?
A health plan is a group of doctors, nurses, hospitals, and other health care providers who give the members of the plan all of the health services that they need. As a member of a health plan, you won’t have to look for doctors or other providers yourself. Your health plan will have all the health care professionals you need.

What is a PCP?
A PCP, or Primary Care Provider, is the person you will go to for regular checkups and other basic health care services. Over time, your PCP will get to know you and your health care needs. Your PCP will also refer you to specialists and other health care providers if you need more specialized health care.

Who should enroll?
Most Medicaid and all PeachCare for Kids members must enroll in a Georgia Families health plan to continue getting health care services.

Who should not enroll?
These Medicaid members will not enroll in Georgia Families:

• Members who can get Medicare
• Blind
• Disabled
• Children in foster care
• Children with special health care needs

Click here to see a complete list of Medicaid members that do NOT need to enroll in Georgia Families.

Please note: Georgia Families is only for members already enrolled in Medicaid or PeachCare for Kids.  If you want to apply for Medicaid or PeachCare for Kids, call or visit your county DFCS (Department of Family and Children Services Office) office.

How do I enroll in a health plan?
There are five ways you can enroll in a Georgia Families health plan:

1. Enroll easily and quickly on this Web site;
2. Call Georgia Families at 1-888-GA-ENROLL (1-888-423-6765) to enroll by phone;
3. Enroll by mail;
4. Fax the enrollment form;
5. Enroll in your community with a Georgia Families staff member.  Click here to find a community enrollment session near you.

Will my benefits change?
No. You will get the same Medicaid or PeachCare for Kids benefits and services that you get now. The only difference is that now you will get these health care services through a health plan.

Will I still have to pay premiums to PeachCare for Kids?
Yes. If you have a child in PeachCare for Kids, you must continue to pay your monthly premium directly to PeachCare for Kids.

Do I get to choose the health plan I want?
Yes. You will have a choice between at least two health plans in your area. Health plans that work with Georgia Families are:

• Amerigroup Community Care
• Peach State Health Plan
• WellCare

How much time will I have to enroll and choose a health plan and PCP?
After you get your enrollment packet by mail, you will have at least 30 days to choose a health plan and a PCP. The letter in your enrollment packet will say your exact enrollment deadline.

What happens if I don’t enroll or don’t make a choice?
If you do not choose a health plan or PCP, they will be chosen for you.

Can I keep seeing the doctor I go to now?
If the doctor you go to now works with a Georgia Families health plan that serves your region, you can choose him or her to be your PCP. Specialists cannot be PCPs. You can find out which PCPs are in which plans by looking on this Web site after you have logged in or by looking in the Provider Directory that comes in your enrollment packet.

Do all my family members in Medicaid and PeachCare have to choose the same health plan?
No. Each member of the household may have a different plan and PCP.

I got a letter saying I can change my health plan after being in Georgia Families for a year. What does this mean?
After being in a Georgia Families health plan for a year, you will be eligible for your “Enrollment Anniversary.” During your Enrollment Anniversary, you will have 30 days to change your current health plan. After this 30-day period ends, you will not be able to change plans until your next Enrollment Anniversary the following year. If you want to change your health plan during your Enrollment Anniversary, login to this website or call Georgia Families at 1-888-GA-ENROLL.

Do I have to change my health plan during my “Enrollment Anniversary” period?
No. You do not have to change your health plan during your Enrollment Anniversary. If you want to stay with your same plan, you do not have to do anything. You will be automatically enrolled with the same health plan for the next year.

Do I have to wait until I get my enrollment packet in the mail before I can enroll?
No. You can enroll in a Georgia Families health plan anytime on or after the enrollment start date in your region.

Where can I get more information?

• Call Georgia Families at 1-888-GA-ENROLL (1-888-423-6765), Monday to Friday from 7 until 7, and Saturday, 8:30 until 12:30, or
• Use this Web site (www.georgia-families.com).