Georgia Families Medicaid

Your health is important to us. That’s why our members get important care and services like:

• A large network of primary care providers to choose from
• Vision and dental care for children and adults
• Free round-trip rides to doctor visits
• Wellness visits and shots to help keep you healthy
• Low- and no-cost medicines
• Specialist services and hospital stays
• Plus lots of extras you can use to take charge of your health

Visit the Georgia Department of Community Health (DCH) website to learn more about Medicaid and other programs.

Copays

Once your copay is paid, you’ll never be billed for a leftover balance. Copays range from 50 cents to $12.50. They are based on the type of service. Please see your member handbook for more information.

Healthy Rewards is a no-cost, optional program for eligible members enrolled in our health plan. The program encourages you to complete qualifying healthy activities and screenings, then rewards you with gift cards to popular retailers. You may be eligible to earn rewards for these activities below:  

• $25 for childhood and adolescent wellness visits
• $25 for child and adolescent dental visits
• $25 for adult wellness visits
• $50 for breast cancer screenings
• $25 for cervical cancer screenings
• $25 for completing your child’s immunizations (shots) on time
• 25 for Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) wellness visits (if completed within first 30 days of enrollment)
• Up to $40 for high blood pressure medication refills
• Up to $40 for ADHD medication management
• $25 for completing lead screening
• $25 for a diabetic retinal eye exam
• $25 for a diabetic A1c screening
• $5 for completing a "What do you know about diabetes?" quiz
• $50 for following up with your doctor after a behavioral health discharge 
• $35 for pregnant moms who go to a prenatal appointment in their first trimester or within 42 days of joining the health plan
• $40 for new moms who go to their postpartum visit 7–84 days after delivery
• Up to $80 for well-baby visits

Enroll and earn rewards

To see what you are eligible to earn, enroll in Healthy Rewards by logging into your Amerigroup account and visiting the Benefit Reward Hub . You can also enroll in the program or learn more by calling Healthy Rewards at 888-990-8681 (TTY 711) Monday through Friday from 9 a.m. to 8 p.m. Eastern time.

If you need help setting up your Amerigroup online account, call Member Services at 800-600-4441 (TTY 711) or Georgia Families 360°SM Member Intake Line at 855-661-2021 (TTY 711).. 

With Amerigroup, you get lots of extra benefits you can really use:

• A dental exam and cleaning every six months for members 21 and older
• A vision exam and glasses each year for members 21 and older
• Free over-the-counter medicine
• Free Boys & Girls Club memberships for kids age 6-18
• Flu Pandemic Prevention Kit for ages 16-21 with completed flu shot
• Amazon voucher to buy wellness items for eligible members ages 15-18
• $75 DoorDash gift card for food delivery in summer for eligible kids
• $75 for electric, water, and heating bills for eligible members
• Taking Care of Baby and Me®
• Free weight-management program and personal exercise kit for ages 10 and up
• Supports to keep you healthy after an emergency
• Pest control services and hypoallergenic pillow for members diagnosed with asthma
• Free mobile phone
• Free flu shots
• Case management services
• Discounts to local stores and restaurants
• Free 24-hour Nurse HelpLine
• Free gym membership voucher for members diagnosed with obesity

Pregnant members and new parents can get:

• Free diapers.
• Free potty training seat.
• Free Sam’s Club membership.

Members with a certain grade point average (GPA) can get:

• A free Chromebook.
• A gift card to use toward college application fees.
• A transportation gift card.
• A gift card for clothing retailers.

Limitations and restrictions apply. Benefits may change.

You can redeem some benefits online through your secure account. View the extra benefits you’re eligible for on the Benefit Reward Hub or call Member Services at 1-800-600-4441 (TTY 711) Monday through Friday from 7 a.m. to 7 p.m. Eastern time.

Access Healthy Rewards

We work with CarelonRx to get you the medicines you need. We cover a wide range of prescriptions and many over-the-counter medicines.

Visit the Pharmacy page to find a pharmacy near you and check if your medicine is covered.

The Georgia Families program is for Georgians eligible for Medicaid, including:

• Children eligible for PeachCare for Kids®
• Women eligible for Planning for Healthy Babies® (P4HB)

To get Medicaid, you must have meet income limits and be a:

• Pregnant woman
• Family with children
• Child under the age of 19

Families who don’t qualify for Medicaid may still get health care for their children.

To find out more about eligibility, visit Georgia Families.

Getting you the right care

The Amerigroup Care Team is made up of health care experts who will help you by:

• Working with you to make healthy life choices
• Sharing health tips like how to take care of asthma
• Helping you take control of your health by completing a health risk screening
• Making sure you get the most out of your health plan
  • Connecting you to health care programs like disease management

If you’d like a Care Team health care expert to call you:

• Send an email to the Care Team with:
  • Your phone number
  • The best time to reach you

Or call our:

• Case Management department at 678-587-4758
• Georgia Families 360°_℠ Intake Line at 1-888-661-2021*

Everything we talk to you about is private.

*This number is for Georgia Families 360°_℠ members only.

How to enroll in disease case management

• Call 1-888-830-4300 (TTY 711) toll free or
• Send an email. Include your:
  • Full name
  • Amerigroup ID number
  • Date of birth
  • Address
  • Phone number
  • Condition(s) for which you’d like case management services

Your case manager will call you within five days to let you know you’re enrolled. If you don’t get a call, call 1-888-830-4300 (TTY 711) toll free Monday through Friday from 8:30 a.m. to 5:30 p.m. Eastern time. Once you’re enrolled, you can leave private messages for your case manager 24 hours a day.

There are many kinds of specialists. A specialist is a doctor who gives care for a certain illness or part of the body. One kind of specialist is a cardiologist, or heart doctor. Another kind of specialist is an oncologist. An oncologist is a cancer doctor.

Your PCP may send you to a specialist for care. This is called a referral. If your PCP wants you to go to a specialist, he or she may help set up your visit with the specialist.

You don’t have to see your PCP first to go to a women’s health doctor for well-woman checkups. An obstetrician/gynecologist (OB/GYN) is a women’s health doctor.

You do not have to see your PCP first to see a behavioral health provider for mental health, alcohol abuse or substance abuse services.

Your member handbook is your go-to guide for health services. It tells you how you can get the most out of your benefits. Read it to find out about:

• Your benefits
• Special programs and services like health education classes, case management and disease management
• Your rights and responsibilities as an Amerigroup member
• How to choose a primary care provider
• How to get help if your doctor’s office is closed
• Recertifying your benefits
• How to reach Amerigroup Member Services if you have questions

The electronic version of your member handbook is searchable. Use "Ctrl + F" to search for keywords. If you’re using a Mac, use "Command + F."

• English
• Spanish

Need your handbook mailed to you?

Call Member Services toll free at 1-800-600-4441 (TTY 711).

A referral is when your primary care provider (PCP) sends you to another provider for care. This care is often from a specialist. As an Amerigroup member, you don’t need a referral to see a provider who’s not your PCP as long as the provider works with your plan.

What is precertification?

Precertification is needed for:

• Inpatient admissions
• Certain behavioral health services like skills training
• Psychological testing
• Certain prescriptions
• Rehabilitation therapies (physical, occupational, respiratory, speech)
• Care from a provider who doesn’t work with your plan

As a member, you don’t make the request. Your PCP, specialist or other provider should send in the request. If your case doesn’t meet the rules for medically needed, we’ll send you a letter. The letter will tell you we could not OK the service and why.

Other benefit details can be found in your member handbook. If you have questions or would like a copy of your member handbook mailed to you, call Member Services at 1-800-600-4441 (TTY 711).