Other Considerations

A Care Maintenance Organization (CMO) and a primary care physician must be selected for children eligible for PCK. This may be done after approval through Georgia Families®. If no CMO and primary care physician are selected, a CMO and physician will be assigned according to the area in which the child lives.

Any physician, medical practice, clinic or hospital that accepts Medicaid also accepts PCK.

PCK health benefits will not start until after the initial premium payment is received. A 45-day initial premium payment period will be given to new PCK applicants. A 30-day initial premium period will be given to PCK enrollees at renewal.

PCK enrollees will no longer lose coverage for non-payment of premiums after the initial premium payment is received for each new enrollment period, which includes the initial eligibility determination at application and annual renewals, due to continuous eligibility restrictions.

Monthly premium payments will still be accrued, and a quarterly statement will be sent to the customer. Premium payments are due 30 days before the first day of the month that enrollees receive PCK health benefits.

Premiums are calculated on a sliding scale based on household income, ranging from $11 to a family maximum of $72. The premium schedule for PCK is shown in the chart below.