Benefits & Services

CareSource covers services that are medically necessary. We also offer rewards and incentives for you. You can learn more here.

Some services have a small cost to you. This is called a copayment or copay. You’ll pay this at the health care office. They cannot deny treatment if you cannot pay. Learn more in your member handbook or call us.

Georgia Medicaid Member Copays

There are no copays for preventive care, family planning, emergencies or dialysis except as listed below:

/ServiceCopays and Exceptions
Ambulatory Surgery Centers/Birthing Centers$3 taken out of the surgical code billed. Only one $3 will be deducted each date of service for multiple surgical procedures.
Federally Qualified Health Center (FQHC)/Rural Health Clinic (RHC)$2
Outpatient service

$3 for all non-emergency hospital visits.

Inpatient services


You won’t have this copay if you were admitted or transferred from:

  • An ER
  • Urgent care
  • Another hospital
  • A skilled nursing facility
  • Other health facility
ER ServicesThere is a $3 copay if the condition is not an emergency health issue.

These Georgia Medicaid members do not have copays for covered care:

  • Under the age of 21
  • Pregnant women
  • Nursing facility residents
  • In hospice care (end-of-life care)
  • In the Breast and Cervical Cancer program
  • American Indian or Alaska Natives

PeachCare for Kids® Copays

PeachCare for Kids® members age six and over have a copay. These copays are no more than five percent of family income. Some are a set amount and some are cost-based. Cost-based means the copay depends on the cost of the care. They are listed below:

Ambulatory Surgery Centers/Birthing Centers$3
Durable medical equipment$2
Federally Qualified Health Centers$2
Free-Standing Rural Health Clinic$2
Home health services$3
Hospital-Based Rural Health Center$2
Inpatient services$12.50
Face or jaw surgeryCost-Based
Orthotics and prosthetics$3
Outpatient services$3
Pharmacy – preferred drugs$0.50
Pharmacy – non-preferred drugsCost-Based
Physician assistant servicesCost-Based
Physician servicesCost-Based
Foot careCost-Based
Eye careCost-Based

Cost-Based Copays

$10.00 or less$0.50
$10.01 to $25.00$1
$25.01 to $50.00$2
$50.01 or more$3

There are no copays for emergency services, preventive care (routine check-ups), shots (immunizations) or routine preventive and diagnostic dental services.

These PeachCare for Kids® members do not have copays for covered care:

  • Under age six
  • In end-of-life care
  • Nursing facility residents
  • Children in foster care
  • American Indian or Alaska Natives

If you have a questions, please see your Navigate member handbook or call us.

Member Services: 1-855-202-0729 (TTY: 1-800-255-0056 or 711), Monday – Friday 7 a.m. – 7 p.m.