ATLANTA – As Georgia processes its first full batch of Medicaid/PeachCare for Kids® eligibility redeterminations in three years, the Georgia Department of Community Health (DCH) is re-sharing options for Medicaid members to maintain, regain, and explore other options for healthcare coverage:
-Members who are no longer eligible for Medicaid or PeachCare for Kids® can see if they are eligible for coverage through the Georgia Pathways to CoverageTM program, which launched July 1, 2023 by applying at gateway.ga.gov. The new program offers Medicaid coverage to eligible Georgians ages 19-64 who have a household income of up to 100% of the Federal Poverty Level (FPL), and who meet other eligibility requirements. Other coverage options are also available through the federal insurance marketplace.
-Members can submit eligibility paperwork up to 90 days after their termination date. If they are still eligible, their coverage will be retroactively reinstated.
-Members who feel they have been denied due to incorrect information, or for another reason, can appeal a denial up to 30 days after they receive their redetermination decision and elect to retain their coverage during the appeals process.
-Georgia Medicaid and PeachCare for Kids members can update their contact information through one of three ways:
Online at Georgia DHS’ benefits website: Gateway.ga.gov
In person at their local DFCS office: dfcs.georgia.gov/locations
By phone at 1-877-GA-DHS-GO or 711 for the hearing impaired
Background on Georgia’s Medicaid redetermination efforts:
-During the COVID-19 pandemic, Medicaid and PeachCare for Kids® members received continuous coverage, even if their eligibility status changed. This has ended.
-States began the process of reviewing all members’ eligibility (called “redetermination”) on April 1.
-Per federal guidance, the Georgia Department of Human Services (DHS), on behalf of DCH, is redetermining eligibility for roughly 2.7 million Georgians in batches during the full federal allowance period of 14 months.
-Georgia must complete all redetermination actions by May 31, 2024.
More information on all options available to Members can be found on the state’s official microsite for Medicaid redetermination, StayCovered.ga.gov.
About the Georgia Department of Community Health
DCH serves as the lead agency for Medicaid and PeachCare for Kids®, which, combined, cover more than 2 million Georgians annually. The agency also oversees the State Health Benefit Plan, Healthcare Facility Regulation Division, and the State Office of Rural Health, among other divisions, accounting for an annual budget of over $18 billion. Through effective planning, purchasing and oversight, DCH provides access to affordable, quality health care to some of the state’s most vulnerable and underserved populations. To learn more about DCH and its commitment to Shaping the Future of a Healthy Georgia, visit https://dch.georgia.gov/.