The Georgia Children’s Health Insurance Program (CHIP) has been available for over 20 years. While many people may ask, “What is CHIP Medicaid?” or “Is CHIP considered Medicaid?” the program is designed to help children who are not eligible for the Medicaid program in Georgia. Even if the parents of the children do not have Medicaid eligibility children still may be able to enroll in CHIP. To learn more about how to apply for CHIP in Georgia, what is covered by CHIP Medicaid and other important pieces of information, continue reading below.
What is Georgia’s Children’s Health Insurance Program?
Both Georgia CHIP and Medicaid for children are designed to help children from low-income families still have access to affordable health care. CHIP in Georgia is called PeachCare for Kids. CHIP and Medicaid enrollment are very similar but follow different guidelines and procedures. Once a child is enrolled in PeachCare for Kids, he or she can see any medical provider that is in network with the Care Management Organization (CMO) associated with the CHIP program. Beneficiaries can pick a primary care doctor of their choosing as long as he or she is in network.
Find out more about qualifications by downloading our free guide.
Is CHIP considered Medicaid in Georgia?
Medicaid for children and CHIP in Georgia offer many of the same health care services. Both CHIP and Medicaid enrollees have their health care funded by state and federal sources. However, CHIP acts as an extension of the Medicaid program for minors. Children from household that do not meet the the requirements for Medicaid can still apply for the Children’s Health Insurance Program and receive coverage for health care services at very little cost. Those enrolled in CHIP will have a household income that is too high for Medicaid, but is still low enough to need assistance in having access to affordable health insurance coverage. PeachCare for Kids is not available for Medicaid ineligible adult claimants.
Who qualifies for CHIP in Georgia?
About 135,000 children are enrolled in Children’s Health Insurance Program or PeachCare for Children across the state of Georgia. Children can still apply for CHIP after being denied Medicaid coverage. CHIP eligible children are those that meet the following program guidelines:
- Be 18 years of age or younger
- Be a United States citizen or legal resident
- They must not have private insurance
- They must the income guidelines for the program
Pregnant women can apply to the Georgia Medicaid program, as Georgia CHIP does not cover expecting mothers. An applicant can find out if he or she is eligible for enrollment by logging into a Georgia Gateway account. When applying for CHIP benefits, petitioners will have to provide proof of both income and of citizenship status. Certain beneficiaries who grow out of the program may be eligible for Medicaid enrollment.
What services are covered by CHIP in Georgia?
Medicaid for children and the CHIP program cover very similar medical services. However, CHIP enrollees will have to cover some of the costs of those services as well as pay a small premium. Services covered by CHIP and Medicaid include:
- Doctor’s visits, emergency room and hospital stays
- Specialist care
- Immunization shots and prescriptions
- Dental and mental health care
- Vision care, including vision exams and eyeglasses
Other medical treatments may be covered by CHIP, especially if deemed medically necessary. Be aware that there may be limits on how often beneficiaries can receive a treatment or service. For example, enrollees will not be able to have a covered eye exam more than once a year. Children’s Medicaid may cover more services than the CHIP program, particularly if the Medicaid recipient has a disability. Georgia CHIP may not cover or only partially cover services provided by out-of-network providers so beneficiaries should seek in-network medical providers whenever possible.
How to Apply for CHIP in Georgia
Knowing how to apply for CHIP is very important for parents and guardians of children who need coverage for health care services. The state allows petitioners to apply for PeachCare for Children in a few ways: online, by phone, in person and by mail. Those interested in applying for CHIP benefits online can utilize the Georgia Gateway website. The Georgia Gateway also allows residents to apply for other state programs for children like Women, Infants and Children (WIC).
To apply for CHIP by phone, dial 1-877-427-3224 and follow the prompts. Applicants with question about the program or need assistance with the application process can also visit their local Georgia Department of Family and Children Services office to turn in the application. Petitioners can pick up an application or print one from the website to complete at home and mail. CHIP applications can be sent to:
426 West 12th Street
Alma, GA 31510
Those who have been denied Medicaid or CHIP enrollment can file an appeal with the program. CHIP enrollment is not for life and will require all beneficiaries to reapply every year. Information on reapplying will be sent to the beneficiaries through the mail.
Learn how to potentially avoid being denied Medicaid benefits for you and your children by downloading our detailed guide.