PeachCare for Kids

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PeachCare for Kids® is a comprehensive healthcare program for uninsured children living in Georgia. The health benefits include primary, preventive, specialist, dental care, and vision care. PeachCare for Kids also covers hospitalization, emergency room services, prescription medications, and mental health care.

Healthcare is a critical pillar of a child’s well-being, and PeachCare for Kids stands as a beacon of comprehensive, affordable, and reliable healthcare for children in Georgia. Established in 1998, PeachCare for Kids has been a cornerstone in providing healthcare coverage to uninsured children in the state. This guide aims to offer an in-depth look at PeachCare for Kids, its benefits, and how it can serve your family’s healthcare needs.

PeachCare for Kids is a healthcare program specifically designed for uninsured children living in Georgia. Created under Title XXI of the Social Security Act in 1997, the program aims to increase access to affordable health insurance for children. It was reauthorized in January 2018 for an additional ten years, ensuring its continued impact on children’s health.

• Comprehensive coverage including primary, preventive, specialist, dental, and vision care.
• Includes hospitalization, emergency room services, prescription medications, and mental health care.
• 24-hour nurse advice line available for immediate healthcare guidance.

• Eligibility restrictions apply, including income limits and other criteria.

PeachCare for Kids offers a broad spectrum of medical services, from primary care to specialist visits. Each child in the program is assigned a Georgia Families Care Management Organization (CMO) responsible for coordinating their healthcare needs.

The program provides comprehensive dental and vision care, including regular check-ups, cleanings, x-rays, and eyeglasses.

• Emergency room services and hospitalization are covered.
• Prescription medications are included in the plan.
• Mental health services are also provided.

No, members do not need a referral to access behavioral health services. Whether you’re seeking help for mental health concerns, or dealing with alcohol or substance abuse, you can directly contact a behavioral health provider. This eliminates the need to first consult with your primary care physician (PCP) and expedites the process of getting the care you need.

Key Points

• Direct Access: You can see a behavioral health provider without a prior visit to your PCP.
• Services Covered: This includes services for mental health, as well as alcohol and substance abuse treatment.
• Simplified Process: By removing the referral step, getting appropriate care is faster and more convenient.

Taking the initiative to reach out to a behavioral health provider directly can significantly speed up the treatment process.

Navigating your healthcare needs can be straightforward with our comprehensive pharmacy services. Here’s a quick rundown of what you can expect:

Wide Range of Medications

• Prescription Medicines: We provide access to an extensive list of prescription medications, ensuring you can get the drugs necessary for your treatment.
• Over-the-Counter Medicines: From pain relievers to allergy meds, many common over-the-counter drugs are also covered, making it easier for you to manage minor health issues.

Convenient Pharmacy Locator

Wondering where to fill your prescription? Our online Pharmacy Page makes it simple to find a nearby pharmacy. With just a few clicks, you can:

1. Locate Pharmacies Near You: Enter your zip code or city to see a list of nearby pharmacies.
2. Check Coverage: Verify if your specific medicine is covered before making the trip.

Additional Support

Aside from medication, our services include support for any questions you may have regarding drug interactions, dosage, and general health advice. Feel empowered with reliable, accessible, and useful information to better manage your health.

Dive into our resources and make medication management easier and more efficient.

For any healthcare-related questions or concerns, PeachCare for Kids offers a 24-hour nurse advice line. You can reach out at 1-800-704-1484 (TDD/TTY 1-800-255-0056) and select ‘nurse’ at the prompt. Additionally, the customer service number for PeachCare for Kids is (404) 656-4507.

Looking for a nearby pharmacy and wondering if your medication is covered? Here’s a simple guide to help you out:

1. Locate a Pharmacy Near You
   • Online Tools: Use online pharmacy locators offered by major drugstore chains like CVS, Walgreens, or Rite Aid. Just visit their websites, enter your zip code, and browse through the options.
   • Health Plan Portals: Log in to your health plan’s member portal. Most insurance providers have a “Find a Pharmacy” tool where you can easily search for nearby pharmacies within your network.
2. Check Medication Coverage
   • Formulary Look-up: Access your health plan’s formulary list, which is usually available on their website or member portal. This list will show whether your prescribed medication is covered.
   • Customer Service: Call the customer service number on your insurance card. Representatives can quickly confirm if your medication is within your plan’s coverage.
   • Mobile Apps: Many insurance providers offer mobile apps that feature tools for checking medication coverage on-the-go. Download the app, log in, and use the medication lookup feature to get instant information.

By following these steps, you can effortlessly find a pharmacy close to your location and ensure your medicine is covered by your health plan.

Enrolling in disease case management is a straightforward process designed to support your health needs. Here are the steps you need to follow:

1. Contact Support:
   • Phone: Call the toll-free number 1-888-830-4300 (TTY 711) for assistance.
   • Email: Send an email including the following details:
     • Your full name
     • ID number
     • Date of birth
     • Address
     • Phone number
     • Health conditions for which you need case management services
2. Response Time:
   • A case manager will reach out to you within five days to confirm your enrollment.
   • If you do not receive a call within this timeframe, follow up by calling the toll-free number Monday through Friday, between 8:30 a.m. And 5:30 p.m. Eastern Time.
3. Ongoing Communication:
   • Once enrolled, you can leave private messages for your case manager at any time, 24/7.

This process ensures you get timely and personalized support for managing your health conditions.

1. Online: Visit the official PeachCare for Kids website.
2. By Phone: Call the PeachCare for Kids customer service number at (404) 656-4507.
3. In-Person: Visit a local Department of Family and Children Services (DFCS) office.

The DCH is the leading agency for PeachCare for Kids and aims to improve the health status of Georgians through various goals, including promoting healthy lifestyles, improving access to quality healthcare, and ensuring value in healthcare contracts. The department also administers services related to Behavioral Health, Medicaid Preventive Health Services, and Mental Health and Substance Use Disorder Parity.

If your child is covered under a private or employer health insurance plan, it’s important to inform the Department of Community Health. Here’s how you can do it:

1. Online Notification:
   • Visit the Gateway web portal.
   • Log in to your account.
   • Select the ‘change’ status option to update your child’s health insurance information.
2. Phone Notification:
   • Call the Department of Community Health at 1-877-427-3224.
   • Follow the prompts or speak to a representative to report the change in insurance coverage.

These steps ensure that the Department has the most up-to-date information about your child’s health insurance, allowing for seamless coordination of benefits.

PeachCare for Kids offers an astonishing array of healthcare services, making it a formidable choice for families in Georgia. With its comprehensive coverage, 24-hour nurse advice line, and the backing of the Georgia Department of Community Health, PeachCare for Kids stands as a reliable healthcare option for your children.

Ready to secure a healthier future for your children with PeachCare for Kids? Don’t hesitate; apply today to give your children the healthcare coverage they deserve.