Health Plans and Medicaid


Group of consumersDo you find that it’s hard to understand the difference between Medicaid and a health plan? Lots of people do — and that’s why we’re writing about it in today’s blog.

Medicaid is a government program that helps low income people pay for medical care. Each state runs its own Medicaid program, and each state has an application form that you must fill out to see if you qualify for Medicaid. People qualify if they meet all the program rules:

  1. They are in one of the groups covered by Medicaid, such as pregnant women and children, older folks who need nursing home care, or people with disabilities,
  2. They meet the income limits in that state.

A few other rules may apply depending on your eligibility group. (Check with your county DFCS office for additional details.)

A health plan is a group of doctors, nurses, hospitals and other providers that work together to give health services to its members. Many states have Medicaid health plans for people in Medicaid. If you qualify for Medicaid and are in a Medicaid health plan, you won’t have to look around for doctors and other providers, because your health plan will have them or find them for you!  At Georgia Families, we help you join health plans. Your health plan will have all the health care professionals you need.

Studies show that people are happier with their health care when they get to choose their own health plan and main doctor. In Georgia, people in Medicaid and PeachCare for Kids come to Georgia Families to choose their health plans and Primary Care Providers (PCPs). At Georgia Families, we help you understand your choices and we help you choose. In fact, most Medicaid and PeachCare for Kids members must enroll in (sign up for) Georgia Families to choose a health plan and PCP. If you don’t enroll, a health plan and PCP will be chosen for you.

If you have any questions about choosing a health plan or doctor, call our call center.

Do you have a topic you’d like us to write about in a blog? Send us an email at blog@georgia-families.com. Please know that email is not private. Messages you send can be copied or read by others. If you send us an email, this tells us that you know and accept the risks. You may email us, but please consider calling, faxing, or sending us a letter if you want to send personal health information (PHI). PHI includes a Medicaid ID number, Social Security number and a member’s medical information.

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