Planning for Healthy Babies

We are excited to serve our Planning for Healthy Babies® (P4HB®) members throughout the state of Georgia.

Planning for Healthy Babies® is a program that provides family planning services at no cost. P4HB® consists of three programs:

  • Family Planning
  • Inter-pregnancy Care (IPC)
  • Resource Mother (Care Management)

Eligibility Requirements

The Department of Community Health sends you a letter to let you know if you’re eligible for P4HB®.

You are eligible for the Family Planning part of P4HB® if you:

  • Are a U.S. citizen or person with qualified proof of citizenship
  • Are a woman between the ages of 18 and 44
  • Are a Georgia resident
  • Are not eligible for any other Medicaid program or managed care program
  • Have family income of no more than 211 of the federal poverty level (FPL)

If you meet these requirements and delivered a very low birth rate (VLBW) baby (less than 3.3 lbs.) on or after January 1, 2011, you will qualify for the Inter-pregnancy Care (IPC) part of the P4HB® program.

If you get Medicaid and delivered a VLBW baby on or after January 1, 2011, you qualify for the Resource Mother part of the P4HB® program.

For more information, visit P4HB.

Family Planning

Family planning providers play an important role in your health care and in reducing the number of babies born with low birth weights. This is done through private preventive services, including:

  • Contraceptive services
  • Pelvic exams
  • Pregnancy testing
  • Screening for cervical and breast cancer
  • Screening for sexually transmitted diseases (STDs), including HIV
  • Basic fertility services
  • Health education
  • Referrals for other health and social services

Family Planning Providers

You do not need a referral to see a family planning provider. You can find a list of network family planning providers in the Find a Doctor/Provider tool. You may see a network or qualified out-of-network family planning provider for your care. This includes Georgia Association for Primary Health Care (GAPHC) providers like rural health clinics, local health departments, Federally Qualified Health Centers and free clinics. CareSource will cover in-network and qualified out-of-network family planning provider services.  For help choosing a family planning provider, call Member Services.

Low-Cost Primary Care Services

The Georgia Association for Primary Health Care helps people with little or no insurance get primary care.

This will help Planning for Healthy Babies® enrollees find low cost primary care services they might not have access to under their family planning health plan.

Visit the website to learn more.

Inter-pregnancy Care

Inter-pregnancy Care (IPC) members get all P4HB® Family Planning benefits plus these benefits:

  • Primary care services, up to five office/outpatient visits per calendar year
  • Limited dental services
  • Management and treatment of chronic diseases
  • Substance abuse treatment including detoxification and intensive outpatient rehabilitation
  • Prescription drugs (non-family planning) for the treatment of chronic conditions that may increase the risk of a another very low birth rate (VLBW) delivery
  • Non-emergency transportation

Women who receive Medicaid and give birth to a very low birth weight (VLBW) baby (a baby weighing less than 3 pounds, 5 ounces) are eligible for Resource Mother services.

This includes case management and help with personal and social problems. It also includes help with social services.

For a full list of benefits, contact Member Services.

Transportation

Family Planning and IPC members can use transportation benefits. Family Planning members can get up to 6 round trip visits per year for covered services. 

Redetermination

 You must show you still qualify for P4HB® services, called redetermination, at least every 12 months. You will get a note from DCH before the renewal deadline. The date is based on the following:

  • New members – 12 months from the original date of eligibility
  • Existing members – 12 months from the last redetermination date

You must confirm your income when you renew. You can use pay stubs to do this. Pay stubs must be less than 90 days from the renewal deadline.

For more information, visit the P4HB website or call 1-877-744-2101 or 1-877-427-3224.

You can also call CareSource Member Services.

Disenrollment

Women who no longer eligible will be disenrolled from the P4HB® program. These include women who:

  • Become pregnant
  • Receive a sterilization procedure and complete all necessary follow-up
  • Move out of the state
  • Become incarcerated
  • Change income status
  • Become unable to become pregnant
  • Are no longer between the ages of 18-44

You can call Member Services to ask for disenrollment or check the status of your request. Questions? Refer to your member handbook or call Member Services.

Member Services:  1-855-202-0729 (TTY: 1-800-255-0056 or 711).