Premium Scheduled by FPL
FPL One Child Family Cap 134 - 158% $11.00 $16.00 159 - 170% $22.00 $44.00 171 - 190% $24.00 $49.00 191 - 210% $29.00 $58.00 211 - 231% $32.00 $64.00 232 - 247% $36.00 $72.00
No premium or co-payment is charged for children under age six (6), children in Foster Care or American Indians and Alaskan Natives (AI/AN).
ELE PCK premium(s) is as follows: 236%-247%, $36.00 for 1 child; $72.00 for 2 or more children. Refer to Section 2069 - Express Lane Eligibility (ELE) . PCK customers are required to pay co-payments for their child(ren). These co-payments are paid to medical care providers on the date medical services are received. However, children under the age of six (6), in Foster Care, American Indian or Alaskan Native are exempt from these co-payments and will not have to pay any fees for services received.
Applicants may apply for PCK the following ways:
Online at gateway.ga.gov
By phone at 1-877-427-3224 or 1-877-423-4745 and follow the prompts
Submit an application in person at a local DFCS or RSM Office by requesting an application for Medical Assistance or by downloading, printing, and completing an application found online at dch.georgia.gov/applications-0 and submitting it in person.
A completed and signed application can be mailed to: RSM P.O. Box 786 Alma, Georgia 31510
How to submit PeachCare for Kids® premium payments.
By internet: gateway.ga.gov
By phone: 1-877 GA PEACH (427-3224) to make a payment anytime.
By mail: PeachCare for Kids® Payment P.O. Box 44031 Jacksonville, FL 32231
Important: The case number should be included on the check or money order.
Initial Premium Payments mailed to another address or not received on time may delay receiving health benefits.
A single Coupon Slip will be sent to the client when their child(ren) becomes PeachCare for Kids® eligible. After that, coupons are sent based upon the client’s request and can be requested through Gateway on the CHIP Triage Center Case Information Search/Summary page. Also, if the client mails in premium payments consistently in a year, they will automatically receive a coupon book for the next year.