Program Benefits and Cost
Notice: PeachCare for Kids® now provides 12 months of postpartum care. To receive these benefits, please report expected due date and/or delivery date at www.gateway.ga.gov or call 877-427-3224.
What are the benefits?
PeachCare for Kids® health benefits include:
- 12 months postpartum benefits
- Care from a doctor when your child is sick
- Preventive services such as immunizations and regular check-ups
- Specialist care
- Dental care
- Vision care, including vision screenings and eyeglasses.
- Hospitalization
- Emergency room services
- Prescription medications
- Mental health care
Each child will have a choice of a Georgia Families Care Management Organization (CMO), a private health plan that is responsible for coordinating your child’s health care. You will also be able to choose your child’s primary care provider.
Institutionalization:
A child must not be an inmate of a public institution or a patient in an institution for mental diseases at the time of initial application or any redetermination of eligibility.
How much does it cost?
PeachCare for Kids® will resume collecting premiums on October 1, 2024, as new applications and renewals are completed. Please pay close attention to any letters/messages you receive from PCK to know if you will need to start paying premiums.
PeachCare for Kids® will resume collecting co-payments on October 1, 2024.
A co-payment is a small fee you will have to pay at the time of your visit to a medical provider. The amount of the co-payment will be different depending on the medical services you receive. While these co-payment amounts can range from $0.50 to $12.50, most will be $2 or $3. If you must make a co-payment, your medical provider will tell you at the time of your visit.
However, there are no co-payments for these services:
- Emergency services
- Preventive care services (routine check-ups for your child)
- Immunizations
- Routine preventive and diagnostic dental services (such as oral examinations, prophylaxis and topical fluoride applications, sealants, and X-rays).
*Exception: There are no premiums or co-payments charged for children that are under six years old, children in foster care, American Indians and Alaskan Natives (AI/AN).
You are not required to pay more than five percent of your yearly income for premiums or co-payments. If your family reaches the five percent limit, you will not be required to make premiums or co-payments for the rest of the year.