Is Amerigroup Medicaid?

If you’re wondering ‘is Amerigroup Medicaid,’ the answer is direct: Amerigroup is a provider of Medicaid health plans, partnering with state Medicaid programs to deliver comprehensive healthcare services to eligible individuals.

In this article, we’ll explore how Amerigroup Medicaid works, from the services offered to the enrollment process.


Key Takeaways

  • Amerigroup is a health insurance provider that offers Medicaid coverage in collaboration with local healthcare providers and community organizations, incorporating a wide range of services and personal health care programs.


  • Eligibility for Amerigroup Medicaid varies by state but generally includes low-income families, pregnant women, children, and people with disabilities; the enrollment process is open year-round and can be initiated online or via phone.


  • Amerigroup Medicaid provides comprehensive health coverage that includes preventive care, wellness checks, chronic condition management programs, and additional benefits such as vision and dental services.

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Amerigroup and Medicaid- An Overview

Medicaid is a vital support system in the health coverage landscape, offering indispensable services like doctor visits, hospital stays, and pregnancy care to low-income individuals and families. But how does Amerigroup fit into this picture?

Born as AMERICAID Community Care in 1994, Amerigroup came to life with a primary focus on addressing the healthcare requirements of children, mothers, and pregnant women enrolled in Medicaid, ensuring low cost health coverage.

Today, Amerigroup partners with local healthcare providers and community organizations, delivering Medicaid coverage to eligible individuals and offering a plethora of services.

What is Medicaid?

Medicaid, a government-funded health insurance program, is engineered to offer affordable health coverage to low-income individuals and families. It’s a lifeline that ensures that even the most vulnerable among us have access to essential health care.

Medicaid insurance is not just about providing doctor visits or hospital stays; it’s a comprehensive health plan aimed at keeping communities healthy and reducing the financial burden of health care.

Amerigroup Community Care is a shining example of a health insurance plan that caters to individuals enrolled in Medicaid. By collaborating with local healthcare providers and community organizations, Amerigroup ensures the provision of essential care. The goal is to keep you healthy, so it’s important to be aware of the Medicaid renewal process to maintain continuous coverage.


How Does Amerigroup Fit In?

As a health insurance plan that caters to individuals enrolled in Medicaid, Amerigroup serves a critical role in the Medicaid program. Amerigroup’s mission is to enhance the Medicaid program by:


  • Simplifying healthcare for its recipients
  • Providing personal health care programs
  • Integrating a variety of healthcare services
  • Supporting independent living for older adults and people with disabilities


All this, including getting a free flu shot, is aimed at helping members stay healthy and ensuring healthy babies.

Amerigroup’s Medicare-Medicaid plans (MMPs) are a sterling example of how the organization enhances the Medicaid program. These plans provide coverage for doctor visits, hospital stays, pregnancy care, labs, and X-rays. Moreover, they frequently provide supplementary benefits such as prescriptions, vision, dental, and over-the-counter items, all designed to benefit Amerigroup members.


The Scope of Amerigroup’s Health Plans

The health plans of Amerigroup extend beyond simply serving Medicaid beneficiaries. They offer a plethora of health coverage options that encompass doctor visits, hospital stays, pregnancy care, labs, and X-rays.


Is amerigroup medicaid or medicare



Additionally, they offer Medicare insurance plans, including Med Supp, Medicare Advantage, and Part D Prescription Drug plans.

Their Medicare-Medicaid plans (MMPs) and Medicare Advantage plans are tailored to meet diverse healthcare needs. They frequently provide supplementary benefits such as prescriptions, vision, dental, and over-the-counter items. This versatility is a testament to Amerigroup’s commitment to addressing individual healthcare needs.

They offer specialty programs such as the Enhanced Personal Health Care Program, which assists primary care physicians in delivering comprehensive care. Additionally, they prioritize a member-centric care coordination approach that is customized to the specific needs of each individual.

Enrollment and Eligibility

While Medicaid eligibility varies by state, it generally includes low-income families, qualified pregnant women and children, and specific other groups. The number of individuals in a household, also known as household size, significantly impacts Medicaid eligibility.

This is because dependents included in the tax return are taken into consideration when assessing eligibility based on family size. And yes, legal non-citizens who meet the eligibility criteria for non-citizens can obtain coverage through Medicaid and Amerigroup Medicaid.

Once you determine your eligibility, the next step is enrollment. Enrolling in Amerigroup Medicaid involves the following steps:


  1. Confirming eligibility based on income and other criteria
  2. Contacting the Amerigroup enrollment number
  3. Submitting the application along with the required documents, which may vary by state.


Do You Qualify for Medicaid?

Medicaid eligibility hinges on several factors such as income, family size, age, and disability status. The income threshold for Medicaid eligibility differs by state. For children, it generally commences at 133% of the federal poverty level (FPL) and may be higher in certain states based on the family size.

Age can indeed have an impact on Medicaid eligibility. Individuals who are 65 years old or older may be eligible for Medicaid, typically based on low income or if they are receiving Supplemental Security Income (SSI).

Individuals with disabilities must:


  • Have been eligible for an SSI cash payment for at least one month
  • Continue to meet Medicaid’s disability standards
  • Fulfill all other eligibility criteria to qualify for Medicaid.


Steps to Enroll in Amerigroup Medicaid

The process of enrolling in Amerigroup Medicaid doesn’t need to be intimidating. It can be initiated by contacting the enrollment number designated for your state. Online enrollment is also available by specifying Amerigroup as the preferred managed care plan. In order to enroll, it is necessary to have proof of residency, proof of income or assets, and, if available, your Social Security card.


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The beauty of Amerigroup Medicaid is that enrollment is open year-round, and eligible individuals can commence receiving benefits immediately. This means you don’t have to wait for a specific period to apply for coverage, and once you’re enrolled, you can start taking advantage of the incredible health benefits that Amerigroup Medicaid offers.

Health Benefits Under Amerigroup Medicaid

A comprehensive array of health benefits is provided by Amerigroup Medicaid. These include specific tests aimed at early disease detection, regular wellness examinations, and vaccinations, all designed to promote the well-being of individuals and their families.

Amerigroup also facilitates the management of chronic conditions through disease management programs tailored to the specific needs of the member. These programs offer resources and education on areas like weight management and smoking cessation to effectively address ongoing health issues.


The holistic approach to health care extends to mental health as well. Amerigroup Medicaid provides coverage for mental health services, including therapy, to ensure that members have access to the essential care for their mental well-being.


Preventive Care and Wellness

Preventive care sits at the heart of the Amerigroup Medicaid plan. Amerigroup provides coverage for:


  • Routine health check-ups, ensuring that members stay ahead of potential health issues
  • Tests for early disease detection
  • Routine wellness exams
  • Shots without prior authorization


Amerigroup promotes preventive care among its members to support them in maintaining good health.

In addition to these services, Amerigroup Medicaid provides support for promoting healthy living through:


  • Complimentary wellness checkups
  • Transportation to doctor visits
  • Weight-management programs
  • A yearly allocation of over $200 for wellness-related expenses for qualifying members


This dedication to preventive care and wellness speaks volumes about Amerigroup’s same commitment to keeping its members healthy.


Amerigroup medicaid benefits



Managing Chronic Conditions

While living with a chronic condition can pose challenges, managing these conditions becomes more manageable with Amerigroup Medicaid. Amerigroup Medicaid provides coverage for chronic conditions including:


  • Asthma
  • Bipolar disorder
  • Chronic obstructive pulmonary disorder (COPD)
  • Congestive heart failure (CHF)
  • Coronary artery disease (CAD)
  • Diabetes


To assist with managing these conditions, Amerigroup offers the following programs and services:


  • Disease Management (DM) programs
  • Condition Care (CNDC) programs
  • Chronic conditions special needs plan (C-SNP) for individuals with diabetes, heart conditions, and end stage renal disease
  • Specialty pharmacies tailored to support and provide services for individuals with complex or chronic conditions


The medication for chronic conditions can be acquired from a designated pharmacy that is affiliated with Amerigroup Medicaid’s network.

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Extra Benefits and Member Services

Amerigroup Medicaid provides additional benefits that deviate from the standard coverage of Medicaid plans, including:


  • Annual vision exams and provision of glasses
  • Biannual dental exams
  • Participation in the Essential/Everyday Extras program
  • Complimentary over-the-counter medicine for its members


Members who are 21 and older can access the supplementary dental care benefits by scheduling exams and cleanings every six months.

In addition to these extra benefits, Amerigroup offers distinctive services to its members, including:


  • Resources for mental health challenges
  • Wellness checkups
  • Round-trip rides to doctor visits
  • Weight-management programs


All without any additional cost. These member services offer various health maintenance benefits, such as Managed Long-Term Services and Supports (MLTSS), after-hours and emergency coverage, and additional extras like vision care, to ensure that members receive the essential care and support they need.


Beyond Basic Coverage

Beyond the standard coverage, Amerigroup Medicaid offers supplementary benefits including dental and vision care services for Georgia families. Dental coverage under Amerigroup Medicaid is administered by DentaQuest and encompasses eligible individuals, including men, women, and children, who are members of Georgia Medicaid.


Amerigroup medicaid card



Vision coverage is another significant benefit of Amerigroup Medicaid. It encompasses an examination and annual dispensing of spectacle frames and lens materials necessary for correcting visual acuity. This coverage is accessible once every 366 days, although refractions and routine eye exams are not included.

These extra benefits ensure that members have access to comprehensive health care beyond just the basics.


Support When You Need It

Navigating healthcare can be perplexing, yet with Amerigroup Medicaid, you’re always supported. Amerigroup provides live chat services enabling members to engage in real-time communication with a representative after logging in to their account.

For private communication with doctors or medical staff, secure messaging is available to members upon logging into their account. These services are accessible during the hours of 7 a.m. to 7 p.m. from Monday to Friday, ensuring that members can get the help they need when they need it.

A variety of channels are available for Amerigroup members to access support services, such as the Community Resource Link online tool, direct contact with Amerigroup, or the mobile app. These resources are designed to make healthcare more accessible and manageable for every member.

Technology for Easy Access

In the digital era we live in today, managing your health coverage should be as simple as a button tap. And with Amerigroup, it is. The Amerigroup Mobile App provides a range of functionalities including:


  • Locating a healthcare provider
  • Verifying benefits
  • Accessing account information
  • Overseeing health plan details
  • Viewing the digital ID card


The app is available for iPhone, iPad, and iPod touch, and requires iOS 9.0 or later, ensuring accessibility to a broad spectrum of iOS users.

The Amerigroup online member portal offers important functionalities including:


  • Account creation
  • Member ID card requests
  • Healthcare provider search
  • Prescription management
  • Communication with Member Services


Security is a top priority, as the portal employs 128-bit and SSL encryption to guarantee the secure transmission of personal and sensitive information.


Amerigroup Mobile App

The Amerigroup mobile app serves as a potent tool, permitting members to conveniently manage their health plans from their mobile devices. The app incorporates recommended security measures such as password protection and encryption for mobile devices.


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Downloading and setting up the Amerigroup mobile app is straightforward. Here are the steps to follow:


  1. Visit the Amerigroup website or your device’s app store.
  2. Search for ‘Amerigroup mobile app’.
  3. Follow the installation instructions.
  4. Log in with your Amerigroup account details to fully set up the app on your device.


What’s even better is that there are no expenses for Amerigroup members to download or utilize the Amerigroup mobile app.


Online Member Portal

The Amerigroup online member portal offers an intuitive platform for managing your health plan. The portal provides features such as:


  • Secure and convenient login
  • Provider search
  • Access to benefits and coverage details
  • Claim tracking
  • Prescription management
  • Communication preference settings


Members can use the Amerigroup online member portal to:


  • Oversee their account details
  • Locate healthcare providers
  • Search for complimentary and affordable services
  • Access and print their member ID cards
  • Oversee prescriptions


The portal is equipped with suitable privacy and security measures to safeguard personal health information, so you can manage your health coverage with peace of mind.

Transitioning From Medicaid

Switching from Medicaid to another health insurance might seem intricate, yet with appropriate guidance, the transition can be seamless. When transitioning from Amerigroup Medicaid, it is advisable to:


  1. Complete the application process for the new plan.
  2. If eligible for a Special Enrollment Period, take advantage of this to enroll outside of the usual open enrollment period.
  3. During the transition, individuals will encounter alterations in their health insurance coverage. Therefore, it is crucial to acquaint oneself with the new insurance choices and comprehend the adjustments in benefits and potential expenses.


If you no longer qualify for Medicaid, it is crucial to refrain from canceling your Marketplace plan until you have verified your Medicaid or CHIP eligibility. In the event that you are determined to be ineligible for Medicaid, your coverage will be smoothly transferred to the new insurance plan, ensuring continuity without any gaps in coverage.


When You No Longer Qualify

Several factors could lead to a loss of Medicaid eligibility, including an increase in income, administrative issues like not maintaining an updated address, and age limits, like when a child turns 19 years old.


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However, if you no longer meet the criteria for Medicaid, you may still be eligible for alternative programs such as the Children’s Health Insurance Program (CHIP), or you may utilize a special enrollment period to register for other health insurance options, such as an employer’s plan or the Affordable Care Act marketplace.

Amerigroup assists individuals who are no longer qualified for Medicaid by offering guidance on the necessity to renew coverage procedures, including Medicaid renewals. They clarify that Medicaid or CHIP coverage will not be automatically renewed, and aid dual-eligible members in accessing simplified care and coverage options.


Exploring Other Coverage Options

When considering alternative health coverage options, it’s important to factor in elements like affordability, reduced premiums, and the broad scope of alternative medical practices. These include alternative medical systems, mind-body interventions, biologically-based treatments, and manipulative therapies.

Making the right choice in health coverage can significantly impact your health and financial well-being. Therefore, it is important to carefully explore all available options and choose the one that best fits your needs and budget.

Remember, though the journey might seem complex, with the right information and guidance, you can successfully navigate the path to optimal health coverage.


Navigating the health coverage terrain, especially Medicaid, can be a daunting task. But with health plan providers like Amerigroup, this process is simplified. Whether you’re just getting started with Medicaid, looking to enroll in Amerigroup, managing chronic conditions, transitioning from Medicaid, or exploring other coverage options, it’s important to understand the benefits and services at your disposal.

Remember, the goal of health coverage is not just about visiting the doctor when you’re sick, but maintaining overall health and wellness. So, take charge of your health coverage, and embrace a healthier tomorrow.

Frequently Asked Questions



What are the different types of Medicaid in Georgia?

In Georgia, Medicaid offers benefits through Fee-for-Service (FFS) or managed care plans. The FFS model involves direct payment to providers, while managed care plans receive a fee for each enrolled person.


→  Is amerigroup Medicaid in georgia?

Yes, Amerigroup offers Medicaid coverage in Georgia, providing additional benefits for Georgia Families and PeachCare for Kids members. These additional benefits include vision and dental exams.


→  What type of insurance is Amerigroup Maryland?

Amerigroup Maryland is a Medicaid managed care provider that has rebranded as Wellpoint.


→  What are the Medicaid options in DC?

In DC, eligible residents can access medical coverage through Medicaid, Alliance, and DC Healthy Families programs, with additional help for paying medical bills in the last 3 months (Retro Medicaid).

There are also 3 Managed Care Plans (MCPs) available for the DC Healthy Families Program, the DC Health Care Alliance, and the Immigrants Children’s Program.


What is Medicaid, and how does Amerigroup fit into it?

Amerigroup is a health plan provider that offers Medicaid coverage to eligible low-income individuals and families by partnering with local healthcare providers and community organizations.

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Russell Noga
( Medicare Expert )

Russell Noga is the CEO of ZRN Health & Financial Services, and head content editor of several Medicare insurance online publications. He has over 15 years of experience as a licensed Medicare insurance broker helping Medicare beneficiaries learn about Medicare, Medicare Advantage Plans, Medigap insurance, and Medicare Part D prescription drug plans.