Written by a parent, not a doctor. Nothing here is medical advice.

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Georgia program

Child insurance above the Medicaid limit (PeachCare for Kids)

PeachCare covers uninsured children whose income is above the free Medicaid limit.

What it is

PeachCare covers uninsured children whose income is above the free Medicaid limit.

The same Gateway application checks Medicaid first, then PeachCare. PeachCare requires your child to be uninsured. An employer offer you did not take is different from coverage your child actually has.

Eligibility rules
  • Children must be under 19, live in Georgia and be ineligible for Medicaid.
  • The March 1, 2026 table gives a four-person monthly limit of $6,929 with the 5% allowance. The published base is $6,792, or 247% of poverty.
  • An existing insurance enrollment blocks PeachCare. Simply being offered employer coverage does not.
What you get
  • $11–$36 a month for one child age 6 or older, or $16–$72 for two or more.
  • No premiums or copays for children under 6.
  • Full child health coverage, with most copays at $2 or $3.
What the help includes
  • Yearly family premiums and copays together are capped at 5% of income.
  • Children in foster care and American Indian or Alaska Native children also have premium exemptions.
  • The premium ranges run from the 134–158% poverty band to the 232–247% band.
If you decide to apply
  1. Ask the hospital financial counselor about PeachCare through Georgia Gateway.
  2. Have ready: current income, insurance status and any coverage-end letter. Ask the counselor to check the cancer team against the exact plan.
  3. Ask which first premium applies and when coverage would begin.

Georgia Gateway · Official page ↗

After you ask
  • PeachCare checks the complete application and any required first premium before coverage begins. After that first payment, missed later premiums do not end the child’s 12-month continuous-coverage period. Unpaid premiums can accumulate. The counselor can check the balance and the renewal notice’s requirements.
  • Premium collection restarted in October 2024. The counselor can compare the new start date with any existing insurance end date.
Good to know

PeachCare cannot pay bills from months before the complete application and first premium arrive.

Other details
  • An earlier admission may need a separate month-by-month Medically Needy review. PeachCare approval does not settle that earlier bill.

Federal background: CHIP.

Official sources
Ask your social worker

“Would PeachCare fit our child, what would the premium be, and does our cancer team take it? Could you help us apply if it is the right step?”

Why I’m asking: I want to understand the next child coverage option if free Medicaid does not fit.

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

File on Gateway, answer the insurance question exactly (enrolled, not offered), pay the first premium at once.

Your social worker

The social worker checks the plan's oncology network and files the Medically Needy request for any earlier months with bills.

The care team

Records and letters when the application asks for them.

Who decides
Georgia's Division of Family and Children Services and Department of Community Health.
Ask your social worker
“What will our monthly premium be? Can you request Medically Needy coverage for last month's admission, since PeachCare cannot cover it?”

How to apply

First step: Apply at gateway.ga.gov (or 877-423-4746). Gateway checks income Medicaid first and moves the child to PeachCare if income is above the Medicaid income limit. Pay the first premium the day the notice arrives.

  1. Apply at gateway.ga.gov. Gateway checks income Medicaid first.
  2. Pay the first premium the day the notice arrives.
  3. Ask DFCS for a Family Medicaid Medically Needy budget for any earlier month with bills.

Official application / program page ↗

Where it starts: Apply through Georgia Gateway, which checks Medicaid first.

What to gather

  • Child's ID and Social Security number
  • This month's income for the tax household
  • Proof the child has no other insurance, or the date it ended
  • Hospital bills from earlier months, for the Medically Needy request

How long: Coverage begins the first day of the month in which the complete application and the initial premium are received. The decision follows the 45-day standard. No coverage for earlier months.

What a yes looks like

A notice with the premium tier and start month, and a Georgia Families plan choice. Check the oncology group is in network before choosing.

What a no looks like, and the next move

Check whether the reason is other insurance, income, or a Medicaid placement (which is better: no premium and three months back). If income is the reason, Katie Beckett does not count parents' income. Keep the appeal date.

Watch out

  • An employer offer is not enrollment: PeachCare tests whether the child is covered today. If your child's insurance ends, PeachCare opens the month the application and first premium arrive, never earlier.
  • PeachCare pays nothing for months before the month your complete application and first premium arrive. The diagnosis admission from last month is not covered by it (that is the spend-down item).
  • After any required initial premium is paid, missed later premiums do not end the child’s 12-month continuous-coverage period under the May 2026 manual. Unpaid premiums can accumulate and renewal has separate requirements. Children under 6, in foster care and American Indian or Alaska Native children have premium exemptions.

Dates that change this

2026-03-01: Income lines are the DFCS table effective March 1, 2026.

2025-06-03: No CHIP waiting period anywhere since June 3, 2025; Georgia never had one.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 8, 2026.

What it is worth

Full child coverage for $11 to $36 a month (one child) or $16 to $72 (two or more), none under age 6. Most copays $2 or $3. Yearly family cost capped at 5% of income. Family-of-four line $6,929 ($6,792 published).

  • $6,792/month — Family of 4, published line
  • $6,929/month — Family of 4, line with the 5% allowance
  • $11/month — Premium, one child, lowest tier (134-158% FPL)
  • $36/month — Premium, one child, highest tier (232-247% FPL)
  • $16/month — Premium, two or more children, lowest tier
  • $72/month — Premium, two or more children, highest tier
  • $2–$3 — Most common copay

Covers: Doctor and hospital care · Prescriptions · Dental and vision · Behavioral health

What it costs the family: Premium $11 to $36 a month for one child, $16 to $72 for two or more, across 134% to 247% FPL. None under age 6, in foster care or for AI/AN children. Most copays $2 or $3. Yearly family cost capped at 5% of income.

The eligibility facts, as published

Age max
18
Income
over the Medicaid line for the child's age and under 247% FPL (+5% column)
Uninsured
yes
Not medicaid eligible
yes
Residency
Georgia

Decisions this site cannot make: Georgia DFCS/DCH PeachCare eligibility

Expect friction on: First premium must arrive before coverage starts · Georgia Families plan network

The trap: PeachCare pays nothing for months before the month your complete application and first premium arrive. Last month's admission is not covered by it (that is the spend-down item).

Where I read this

← Back to your options