Georgia program
Another way to pay your work premium (CHIPRA assistance)
Georgia can pay your share of a qualified work plan when your child has Medicaid and the employer pays at least 40%.
What it is
Georgia can pay your share of a qualified work plan when your child has Medicaid and the employer pays at least 40%.
The premium-help unit checks this option alongside HIPP. It requires Medicaid and a qualifying employer contribution. The two programs do not add together for the same premium.
Eligibility rules
- The child must be under 19 and have Medicaid. The employer must pay at least 40% of the premium.
- The employer plan must meet qualified-plan rules and save Medicaid money in the state’s cost review.
What you get
- Payment of the approved employee premium share.
- Your work plan stays first, with Medicaid behind it.
What the help includes
- Approval names the premium amount the state will pay. It does not create an extra payment on top of HIPP for the same cost.
- Approved CHIPRA members in a Medicaid care-management organization move to fee-for-service Medicaid. The clinic must check authorizations and billing under that arrangement. This is not PeachCare as secondary work insurance.
- CHIPRA pays the approved premium, not a separate reimbursement for copays, coinsurance or deductibles. Those charges follow the child’s coverage rules.
If you decide to apply
- Ask the DCH premium-help unit which packet fits your employer plan.
- Have ready: the Medicaid notice, your premium amount and your employer’s contribution percentage from the benefits office.
Georgia premium-help unit: 678-564-1162, option 2 · Official page ↗
After you ask
- The unit can explain the initial review timing and which premium proof it needs. A written decision confirms the approved amount.
Good to know
Approval changes how your child’s Medicaid is handled. The oncology team needs to check existing treatment approvals, clinic access and billing before the change.
Other details
- A failed review can involve the contribution percentage, plan type or cost test. HIPP has a separate review through the same unit.
“Would CHIPRA premium help fit our employer’s contribution better than HIPP? What are the benefits and drawbacks, and could you help us use the right application if you recommend it?”
Why I’m asking: I want the premium-help unit to consider the option that fits our work insurance.
More background and detailed requirements
Additional program information and published rules
Who does what
The three parts, side by side. The agency decides; nobody on this page does.
You
Ask your employer's benefits office the employer's share and hand it to the unit.
Your social worker
The social worker helps the clinic supply the same treatment-cost information used for other employer-premium help, if the unit requests it.
The care team
Records and letters when the application asks for them.
- Who decides
- Georgia's Department of Community Health premium-assistance unit.
- Ask HR
- “What percentage of the health premium does the company pay, and what is the employee's medical-only share?”
How to apply
First step: When you call the premium-assistance unit (678-564-1162) about help paying the work-plan premium, ask which packet applies and give the employer's contribution percentage.
- Ask HR the employer's contribution percentage.
- Give it to the premium-assistance unit when you call about HIPP.
Official application / program page ↗
Where it starts: Ask the unit which packet applies
What to gather
- Medicaid notice
- The employer's contribution percentage and the employee premium, from your employer's benefits office
How long: No published standard. Ask the unit.
What a yes looks like
A written approved premium amount.
What a no looks like, and the next move
Ask whether it was the 40% gate, the plan type or the cost test. Help paying the work-plan premium is the other option.
Watch out
- Not additive with help paying the work-plan premium for the same premium.
- Needs the child on Medicaid and the employer paying at least 40%.
- Not a way to add PeachCare as secondary insurance.
The numbers and the rules
The arcane layer, kept on purpose. Checked September 8, 2026.
What it is worth
Payment of the employee share of a qualified employer plan's premium when the employer pays at least 40% and the plan is cost-effective.
- $40 (at least) — Employer contribution gate
Covers: Employer plan retained with Medicaid secondary
What it costs the family: None.
The eligibility facts, as published
- Age max exclusive
- 19
- Medicaid
- yes
- Employer contribution percent min
- 40
- Qualified plan
- yes
- Cost effective
- yes
Decisions this site cannot make: Qualified plan and cost-effectiveness review
Expect friction on: Employer contribution verification
The trap: Not additive with help paying the work-plan premium for the same premium.
Where I read this
- CHIPRA Premium Assistance — Georgia Department of Community Health, read August 27, 2026
- Health Insurance Premium Payment Program — Georgia Department of Community Health, read August 27, 2026