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Peachcare verification form 2026

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The document is an Income Verification Form for obtaining health benefits through PeachCare. It outlines the requirements for submitting proof of both earned and unearned income, including specific documentation needed for each family member. The form emphasizes the importance of providing accurate income information and includes a checklist to guide applicants on what papers to submit.

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Click ‘Get Form’ to open the peachcare verification form in the editor.
Begin by entering your Family Account Number at the top of the form. This is essential for processing your application.
In the 'Earned Income' section, list each family member's employment details. For each job, provide the employer's name and indicate whether you have included proof of income.
If applicable, fill out the 'Unearned Income' section by specifying any government assistance received. Ensure you check if proof of income is included.
Complete the 'Deductions' section by listing any relevant deductions such as alimony or student loan interest, and confirm that you have provided proof for these deductions.
Review all entries for accuracy and completeness before submitting. Remember to write your Family Account Number on all documents sent.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Is PeachCare for Kids and Peach State the same thing?

Peach State Health Plan (Peach State) is a health plan participating in Georgia Families (GF). It is a managed care program for Medicaid and PeachCare for Kids members. We offer our members local healthcare programs and services. Peach State Health Plan helps our members grow healthy and stay healthy.

What is the maximum amount you can make to qualify for Medicaid?

Explore these related articles, suggested for readers like you. Household size138% of the federal poverty level Individual $24,826 Family of 2 $33,562 Family of 3 $42,297 Family of 4 $51,0322 more rows

What is the monthly income limit for Medicaid in Georgia?

Have a household income of up to 100% of the Federal Poverty Level (FPL). For example, in 2025, this equals: $15,650 per year or $1,304 on average per month for one person. $26,650 per year or $2,220 on average per month for a family of three.

What is the maximum income to qualify for PeachCare in Georgia?

Income Verification Includes: All income information must be the most current or recent information. Employer Verification Form must be completed by the employer. Employer must list dates and amounts for four consecutive weeks or 1 month of paystubs.

What is income verification for Medicaid in Georgia?

Apply Visit Georgia Gateway online at .gateway.ga.gov. Click Apply for Benefits. Select Medical Assistance when asked for the type of application you want to submit. Follow the prompts to apply.

peachcare income limits 2022

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How much do you have to make to qualify for PeachCare in Georgia?

Requirements. PeachCare for Kids (PCK) provides health insurance for uninsured children under the age of 19 living in Georgia. These children are in families with incomes between 134 to 247 percent of the federal poverty limit.