Frequently Asked Questions
Amerigroup Georgia Families
Georgia Families began in 2006. Amerigroup members living in the Atlanta and Central regions first joined on June 1, 2006. Members living in the North, East, Southeast and Southwest regions first joined on September 1, 2006. In 2012, Amerigroup expanded into the entire state of Georgia.
Amerigroup Community Care is one of the health plans offered to you by Georgia Families. We’ve offered health care benefits to people enrolled in the Georgia Families programs since 2006.
Georgia Families delivers health care services to members of Medicaid and PeachCare for Kids®. Your health care coverage is provided by the Department of Community Health (DCH) and one of the health plans in your region. You’ll still be in Medicaid. Your children will still be in PeachCare for Kids®. Now you’ll get health care services from one of the health plans in your region.
With us, you get all your regular Medicaid benefits from Georgia Families program, plus:
- Free, preapproved over-the-counter medicines prescribed by your doctor
- Free memberships to Boys & Girls Club for kids age 6 to 18 (not including summer camp)
- Disease management and health education programs that help you manage health conditions
- And more!
Georgia Pathways to Coverage
Georgia Pathways is a new program to help low-income Georgians qualify for Medicaid who otherwise would not qualify for traditional Medicaid.
To be eligible for Georgia Pathways, an individual must:
- Be a Georgia resident.
- Be a U.S. citizen or legally residing non-citizen.
- Not be eligible for any other Medicaid coverage.
- Be from ages 19-64.
- Have a household income up to 100 percent of the Federal Poverty Level.
- Prove you are doing one or more qualifying activities for at least 80 hours per month.
- Not be incarcerated.
No. You must apply for Georgia Pathways and meet its requirements to be approved.
Georgia Pathways covers many of the same medical services as other Medicaid plans, including:
- Doctor visits
- Hospital stays
- Emergency services
- Lab and X-rays
- Family planning services
- Mental health services
- Preventive and wellness services
- Chronic disease management services
Read your Georgia Pathways member handbook to learn more.
This benefit is covered by the state for those ages 19-20. If you are age 21 or older, you must pay for the cost of travel to a doctor visit or pharmacy to pick up your medicine.
A person must show they are engaged in at least 80 hours per month of a qualifying activity or combined activities at the present time.
For more information, visit the Georgia Pathways website.
Yes, you could be eligible, but you still must complete at least 80 hours per month of Qualifying Activities. If you are not working 80 hours per month, then you can choose other Qualifying Activities to reach 80 hours each month to be eligible for Georgia Pathways.
No, time spent looking for a job does not count as a Qualifying Activity.
The easiest way to report your hours each month is online at gateway.ga.gov through 'Report My Changes.' You also must prove your hours. You can upload a pay stub or volunteer form.
You can also report your hours each month by:
- Mailing in a paper form to your local DFCS office.
- Calling 877-423-4746 (TTY 711) or 711 for those who are deaf, hard of hearing, deaf-blind or have difficulty speaking.
- In person at your Division of Family and Children Services (DFCS) office. To find the location and business hours for a DFCS office, visit: dfcs.ga.gov/locations.
If you meet the hours and activities threshold for six months in a row, you will be exempt from reporting. But you must let the state know of a change in circumstance.
If you can show you meet the monthly 80-hours employment minimum during the most recent six months in a row before you apply, you will be exempt from reporting. But you must let the state know of a change in circumstance.
You can also request a Good Cause Exception when reporting your hours. You will be allowed up to 120 hours of Good Cause Exception hours in a year. For more information, visit https://dch.georgia.gov/georgiapathways.
To stay eligible for Medicaid coverage through Georgia Pathways, you must report 80 hours of qualifying hours and activities to the state each month through one of these channels:
- Online at gateway.ga.gov: You can upload documents (pdf, jpg, tiff, bmp, .docx) through your Gateway Customer Portal account.
- Mail: You can mail paper form and attach documents to show proof. Mail them to a local DFCS office. Mail must be postmarked by the 17th of the month.
- In-Person: You can provide documents to a local DFCS office. To find the location and business hours for a DFCS office, visit: dfcs.ga.gov/locations. Documents must be stamped upon receipt by the 17th of the month reported.
- Phone: You can call 877-423-4746 or 711 for those who are deaf, hard of hearing, deaf-blind or have difficulty speaking. But you must submit documents to support this through one of the other channels by the 17th of the month.
To help keep an active status, you should:
- Report hours and activities no later than the 17th of each month to keep coverage for the next month. If you do not report by the 17th of the month, your coverage will stop by the first day of the following month.
If you have a disability, you may still be eligible for Georgia Pathways. You must do at least 80 hours per month of one or more qualifying activities. If you need help, reach out to a DFCS eligibility specialist to find out how to request a reasonable change.
Your primary care provider
Yes, providers are told about changes. And Amerigroup can answer any of your doctor’s questions.
We want you to have a doctor who knows how to give you the right care for your needs. You can see if your PCP works with our plan by using our online provider directory.
Yes, you can change your PCP at any time. Just log in to the website or you can call Member Services at 1-800-600-4441 (TTY 711). (First time users will need to register.)
Please contact Member Services at 1-800-600-4441 (TTY 711) to see if your doctor is taking part in the program. If not, we have a large group of providers you can choose from.
If you see a doctor who doesn’t work with Amerigroup, you may have to pay for your health care. Always carry your Medicaid or PeachCare for Kids® card and your Amerigroup card with you. Show the doctor’s office both cards before you see the doctor.
Enrolling and renewing
The Georgia Families program is required for PeachCare for Kids® and certain Medicaid members. There are some types of Medicaid that are not in the program. Please call Compass at 1-888-423-4746 to find out your status.
Call 1-888-GA-ENROLL (1-888-423-6765) (TTY 1-877-889-4424) and tell them you want to join Amerigroup.
To enroll in Georgia Families, call 1-888-GA-ENROLL (1-888-423-6765) (TTY 1-877-889-4424) Monday through Friday 7 a.m. to 7 p.m.
To learn more about Medicaid or PeachCare for Kids®:
- Visit the Department of Family and Children’s Services (DFCS) near you
- Go to the Georgia Families website
Make sure Georgia Families and your health plan always have your current address and phone number. If we don’t, you may not get important information about your health care and benefits.
You’ll still get the same services you got from Medicaid or PeachCare for Kids®. We focus on getting you and your family the right care. Amerigroup provides you and your family with health education. We’ll also invite you and your family to fun health fairs and wellness clinics.
No, you’ll still send payments to PeachCare for Kids®. You can pay by phone, online or by mail, or set up payments from your bank or credit card.
Yes, you’ll get your new ID card by mail. It will have the name of your provider. You must call your provider when you need health care unless it’s an emergency. Check to make sure the doctor and health plan you choose are on it. Do not throw away your Medicaid or PeachCare card. Bring both cards to the doctor’s office.
Call Compass to find out why your coverage was canceled at 1-877-423-4746.
Your enrollment anniversary depends on when you first enrolled in Georgia Families. You can call 1-888-GA-ENROLL (1-888-423-6765) (TTY 1-877-889-4424) to find out when you need to re-enroll.
No, you don’t need to take any action to stay with us.
For members in Foster Care, Department of Juvenile Justice and Adoption Assistance
We offer health care benefits to members enrolled in Georgia Families 360°SM and Georgia Families programs throughout the state of Georgia. We help make sure all the systems that support children in the Georgia Families 360°SM program work together by:
- Training school, court and law enforcement staff
- Planning creative, convenient access points for members to receive health care service (medical vans, at schools, court systems, etc.)
- Hosting back-to-school events, town halls and other community events across the state
The Georgia Department of Community Health chose Amerigroup Community Care as Georgia’s single care management organization (CMO) in charge of planning care for children in Foster Care, children receiving Adoption Assistance and select youth in the juvenile justice system.
The Georgia Families 360°SM program is required for all members in Foster Care, Adoption Assistance and select youth in the Department of Juvenile Justice program. The exceptions are Foster Care and/or Adoption Assistance members under the age of 21 under Title IV-E of the Social Security Act who are enrolled in the Georgia Pediatric Program (GAPP). In addition, any members that live outside the state of Georgia will not be enrolled in the program.
Amerigroup began serving Foster Care, Adoption Assistance and Department of Juvenile Justice members in the GF 360°SM program across the state of Georgia on March 3, 2014. We began serving members in the Georgia Families program statewide in Georgia in 2006.
You don’t need to take any action. As a Georgia Families 360°SM member, you don’t have to re-enroll each year to stay with Amerigroup. Just make sure we always have your current home address, email address and phone number. If we don’t have your current contact information, you may lose your benefits.
You’ll still get the same services you received from Medicaid. We focus on getting you the right care. We offer health education and invite you to fun events in your community.
An Ombudsman is someone who will listen to any concerns you may have. He or she will speak and act on your behalf to make sure you get all medically necessary covered services.
You can reach the Office of the Ombudsman by phone at 1-855-558-1436 (TTY 711) or by email.
We help you get the right services and supports, plus special services just for Amerigroup members. Find out more about benefits.
A care coordinator is a person who helps make sure all of your health care needs are identified. He or she also helps you find doctors in your area who work with our plan to treat your needs. All Georgia Families 360°SM members get a care coordinator. Your care coordinator will help you:
- Complete a health risk assessment
- Talk to you about health goals
- Monitor your care and progress
- Review treatment and results
- Get medical, dental and behavioral health care
- Make changes to the care you get right now
- Find services you may need and make a referral
- Schedule appointments
- Manage your health benefits
- Connect you with local resources
If you have questions about care coordination, call the Member Intake Line at 1-855-661-2021 (TTY 711).
(This applies to Adoption Assistance members only; members in Foster Care and Department of Juvenile Justice are automatically enrolled in Amerigroup.)
If you don’t like something about Amerigroup, please call the Georgia Families 360°SM Member Intake Line at 1-855-661-2021 (TTY 711). We‘ll work with you to try and fix the problem. If you’re still unhappy, you may be able to change to Fee-for-Service Medicaid. You can ask for the change without cause during your first 90 days of enrollment. After 90 days, you can make a change every 12 months during your enrollment anniversary. Please call 1-855-661-2021 (TTY 711) for disenrollment information.
(This applies to Adoption Assistance members only.)
You can send an email. Tell them you’d like to return to the Amerigroup Georgia Families 360°SM health plan program or you can call our Georgia Families 360°SM Member Intake Line at 1-855-661-2021 (TTY 711).
You can call our Georgia Families 360°SM Member Intake Line at 1-855-661-2021 (TTY 711) 24 hours a day, 7 days a week.
You can call our 24-hour Nurse HelpLine at 1-855-661-2021 (TTY 711).
Call 911 or go straight to the ER if you have any life-threatening symptoms like:
- Severe chest pains
- Problems breathing
- Severe bleeding or head trauma
- Loss of consciousness
- Sudden loss of vision or blurred vision
Your primary care provider (PCP) is the main person who gives you health care. Your primary care dentist (PCD) is the main person who gives you dental care.
We want you to have a doctor who’ll meet your medical needs. You can find out if your PCP and/or PCD are doctors in our plan by going to our online provider directory.
Yes, you can change your PCP at any time. Just log into the website or call Member Services. You can change your PCD at DentaQuest or by calling 1-800-895-2218 (TTY 711). PCP and PCD changes start the next business day.
To find out more about Georgia Families 360°SM, call the Member Intake Line toll free at 1-855-661-2021 (TTY 711) 24 hours a day, 7 days a week.
For more information on Amerigroup:
- View your member handbook
- Call Member Services at 1-855-661-2021 (TTY 711) 24 hours a day, 7 days a week
Yes, you’ll get your new ID card in the mail if you’re an Adoption Assistance member. It’ll have the name of your provider. You must call your primary care provider and schedule a visit within 90 days of getting your ID card. Call your primary care provider when you need health care unless it’s an emergency. Check to make sure the doctor and health plan you chose are on it. Don't throw away your Medicaid card. Bring both cards to the doctor’s office. If you’re a Foster Care member, your Division of Family and Children Services caseworker will register you and print your ID card. If you’re a Department of Juvenile Justice (DJJ) member, your DJJ Juvenile Probation/Parole Specialist will print your ID card.
Please contact us to see if your doctor is taking part in the program.
If you see a doctor who isn’t part of the doctors in the Amerigroup plan, you may have to pay for your health care. Always carry your Medicaid card and your Amerigroup card with you. Show the doctor’s office both cards before you see the doctor.
Call 1-855-661-2021 (TTY 711) to find out why your benefits were canceled.
All your regular Medicaid benefits are included in the Georgia Families 360°SM program, plus:
- Free, preapproved, over-the-counter medicines prescribed by your doctor
- Free membership to the Boys & Girls Club for members ages 6 to 18 (not including summer camp)
- Disease management and health education programs that help you control health conditions
- And many more
All benefits may not be available for members in the Department of Juvenile Justice program.
Please call the Georgia Families 360°SM Member Intake Line to find out more.
Your enrollment anniversary depends on when you first enrolled in Georgia Families 360°SM. You can call 1-855-661-2021 (TTY 711) to find out when you were enrolled with Amerigroup in the Georgia Families 360°SM program. Call 1-888-GA-ENROLL (1-888-423-6765) (TTY 1-877-889-4424) to find out when you need to re-enroll.
You don’t have to take any action to stay with Amerigroup if you or the youth remain in the Foster Care, Department of Juvenile Justice or Adoptive Assistance programs.
For more information on Amerigroup:
Call Member Services at 1-800-600-4441 (TTY 711) Monday to Friday 7 a.m. to 7 p.m. Eastern time.