Eligible

 

Drawing of a doctor visitEligible is a word that’s used in talking about health insurance.

“Who is eligible for Medicaid” means “who qualifies for Medicaid?” To qualify, a person must be in a group that Medicaid covers. The person must also meet the Medicaid income limits. (The law tells what the groups are and what the limit is.)

We at Georgia Families do not decide who qualifies. The Division of Family and Children Services does that. Once they decide, they tell us. Then we can help new Medicaid members choose a health plan. Their health plans will provide all their Medicaid services.

To find out if you qualify for Medicaid, check with your local DFCS office. You can find your local office on the DFCS website. Check it out!

If you qualify, Georgia Families can help you choose the best health plan for you and your family.

If you have any questions, call our call center. You can also find answers on our Facebook page and Twitter feed.

Did this blog help you understand what eligible means? Let us know! Email us 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.

Which Health Plan Should You Choose?

 

It’s time to choose a health plan to get your Medicaid services. Remember, a health plan is a group of doctors, nurses, hospitals and others that work together to give health services to members.

We at Georgia Families can help you choose by telling you which extra services each plan offers.  You should pick the health plan that best meets the needs of you and your family.  It will be easier to choose if you compare the plans.

Or, if you currently see a doctor or specialist that you like, find out which health plan they work with.  You can also use this information to help pick the plan that’s best for you.

If you have any questions, call our call center. You can also find answers on our Facebook page and Twitter feed.

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.

Some Medicaid Members Cannot Join Health Plans

 

Group of Medicaid members.Most Medicaid and all PeachCare for Kids members must enroll in a Georgia Families health plan to get their Medicaid health care services.

Georgia Families is only for members already enrolled in Medicaid or PeachCare for Kids. If you want to apply for Medicaid or PeachCare for Kids, call or visit your county DFCS (Department of Family and Children Services Office) office.

Almost everyone in Medicaid has to join Georgia Families. But some people cannot join a health plan, and will continue to get health services the way they do now.

 

Here is a list of people who cannot join a health plan:

  • People who need special medical services or live in an institution
  • People in Medicaid who qualify for Medicare 
  • Peope in Medicaid that the government approves are part of an Indian tribe 
  • People who qualify for Supplemental Security Income (SSI) 
  • Children in the Children’s Medical Services Program 
  • Children in the Georgia Pediatric Program 
  • Children with care coordination by the MATCH program (Multi-Agency Team for Children) 
  • People in Long Term Care 
  • People in the SOURCE program (Service Options Using Resources in Community Environments) 
  • People in Pre-Admission Screening and Resident Review 
  • People who are getting Hospice care 
  • People who get Health Insurance Premium Payments (HIPP) 

If you think you may not have to join a health plan, call our call center and we’ll answer your questions.

Do you have anything that you’d like to see us write about in this blog? Let us know! Email us 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.

Changing Health Plans

 

Two women reviewing papers.If you want to change health plans, you can do it — but only during certain times. Read this blog to find out when and how to change plans.

Enrollment means signing up for (or joining). When you enroll in a health plan, you sign up for the plan through Georgia Families.

When you qualify for Medicaid or PeachCare for Kids, it will be time to enroll. You will get a Georgia Families enrollment packet in the mail, and you will have at least 30 days to choose a health plan and PCP for each person in your family who is listed in the packet. The letter in your enrollment packet will also say your exact enrollment deadline.

If you do not choose by the end of 30 days, we will choose a plan for you. But it’s much better if you choose, because then you’ll have the best doctor for your family’s needs.

Then, after you have been in Georgia Families for a year, you will get a letter saying that you can change plans if you want to.  It will say that you can change your health plan during your “Enrollment Anniversary.”

During your Enrollment Anniversary, you will have 30 days to change your health plan. After the 30 days end, you will not be able to change plans until your next Enrollment Anniversary the following year.

If you want to change your health plan during your Enrollment Anniversary, log in to this website or call our call center.

Do you have ideas about things to write about in this blog? Let us know! Email us 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.

Choosing Doctors

 

Woman making a phone call.When you enroll in a health plan, you choose your own doctor — called a Primary Care Provider (PCP). If you do not choose one at the time of enrollment, your health plan will choose one for you. It’s better if you choose! Read more to find out why.

A PCP, or Primary Care Provider, is the person you will go to for regular checkups and other basic health care services. Over time, your PCP will get to know you and your health care needs. Your PCP will also send you to specialists and other health care providers if you need more specialized health care.

Your PCP will manage all of your health care needs, and keep your records in one place.  Your children’s doctor will help you remember their Health Check visits, and make sure they are on the right track as they grow up.

You might already know a doctor that you like and think that they are the right fit for you or your children. Sometimes, you can find a good doctor by asking family or friends where they go for health care. Once you find a doctor or clinic that you think might make a good PCP, ask these questions:

  1. “Where is the doctor’s office, and will it be easy for me to get there from my home and work?”
  2. “Do I like the doctor, and do the doctor and staff seem professional?”
  3. “Will I be comfortable asking this doctor questions and sharing information about my health?” Or, if the doctor is for my children, “Will they be comfortable with the doctor?”
  4. “Does someone on the office staff speak the language that my family uses at home?”

After you find a doctor or clinic that is a good fit for your life and your family, ask which Medicaid health plan he or she works with. If you want to see that doctor, you must enroll in a health plan that the doctor works with.

If you have questions about doctors and health plans, call our call center.

Did this blog help to explain choosing a doctor?  Let us know!  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.

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.

Health Check visits

Picture of a boy being examined by a doctor.Keeping kids healthy is an important goal for Georgia Families.

We know how busy you can be juggling family schedules, but it’s important to make time for your children’s health.

Children who are Medicaid members or in PeachCare for Kids should get regular checkups called Health Check visits. Regular checkups from birth through age 18 will help your healthy kids grow up to be healthy adults.

With regular Health Check visits, the doctor and people who work in the doctor’s office will get to know your children and their health care needs. The doctor can identify any problems early on. The doctor can also answer your questions about how your children are growing, what they should be eating and how they are feeling day to day. When your children are teens, the doctor can talk with them about exercise, good sleep habits, drugs and alcohol, and HIV/AIDS.

At each Health Check visit, the doctor will check your child’s eyes and hearing, height and weight, and teeth and gums, to ensure that the child is growing in healthy ways. The doctor will also give your child shots for immunization, do physical exams that are required for school, and run routine lab tests that check for hard to find illnesses.

You can get on a Health Check schedule by calling your health plan and you can make appointments with your children’s doctor. Let the doctor’s office know you want to get regular checkups for your kids from birth through adulthood. You can find the phone number for the plan on the back of your health plan card.

Do you have ideas for more blogs? Let us know! Email us 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.

Facebook and Twitter

Family sitting on a couch.Georgia Families is here to serve you! We want to give you information about our program in as many ways as possible, so we’ve started this weekly blog to answer your questions and help you understand all about health plans and Medicaid and PeachCare for Kids services.

We’ve also found other ways to communicate with you about your health care.

Visit the Georgia Families Facebook page! You’ll find all sorts of information there, such as how to get in touch with us, what you can find on this website, and how to find a community meeting near you. There’s also an update about the newest blog entry every week!

We also have a Twitter feed. We tweet almost every day, because we want to give you all the information you need. Go to Twitter to learn about Georgia Families and to find out about upcoming events near your community.

You don’t need to join Twitter to see our Twitter feed, or Facebook to see our Facebook page. But if you are already a member on either, we’d really like you to join us as a friend or follower.

Don’t forget to tell your friends and family that there are new ways to find out about their health choices!

Do you have ideas about what we can post on Facebook and Twitter or to this blog? Let us know!

Email us 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.

Why email isn’t private

Picture of computersYou may have seen our warnings that say “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.” We post those at the end of every blog and on our Twitter updates.

We post that warning because we want to make sure you understand the privacy risks any time you use email to communicate.

Our computer systems at Georgia Families, such as the email blog@georgia-families.com, are very secure — and we have special software that protects us and you. But most personal email accounts are not protected in that way. When you send us an email using your personal email account, it’s like sending an electronic postcard! Before the email reaches its destination many people have the opportunity to see what you wrote.

Think of a postcard going through the mail system. Along the way, postal workers could read it if they wanted to. The same is true of email. When you send an email from a public computer or even your own computer, the email makes many stops on its electronic journey. It’s not private! Many people (network managers, security workers, hackers) could read it if they wanted. Most of them won’t read email, but every once in a while hackers get valuable information about people by doing just that.

So please don’t put anything private in an email to us or to anyone else; don’t send your Social Security Number, your Medicaid ID number, or anything you don’t want the whole world to see. Georgia Families cannot guarantee the security of the transfer of your messages to our servers. Keep your personal information private.

We really, really want to hear feedback from you about our blogs, Facebook and Twitter pages. We want to know if people are reading them and learning from them! Write us an email to tell us what you think — just don’t include information that is private.

Please send suggestions and comments, questions and ideas.

Please do not send anything about your health care or information such as your Social Security Number and date of birth.

We can answer any questions about the Georgia Families program for you. But, if you have questions about your health plan, your doctor, payments or health care, call our call center.

Did this blog help to explain email security and protected health information to you? Let us know! Email us 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.

Information about your health is protected

Picture of doctor examining a young man.A few years ago the government put in place laws to protect everyone’s health records and health information. Certain information is called “protected health information” and cannot be shared without your permission.

So, if you visit a doctor or join a health plan, only certain people at the doctor and plan offices have access to things like your health records.

At Georgia Families we are very careful with each member’s protected health information, and we do not share any details about you without your permission, including your family’s names, dates of birth, Social Security Numbers and health and payment histories.

Everything that is “protected health information” is spelled out in HIPAA, the Health Insurance Portability and Accountability Act. That’s the federal rule that says that health providers must protect each person’s health information. You may remember that each time you go to a new doctor or other provider someone asks you to sign a paper that says you know about the HIPAA privacy rules.

Protecting your health information is important if you are in Medicaid or PeachCare for Kids. We will do everything in our power to keep the information you give Georgia Families private.

If you have any questions about protected health information, or are not sure whom you should share your health information with, ask our call center staff.

Do you have a topic you’d like us to write about in a blog? Or would you like to know more about this topic — protected health information? 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.

Older posts «

» Newer posts