P4HB Eligibility

Georgia women who meet the eligibility requirements for the P4HB® program will be enrolled through the DCH enrollment process administered through the Georgia Department of Human Services. Point of service enrollment will not be utilized. Pregnant women enrolled in the Right from the Start (RSM) Medicaid Program will have facilitated enrollment into the P4HB program upon termination of their RSM eligibility. They must provide proof of continued income eligibility to DCH’s enrollment broker. Eligible members will be provided with a membership card that identifies their affiliation with the P4HB program.

Applications for enrollment are available on this website in English and Spanish and can be completed online or a PDF can be downloaded here (spanish), completed and mailed in.

Eligible P4HB women will be enrolled in one of three components of the P4HB family planning waiver program:

• Family Planning Only - family planning and family planning related services for eligible participants for the duration of the waiver.
• Inter-pregnancy Care - family planning and additional services for women who have delivered a VLBW (<1500 grams or 3.3 pounds) baby for a 24 months duration.
• Resource Mother Outreach – inclusive of a specially trained case manager to women on traditional Medicaid plans who have delivered a VLBW baby for a 24 months duration.

Enrollees must meet the following eligibility requirements:

• Be a U.S. citizen or person with qualified proof of citizenship
• Be a woman between the ages of 18 through 44
• Be able to become pregnant
• Be a Georgia resident
• Not be eligible for any other Medicaid program or managed care program
• Meet family gross income requirements of no more than 211 percent of the federal poverty level (FPL). See the chart below: 

If you meet the above requirements, you are eligible for the Family Planning component of the Planning for Healthy Babies (P4HB) Program. If you meet the above requirements and you have also delivered a VLBW baby (less than 1,500 grams) on or after January 1, 2011, you will qualify for the Interpregnancy Care (IPC) component of the P4HB program. If you currently receive Medicaid and delivered a VLBW baby on or after January 1, 2011, you will qualify for the Resource Mother component of the P4HB Program.

Women are eligible for the IPC/RM component for 2 years (24 months) from start of eligibility.