Georgia Families 360°SM
Amerigroup Community Care is Georgia Families 360°SM's single care management organization (CMO) in charge of coordinating care for children in Foster Care, children receiving Adoption Assistance and select youth in the Juvenile Justice system.
You want the kids in your care to grow up happy and healthy. We do too! That’s why Georgia Families 360oSM members get important care and services from Amerigroup like:
- Care from a primary care physician who works with your plan that you choose
- Wellness visits and shots to help keep your child healthy
- Vision and dental care
- A full list of prescriptions
- Specialty doctor services and hospital stays
- Behavioral health services
Plus lots of extras!
With Amerigroup, you get lots of extra benefits to help you stay healthy like:
- A dental exam and cleaning every six months
- Free over-the-counter medicine
- Personal exercise kit
- Free weight-management program for ages 10 and up
- Free round-trip rides to doctor visits
- GED assistance
- Supports to keep you healthy after an emergency
- Pest control
- Respite care for caregivers
- Free flu shots
- Case management services
- Free 24-hour Nurse HelpLine
You’ll also get benefits to help your child stay active and keep learning like:
- Free Boys & Girls Club memberships for kids 6–18
- Free Girl Scout membership
Different eligibility rules apply to each benefit. Look in your member handbook or call us at 1-800-600-4441 (TTY 711) to learn more.
We work with Express Scripts to get you the medicines you need. We cover a wide range of prescriptions and many over-the-counter medicines.
We have good news! Mosquito repellent is now available as a Medicaid benefit. Get more information below.
Preferred Drug List
We have a list of commonly prescribed drugs your doctor can choose from. It’s called a Preferred Drug List (PDL). Prescription and certain over-the-counter medicines are covered. Your doctor may need to get preapproval for some drugs to be filled. Your request should include why the drug is needed and how much is needed. Requests for brand-name drugs when generics are available also need preapproval.
Search for brand-name and generic drugs that are on your medication list.
Search for your drug by:
- Typing the name (at least first three letters) of the drug in the search box
Using the A-Z list to search by the first letter of your drug
- Clicking on therapeutic class of the drug
If you need a drug that isn’t listed on our formulary, you or someone you choose to act for you can request a formulary exception. Just email firstname.lastname@example.org.
Your pharmacy benefits
Over 50,000 pharmacies across the U.S. work with us. And we offer specialty pharmacy services for hard-to-find medicines. To view a list of pharmacies in your plan, use our provider directory.
Have your prescriptions filled easily
Just show the prescription from your doctor to a pharmacy in your plan. Or your doctor can call in the prescription. You’ll need to show the pharmacy your Amerigroup ID card and your Medicaid or PeachCare for Kids® ID card to get your prescription. Try to use the same pharmacy each time so your pharmacist will know about problems that may occur when you’re taking more than one prescription. If you use another pharmacy, tell the pharmacist about any medicines you’re taking.
Helping you manage all the moving pieces
Our new Medication Synchronization program (Med Sync) makes getting all your medicines easier — at no extra cost to you.
Med Sync helps align your refill schedules so you can pick up most of your medicines on just one day each month.
Our Med Sync program can help you:
- Cut down on trips to the pharmacy
- Make sure you have your medicines when you need them
- Work with your pharmacist so you can stick to a medicine routine
Get started with Med Sync today! Talk to your pharmacist about coordinating your prescriptions to get started.
Have more questions about Med Sync? Call 1-800-600-4441 (TTY 711).
Drug interactions and side effects
Learn more about drug interactions or side effects on the ESI Drug Information website.
Your provider can email and ask us for an exception.
Common over-the-counter (OTC) medicines
Pharmacy Change Request Form
Member Reimbursement Form
Express Scripts online registration
Frequently asked questions
What pharmacies work with Amerigroup?
For a list of pharmacies that work with your plan, look in your provider directory. Or call Member Services at 1-800-600-4441 (TTY 711) or ask your local pharmacy for help.
Are over-the-counter (OTC) products covered? Do I need a prescription?
We cover many OTC products, like:
- Pain relievers
- Some vitamins
All OTC products need a written prescription from your doctor and can be filled at any pharmacy in your plan.
How does my doctor request preapproval?
Your doctor can ask for preapproval on medicines by calling the Pharmacy department at 1-800-454-3730.
What if a copay is needed and I can’t pay it?
If you don’t have the copay for your medicine, your pharmacy should still give you the medicine. If the pharmacy lets you take the medicine without paying the copay, you’ll have to pay it at a later time.
What happens if my medicines are lost or stolen?
If your medicines are lost or stolen, call your doctor to approve the pharmacy to refill your prescription early. The pharmacy may have to call us for preapproval. Replacement of lost or stolen medicines will be reviewed on a case-by-case basis.
What if I paid out of pocket for a medicine and want to be paid back?
If you paid for a medicine, ask your provider for a refund. Your provider will send us a claim.
The Georgia Families 360°SM program is required for all members in:
- Foster Care
- Select youth in the Department of Juvenile Justice
Members enrolled in the following programs are excluded:
- Children under 21 who are:
- In Adoption Assistance under Title IV-E of the Social Security Act
- Enrolled in the Georgia Pediatric Program (GAPP)
- Children living or assigned out of the state of Georgia
- Members enrolled in Medicare
Getting you the right care
The Amerigroup Care Team is made up of health care experts who will help you by:
- Working with you to make healthy life choices
- Sharing health tips like how to take care of asthma
- Helping you take control of your health by completing a health risk screening
- Making sure you get the most out of your health plan
- Connecting you to health care programs like disease management
Or call our:
- Case Management department at 678-587-4758
- Georgia Families 360°SM Intake Line at 1-855-661-2021*
Everything we talk to you about is private.
*This number is for Georgia Families 360°SM members only.
There are many kinds of specialists. A specialist is a doctor who gives care for a certain illness or part of the body. One kind of specialist is a cardiologist, or heart doctor. Another kind of specialist is an oncologist. An oncologist is a cancer doctor.
Your PCP may send you to a specialist for care. This is called a referral. If your PCP wants you to go to a specialist, he or she may help set up your visit with the specialist.
You don’t have to see your PCP first to go to a women’s health doctor for well-woman checkups. An obstetrician/gynecologist (OB/GYN) is a women’s health doctor.
You do not have to see your PCP first to see a behavioral health provider for mental health, alcohol abuse or substance abuse services.
Your member handbook is your go-to guide for health services. It tells you how you can get the most out of your benefits. Read it to find out about:
- Your benefits
- Special programs and services like health education classes, case management and disease management
- Your rights and responsibilities as an Amerigroup member
- How to choose a primary care provider
- How to get help if your doctor’s office is closed
- Recertifying your benefits
- How to reach Amerigroup Member Services if you have questions
The electronic version of your member handbook is searchable. Use "Ctrl + F" to search for keywords. If you’re using a Mac, use "Command + F."
Need your handbook mailed to you?
Call Member Services toll free at 1-800-600-4441 (TTY 711).
A referral is when your primary care provider (PCP) sends you to another provider for care. This care is often from a specialist. As an Amerigroup member, you don’t need a referral to see a provider who’s not your PCP as long as the provider works with your plan.
What is precertification?
Precertification is needed for:
- Inpatient admissions
- Certain behavioral health services like skills training
- Psychological testing
- Certain prescriptions
- Rehabilitation therapies (physical, occupational, respiratory, speech)
- Care from a provider who doesn’t work with your plan
As a member, you don’t make the request. Your PCP, specialist or other provider should send in the request. If your case doesn’t meet the rules for medically needed, we’ll send you a letter. The letter will tell you we could not OK the service and why.
Other benefit details can be found in your member handbook. If you have questions or would like a copy of your member handbook mailed to you, call Member Services at 1-800-600-4441 (TTY 711).
We put tools and technologies in your hands to make it easier to access care and services. Your Care Plan is a tool for Georgia Families 360°SM members. It helps you:
- Stay connected with your care coordinator
- Get your care coordinator’s phone number and email address
- Send secure messages about diagnoses, goals, medicines, services and more
- Stay up-to-date on your care plan
- View your goals and objectives
- Check due dates and status for goals and objectives
Transitioning member to Amerigroup Managed Care
Georgia Families 360°SM Round Up
The Amerigroup Managed Care Office of the Ombudsman
The Amerigroup Office of the Ombudsman helps solve problems from a neutral view to ensure members get all medically necessary treatment. The Ombudsman provides a voice to speak and act on behalf of members in adoption assistance, foster care and Department of Juvenile Justice custody. They make sure the member’s voice is heard and help solve issues quickly. Get more information about the Amerigroup Office of the Ombudsman in your member handbook.
Care Coordination Team Contacts
Take online courses. Get continuing education credits!
Relias is an online learning system. It gives you access to courses ranging from ADHD to Trauma Informed Care. Most courses are approved by licensing boards. You can get continuing education credits too! Ready to start learning? Email and ask for an access code. Once you have your access code, log in and let the learning begin!