Right from the Start Medical Assistance Group (RSM)
Medicaid (RSM) for Pregnant Women pays for medical care for pregnant women, including labor and delivery, for up to 60 days after giving birth. Pregnant women who qualify are entitled to the full-range of Medicaid covered services including physicians' visits, prescription medicines, and inpatient and outpatient hospital services. Effective January 1, 2014, the program uses 220 percent of the federal poverty level as the ceiling for eligibility for pregnant women.
Medicaid for Children Under 19 pays for medical care for children ages 0 through the month of the 19th birthday. These children may qualify at various income levels depending on age, family size, and income. Children who qualify are entitled to the full-range of Medicaid covered services including doctors’ visits, health checkups, immunizations, dental and vision care.
Medicaid for Parent/Caretaker with Children provides Medicaid benefits for eligible children under age 19, and the eligible adults, who meet tax filer or non tax filer status for the children and are within certain income limits
Planning for Healthy Babies (P4HB) provides no cost family planning services to eligible women 18-44 in Georgia.
Chafee Independence Program provides healthcare for children who age out of Foster Care for the month of their 18th birthday until age 21.
How to Apply
There are three ways to apply:
- You may apply online at www.compass.ga.gov
- Visit a RSM County Office near you
- Call RSM toll-free 877-427-3224
For More Information
- Centers for Medicare & Medicaid Services (CMS) www.cms.gov
- Health Insurance Marketplace www.healthcare.gov
- DCH Fact Sheet, 2014 Medicaid Eligibility (embed link to new fact sheet)
PeachCare for Kids®
PeachCare for Kids is Georgia’s State Children’s Health Insurance Program (S-CHIP) that provides working families with high-quality, low or no cost major medical health insurance for children ages 0 to 19. Coverage includes check-ups, prescription medicines and hospitalization. Dental and vision care and mental health services are included at no additional cost to members. Family income and other qualifications are used to determine eligibility for the program administered by the Georgia Department of Community Health.
Applicants to the PeachCare for Kids program are also assessed for Medicaid eligibility. If the applicant is potentially eligible for Medicaid, the application will be sent to the RSM Outreach Project, or your local DFCS office if you are applying or receiving assistance in other programs in addition to Medicaid, such as SNAP, for assessment. The applicant will then be notified by letter of his or her eligibility status (i.e. denied or approved) in either Medicaid or PeachCare for Kids.
How to Apply
If the PeachCare for Kids’ applicant is determined eligible for Medicaid, the RSM specialist will enroll the applicant in Medicaid instead of denying health care coverage altogether. To apply for PeachCare for Kids, please click on:
- PeachCare for Kids Application – English
- PeachCare for Kids Application – Spanish
- To learn more about PeachCare for Kids, go to http://www.peachcare.org/
Women’s Health Medicaid
Women’s Health Medicaid is a program that pays for cancer treatments for uninsured or under-insured women who have been diagnosed with breast or cervical cancer and cannot afford to pay for treatment. The program is administered by the Georgia Department of Public Health.
To be eligible for this program, the applicant must meet the following criteria:
- Age – Under 65 years old
- Citizenship – Must be a U.S. citizen or lawfully admitted immigrant
- Residency – Must be currently residing in Georgia
- Diagnosis – Must have breast or cervical cancer; this may include precancerous conditions of the breast or cervix
- Health care coverage – Applicant cannot have health insurance that pays for cancer treatments; the applicant cannot be currently receiving Medicaid or Medicare
How to Apply
To apply for the Women’s Health Program:
- Contact your local county Public Health Department. Look in your local telephone book under “Health” or “Public Health” (in the blue county government pages) or call 404-657-2700.
- Although this program has to be applied for at a health department, an RSM specialist will contact the applicant to notify them of their eligibility. An RSM worker will attempt to refer (link to Collaborative & Referral Programs page) a denied applicant to a program that may be able to assist them.
- To learn more about Women’s Health Medicaid, visit: www.dph.georgia.gov/breast-and-cervical-cancer-program-bccp
Emergency Medical Assistance
Persons who are ineligible for Medicaid due to citizenship status may apply to get assistance in paying bills that were incurred due to a medical emergency. This includes the cost of labor and delivery. Emergency medical assistance, however, is not an ongoing coverage plan. Applicants must apply for this service as each medical hardship is incurred.
- To determine whether you qualify for this assistance, call an RSM eligibility specialist toll-free at 877-427-3224 or visit a RSM county office near you.
- Please specify if you need to speak with an interpreter. If you use an interpreter that is assigned to you by RSM, you will not be charged a fee for this service.
- You may also click RSM bilingual staff to find an RSM Medicaid specialist that may speak your language.
Collaborative Programs & Referrals
When Right from the Start Medicaid professionals assist clients who are ineligible for Medicaid or who have other health-related needs, they refer the clients to other programs that may be of assistance to them.
The following programs are often referrals of RSM specialists to clients in need: