Haris Ashley
Georgia Medicaid offers free and low-cost health insurance to its residents. Enrollees receive services through either managed care or fee-for-service arrangements. Amerigroup is one such insurance provider that has served Georgia families since 2006 through its Medicaid insurance and other low-cost health coverage. Peach State Health Plan is another health maintenance organization that serves the Medicaid and PeachCare for Kids® populations in partnership with the Georgia Families Program. Cigna HealthCare of Georgia, Inc. is another health insurance provider in the state.
| Characteristics | Values |
|---|---|
| Insurance Company | Amerigroup |
| Cigna HealthCare | |
| Peach State Health Plan | |
| Wellcare | |
| Coverage | Medicaid |
| PeachCare for Kids | |
| Georgia Families | |
| Georgia Families 360º | |
| Planning for Healthy Babies | |
| Medicare Advantage Prescription Drug plans (MAPD) | |
| Dual Eligible Special Needs Plans (DSNP) | |
| Prescription Drug Plans (PDP) | |
| Additional Benefits | Dental, hearing, and vision services |
| Transportation and fitness services | |
| Spendables™ Cards | |
| Wellness programs | |
| Postpartum coverage |
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What You'll Learn
Amerigroup Community Care
Amerigroup offers a range of services, including Medicaid, PeachCare for Kids, Planning for Healthy Babies, and Georgia Families 360° benefits. They also provide support for pregnant women, families with children, and children under the age of 19, including those in foster care, adoption assistance, or select youth in the Department of Juvenile Justice system.
Amerigroup is committed to keeping both mothers and babies healthy. They encourage pregnant members to participate in their "Taking Care of Baby and Me" program, which offers comprehensive case management and care coordination for expectant mothers and their newborns. Additionally, Amerigroup collaborates with various healthcare providers and community agencies to meet the needs of members with mental health and substance use disorders, as well as those with intellectual and developmental disabilities.
Amerigroup members can access care and services easily without leaving home. They can also download the Sydney Health mobile app to access their accounts and receive important notices, such as changes to postpartum coverage. Amerigroup has also been proactive in providing support to members impacted by winter weather in Georgia and during the national Public Health Emergency (PHE) that ended on May 11, 2023.
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Peach State Health Plan
The Georgia Department of Community Health, which oversees Peach State Health Plan, is responsible for advancing the health, wellness, and independence of Georgia residents by providing access to free and low-cost healthcare coverage through programs like Georgia Medicaid and PeachCare for Kids.
Georgia Medicaid offers various benefits, including postpartum coverage. As of October 31, 2022, eligible pregnant women can receive 12 months of postpartum services under the state plan, which is an increase from the previous six months of coverage provided through the 1115 demonstration. This extension of postpartum coverage was made possible by the American Rescue Plan Act (ARPA).
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Wellcare Medicare products
Wellcare, offered by Centene, provides Medicare Advantage plans in 32 states, as well as standalone Medicare Prescription Drug Plans (PDPs) across all 50 states and Washington, D.C. Wellcare's Medicare Advantage plans include HMO, PPO, and Special Needs options, allowing customers to choose the plan that best suits their needs.
Original Medicare coverage includes doctor and hospital services, but Wellcare's Medicare Advantage plans go beyond this by offering additional benefits, such as prescription drug coverage, dental, hearing, vision, and fitness memberships. This means that members can access a wider range of healthcare services and live healthier lives.
Wellcare simplifies the healthcare experience for its members. They achieve this by offering a variety of plans, each with different features and benefits, ensuring that members can find a plan that meets their specific needs. Wellcare also provides resources and support to help members understand Medicare, including information on eligibility and how to join a Medicare Advantage Plan.
Wellcare's Medicare Advantage plans are widely available across the United States, currently offered in 32 states, making them accessible to a large portion of the population. The standalone Medicare Prescription Drug Plans are even more widely available, being offered in all 50 states and Washington, D.C., ensuring that members across the country can access the prescription medications they require.
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Cigna HealthCare of Georgia
Cigna HealthCare offers health insurance plans, including medical and dental insurance to individuals and families in Georgia. Cigna HealthCare of Georgia, Inc. is one of the subsidiaries of The Cigna GroupSM that provides healthcare products and services. These plans include virtual urgent care from $0, $0 preventive care visits, $0-$3 for preferred generic prescription drugs, and more.
Cigna Healthcare's plans offer quality plan options, personalized support, and low costs. They also provide international health insurance and Medicare coverage. Additionally, Cigna offers accidental injury, critical illness, and hospital care plans distributed through operating subsidiaries of The Cigna Group Corporation. These plans are administered by Cigna Health and Life Insurance Company and insured by Cigna Health and Life Insurance Company (Bloomfield, CT).
Cigna Healthcare's website and mobile app, myCigna®, help customers find in-network providers, order and refill prescriptions, pay claims, and more. The app also provides data-driven customized alerts for health coaching, specialized care, and cost savings. Customers over 18 can earn rewards through the Cigna Take Control Rewards® program, and additional benefits are available through the Cigna Healthy Rewards® discount program.
Cigna Healthcare also provides 24/7 support and access to licensed clinicians for health questions. The monthly premium for Cigna Healthcare's coverage varies depending on location, household size, income, and other factors. Open Enrollment for 2026 starts on November 1, 2025.
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Georgia Families Program
The Georgia Families Program is a collaboration between the Georgia Department of Community Health (DCH) and private health plans, known as care management organizations (CMOs). The program provides benefits and healthcare services to around 1.3 million members, including Medicaid and PeachCare for Kids® enrollees, Planning for Healthy Babies® (P4HB) participants, and Georgia Families 360° members.
PeachCare for Kids® is the State Children's Health Insurance Program, while the P4HB program is Georgia's Section 1115 Family Planning Waiver program. Georgia Families 360° is designed to coordinate care for children, youth, and young adults in foster care, receiving adoption assistance, or involved with the Department of Juvenile Justice.
The Georgia Families Program offers a choice of health plans, allowing members to select the one that best suits their needs. This flexibility ensures that individuals and families can access the specific healthcare services they require.
The program has recently undergone some changes, with the Georgia Department of Administrative Services (DOAS) awarding the new Georgia Families® contract to four successful health plans. UnitedHealthcare of Georgia, Inc. was identified as the successful health plan for the Georgia Families® 360° contract.
Additionally, the Georgia Families Program has been making improvements to postpartum coverage. In 2021, the Medicaid agency extended postpartum services from 60 days to six months for eligible pregnant women. More recently, with the American Rescue Plan Act (ARPA), the Medicaid agency can now provide 12 months of postpartum coverage, offering even more comprehensive support to new mothers.
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Frequently asked questions
Amerigroup, Peach State Health Plan, and Wellcare are some of the insurance providers that service Georgia Medicaid.
The toll-free number for Amerigroup Georgia Medicaid's Member Services is 800-600-4441 (TTY 711).
Amerigroup covers programs such as PeachCare for Kids, Planning for Healthy Babies, and Georgia Families 360° for eligible members.
The Medical Assistance Plans Division at the Georgia Department of Community Health provides access to free or low-cost health care coverage for Georgia Medicaid and PeachCare for Kids enrollees.
Georgia Medicaid enrollees can receive services through either managed care plans (Georgia Families or Georgia Families 360°) or fee-for-service arrangements, offering different models of healthcare delivery and payment.
