Peach State Health Plan

Peach State Health Plan is located in Smyrna, Georgia, and is affiliated with Centene Corporation. Offers healthcare solutions tailored to Georgia residents.

Last week, Peach State and Augusta University leaders officially unveiled the 2023 class of “Peach State Scholars.” These students will participate in the MCG 3+ Primary Care Pathway Program to address Georgia’s critical physician shortage.

PeachCare for Kids(r)

PeachCare for Kids(r), or S-CHIP, provides health coverage at no or low cost for Georgia children up to age 18. Households must meet specific criteria, such as income requirements, to be eligible for this program.

PeachCare for Kids enrollees will be assigned to a care management organization (CMO), which will coordinate his or her healthcare. Parents have three choices of CMOs from which they can select: Peach State, Amerigroup, and WellCare of Georgia – Make sure your physician knows which are accepted before choosing one!

PeachCare for Kids not only ensures all children have access to quality health care, but it also assists families in managing their finances. Families do not pay more than 5% of their annual household income in premiums and co-payments. Should a family’s income change, they should notify PeachCare immediately so as not to overpay.

PeachCare for Kids provides nearly all medical services, excluding prescription drugs and mental health treatments, with coverage including dental and vision care and preventive health services such as immunizations and well-child checks. Each child in PeachCare for Kids is assigned their own Georgia Better Health Care primary care provider to assist them with their health needs.

Parents whose children receive PeachCare for Kids will be informed 45 days before their eligibility expires and provided with a renewal form and instructions to submit the required information to renew coverage. More details of this process are available at http://gafci.com/renewal.

PeachCare for Kids provides services for children whose households earn up to 280% of the federal poverty level and offers asthma and diabetes care management. UGA Extension’s Healthy Living program uses scientific principles in everyday living for farmers, families, and communities – offering both online and in-person programs to promote healthier lives by teaching people about healthy food options, making their homes more energy efficient, and cooking on a budget.

Ambetter

Ambetter Health Insurance of Georgia takes an approach that emphasizes quality healthcare delivery within local communities. Their parent company, Centene Corporation, is a Fortune 500 company that offers high-quality yet cost-effective products through the Health Insurance Marketplace in many states. It serves one out of 15 people across the US with programs and resources designed to promote whole health.

Ambetter allows individuals to view coverage options and costs in one convenient location, determine eligibility for financial subsidies, and enroll directly for coverage – making enrollment simple at any time, day or night! Available across Georgia’s 149 counties.

Individuals looking for an Ambetter plan that meets their needs and budget can choose between Ambetter Essential Care, Balanced Care, and Secure Care. Each program offers different monthly premiums, deductibles, and out-of-pocket maximums; some plans even provide dental and vision benefits.

Ambetter Telehealth allows members access to in-network providers for non-emergency medical issues at no cost, offering advice and diagnosis via phone or video with expert assistance. They can upload images for diagnosis and receive medication prescriptions; this service can also be used to schedule doctor visits.

Ambetter offers more than just its Telehealth service to its members to promote good health. In particular, Ambetter partners with the University of Georgia Cooperative Extension to provide education and programs designed to promote whole health; such programs help individuals lead a healthier lifestyle, shop more innovative, and make wiser food decisions.

Centene provides two health insurance products through Texas’ Health Insurance Marketplace: Superior HealthPlan’s Ambetter from Superior HealthPlan and Celtic Insurance Company’s qualified health plan issuer status make for mixed customer reviews; some customers even report difficulties with it.

Preventive & Clinical Practice Guidelines

Clinical practice guidelines provide healthcare professionals a framework for diagnosing and managing health conditions. Based on available evidence and professional opinion from healthcare providers, VillageCareMAX offers access to multiple preventive and clinical practice guidelines designed to identify and address health challenges such as chronic diseases, gastrointestinal disorders, depression, obesity, and anxiety. Please use these guidelines in conjunction with professional medical judgment when selecting treatment options from this collection.

Ambetter from Peach State Health Plan is part of Centene’s certified Qualified Health Plans in the health insurance marketplace. Centene is dedicated to improving its members’ and communities’ health and wellbeing with an approach rooted in quality healthcare being best provided locally.

The U.S. Preventive Services Task Force is an independent, volunteer panel of national experts who recommend primary care clinical preventive services. To ensure the public trust is earned with their advice, the Task Force adheres to transparent and clear processes for developing recommendations and globally accepted standards for guideline creation, detailed in its report “Clinical Practice Guidelines We Can Trust.”

Member Resources

Members require access to healthcare information to make well-informed healthcare decisions and efficiently manage their benefits and health plans. A member resource center provides a central source of answers on medications, doctors/hospital searches, premium payments, or finding ways to pay premiums – everything in one convenient location! Designed by Peach State Health Plan and Sharecare with login access for accessing tools/resources or viewing the Member Handbook.

*These tools are only accessible to members with an active account who can log in to their member profiles to access them.