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Learn About CHIP in Georgia

Georgia CHIP, otherwise known as PeachCare for Kids, is a federal and state funded health insurance program that provides comprehensive benefits and coverage to qualifying children who would otherwise not have insurance. PeachCare for Kids is not quite the same as the Medicaid benefits program. While there are income limits for coverage, those limits are higher than that of the state Medicaid program. CHIP insurance is designed to provide coverage to children with families that make too much for Medicaid, but too little for private insurance. The program offers parents an affordable alternative health insurance plan for their children.

The Children’s Health Insurance Program (CHIP) exists within every state within the U.S. However, while a program exists in each state, each state determines the coverage and costs associated with the program within a state. Therefore, PeachCare for Kids is exactly like another state program that you may have been previously familiar with. If interested in submitting an application, you are strongly encouraged to learn more about benefits and coverage, costs, eligibility requirements and how long coverage is provided through PeachCare for Kids.

What is CHIP in Georgia?

CHIP Medicaid, also referred to as the Georgia PeachCare for Kids, was established within the state in 1998. Today, around 134,000 eligible children are enrolled in Georgia PeachCare for Kids each year. PeachCare for Kids provides insurance to children who do not have another form of insurance and are not eligible for Medicaid due to family income.

This health insurance for kids program is funded by both the federal government and state in order to provide underinsured children with quality health insurance and access to medical care that is needed at every state throughout development.

Who does Georgia CHIP cover?

If considering a CHIP application in Georgia, it is worth taking a look at the eligibility requirements associated with the program prior to completing the application process. By reviewing the program’s qualifications, you will be better prepared for the application process and you will gain an understanding as to whether or not your child may qualify for PeachCare for Kids.

CHIP eligibility requirements are based upon age, citizenship, residency and income factors. In order to be eligible for benefits, children must be no older than 18 years of age, residents of Georgia and either a United States citizen or a qualifying legal immigrant. Children can only qualify if they do not have access to another form of health insurance and are not eligible for the Georgia Medicaid program.

In order to receive CHIP benefits in Georgia through the PeachCare for Kids program, you must meet income-related eligibility requirements. These income limits are higher than the state Medicaid program’s income limits, so you may qualify for coverage for your child, even if you were previously denied for Medicaid. The maximum income is determined by federal poverty guideline standards for your family size. Your income will determine your child’s eligibility for PeachCare for Kids as well as determine the amount that you can expect to pay out of pocket for your child’s insurance.

How to Apply for CHIP in Georgia

If applying for CHIP coverage in Georgia, it is worth knowing that you may do so online, over the phone, in person or by mail. Generally, an online application is considered the easiest and fastest way to apply as you can submit your application from the comfort of your own home and without having to worry about postage times or office hours. Alternatively, you can also contact PeachCare for Kids by phone and provide your information over the phone in order to submit an application.

If you would like to submit a CHIP application in person, you may do so at any DFCS office or RSM group office. Alternatively, you may also request a printed copy of the application or find one online and mail the completed application. To learn more about applying for benefits, download our comprehensive guide to CHIP benefits today.

What is included with Georgia CHIP coverage?

As stated previously, the children’s health insurance program in Georgia provides different levels of coverage and benefits in comparison to other state programs. In Georgia, CHIP benefits include, but are not limited to:

  • Visits to a physician’s office.
  • Preventive services, including regular check-ups and immunizations.
  • Specialist care.
  • Dental care.
  • Vision care.
  • Mental health care and services.

After you are approved for CHIP insurance, you will be given a choice of health plans as well as the ability to choose your child’s primary care provider.

How much is CHIP health insurance in Georgia?

Georgia CHIP costs are based upon your family’s income at the time of your application. Your monthly premium could be free or it could be a small fee with a maximum amount that may be required for one or two or more children, regardless of income levels. Therefore, it is important that you always report any changes to your income or household size as changes such as these can affect your monthly premium amount. Once you complete your application, you will be provided with further instructions on how you can make your first premium payment.

CHIP Medicaid has an approximate maximum for out-of-pocket costs. This maximum is typically around 5 percent of your annual gross income. This maximum is applied each year that your child retains coverage benefits.

How long do CHIP benefits last in Georgia?

Georgia CHIP insurance usually lasts for a full 12-month period following the approval of your application. When nearing the end of the 12-month beneficiary period, you will be given the option to renew coverage, so long as your child still qualifies for benefits. In order to avoid a lapse in your child’s health insurance coverage, it is very important that you complete the renewal application in a timely manner once you receive it.

In some cases, CHIP benefits can be interrupted or canceled. If your child turns 19 years old or if your child moves outside of Georgia, benefits will not continue, regardless of the amount of time remaining of the beneficiary period. Additionally, it is worth knowing that if you fall two months behind on your premium payments, benefits will be canceled. If the policy is canceled and you would like to reapply for health insurance for your child, you will be required to make a payment in order to reinstate coverage. To learn more about getting and maintaining benefits, download our guide to CHIP today.