Your options for health insurance in Georgia have changed since the Affordable Care Act (ACA) became law. All health insurance plans offered through the Georgia health insurance marketplace must be ACA approved and purchased through the government website Healthcare.gov.

As with all states, you can only sign up for ACA health insurance during the annual Open Enrollment Period. In Georgia, OEP for 2020 starts on November 1st and ends on December 15th, 2019.

There are exceptions when you can apply if you have a qualifying event such as losing insurance through an employer, having a baby, or other life changing events.

Georgia residents affected by Hurricane Michael also were granted a Special Enrollment Period until February 20th to apply for health insurance.

When purchasing a health plan online on the Georgia marketplace, you have different options from a variety of healthcare providers available in the state.

This is important, since everyone has different needs (and budget) when it comes to their health.

Depending on your budget, you can adjust your deductible, coinsurance, and copay to a level that works for you.

As you’ll see, not all insurance providers and plans are available in all counties, and premium prices may be more expensive depending on your specific location.

Health insurance plans in Georgia that comply with the Affordable Care Act can be expensive. The average price for a single adult age 40 on a Silver plan in Georgia is $590 per month.

For a family of three it costs around $1,887 each month.

Depending on which county you live in, your monthly rates could be even higher. This is partly because the coverage is comprehensive and must include things like maternity benefits, prescription drugs, and mental health services.

Medical expenses for pre-existing conditions are also covered, which means that no one can be denied insurance based on their health.

Because not everyone can afford to pay these premiums, there are government programs known as subsidies to help offset the costs.

If you’re looking for cheaper monthly payments and do not qualify for a subsidy, you can look into a plan with a high deductible.

In some counties, people who are under the age of 30 can get a Catasphrophic level health plan which has the lowest premiums, but also covers less.

For example, you would have to pay more out of pocket on medical expenses with a Catasphrophic plan before receiving any of the benefits.

This can be to your advantage if you are in good health, however, since the plans have significantly lower monthly premiums than other ACA options. The average cost for a 21 year old on a Catasphrophic is $167 per month in Georgia, compared to $363 for the Platinum plan - although this can vary depending on the county.

Age is one of the biggest factors which determines the price for health insurance, as well as your county, tobacco use, and the number of people on the policy. Another factor that affects your monthly rate is the type of plan you choose. In Georgia the following kinds of health insurance plans are available through the marketplace:

• HMO: Health Maintenance Organization
• POS: Point of Service
• PPO: Preferred Provider Organization
• EPO: Exclusive Provider Organization

The kind of plan you choose will determine which doctors and hospitals are available in your network that will be covered by the insurance company.

HMOs tend to have the cheapest monthly rates, although they can be more restrictive in the choice of providers.

PPOs have more flexibility in where you can receive medical services, although the monthly premiums are higher than other plans.

If you missed the open enrollment period and do not qualify for a special enrollment, there is an additional, temporary option available in Georgia: short term medical plans (STM).

If you’re not familiar with short term medical insurance, here’s a brief overview of what it is and how it can work for you.

STM plans are a temporary alternative to the insurance plans you can buy on the Georgia marketplace. They’re helpful for people who missed the window to sign up for an ACA plan, were dropped from an employer (or parents’) plan, or are retired and waiting for Medicare benefits to start because they cover the basics: unforeseen accidents, illnesses, and hospital visits. Some have coverage up to a million dollars.

Short term medical insurance is also referred to as “gap coverage” since it can cover you until the next open enrollment period begins and you can apply for ACA insurance.

Unlike ACA plans, you can purchase an individual or family short term medical insurance plan in Georgia at any time on Agile Health Insurance.

There are some changes within the STM industry recently that are worth noting. Starting in 2019 there is no longer a tax penalty for having short term insurance.

You can now purchase a short term plan in the state of Georgia for up to 364 days, and also obtain back-to-back policies for up to 36 months. Each policy constitutes a new term, and so you will have to reapply and can be denied.

Before committing to a short term plan however, it’s very important to have a full understanding of what the insurance does (and does not) cover.

Short term medical plans are a basic and more limited form of health insurance. They help provide a layer of financial protection for unforeseen accidents and illnesses, but are not the same as comprehensive health insurance.

Short term medical plans offer streamlined benefits, and do not cover certain areas of medical expenses. In particular: maternity, prescription drugs, and mental health services.

Pre-existing conditions are also not covered by most STM plans, although you can purchase a supplemental waiver if you need to have something included.

Since pre-existing conditions are not factored into the plan, the monthly premium are way less expensive than ACA insurance, which is one of the biggest distinctions with STM.

There are also less benefits included, which contributes to the lower monthly premiums.

In a typical short term plan, medical expenses related to pre-existing conditions would not be covered. This does not apply for new conditions that develop while you have an STM plan - these would be covered for the length of the term.

With most short term plans in Georgia, when you apply for a new policy, the underwriting process would determine that the new conditions would no longer be covered because they have now gone from “new” to “pre-existing”.

To avoid these situations you can buy a “pre-ex waiver” which provides coverage for certain conditions.

For many people in Georgia who need health insurance, short-term plans are a great way to have affordable protection in case of accidents and illnesses.

Depending on your situation however, a short-term plan may not be right for you. If saving money on health insurance is important to you and your family, it’s certainly an option certainly worth exploring.

Medicaid is a government run health insurance program that provides free or low-cost health coverage for people with low income or disabilities. There are more than 2 million Americans receiving Medicaid benefits in Georgia.

To qualify for Medicaid, you must have an income of less than 138% of the Federal Poverty Level (FPL).

This means that in 2018 your income must be less than $16,753 as a single individual be eligible for Medicaid.

For a family of four, the limit is $34,638 (based on figures for 2018). You can apply for Medicaid at any time online or in person at the state Medicaid agency.

If you do not qualify for Medicaid, you may still be able to get financial assistance through a local hospital program.

If you fall between 100% and 400% of the Federal Poverty Level you can qualify for a government subsidy for an ACA health plan.

There are also non-profit clinics known as Community Health Centers (CHC) which are designed to serve those who are uninsured or underinsured.

Georgia Health Facts:

1. 49 percent of Georgians with health insurance in 2017 obtained it through their employers.
2. 13.4 percent of people living in Georgia do not have health insurance coverage.
3. Average life expectancy in Georgia is 73.5 years.
4. More than 460,000 people enrolled in ACA plans for 2019 during open enrollment, a drop of more than 20k from 2018.

Health insurance plans in Georgia (and across the country) have become more expensive since Obamacare plans were first introduced.

For 2019 the average price for health insurance premiums in Georgia rose 4%, which is actually one of the lowest increases in the nation.

According to recent data, in 2018, a 40 year old non smoker in Georgia would pay on average of $440 a month for an ACA SIlver plan without a government subsidy. In 2018 it would have cost $421. In 2018 the national average cost of an individual ACA plan was $440 per month, and over $2300 for a family of four.

The Milliman Medical Index found that the average national cost of health insurance for a family of four is now over $28,000 per year.

To help make it more affordable, some people in Georgia rely on government subsidies as well as other programs to help with medical expenses. The subsidy amount can range from around $140-479 per month depending on your age, income, and county.

For example, in Georgia a 40 year old non smoker making $30,000 a year in 2019 is eligible for a $233 advanced premium tax credit per month to pay for health insurance.

In fact, 89.4% of people in Georgia who enrolled for an ACA plan in 2016 were eligible for federal subsidies. Unfortunately though, ACA plans are still out of reach for many individuals and families, especially tho

No matter what condition you’re in, it’s always financially responsible to have some kind of health insurance, but the right kind of health insurance for you depends on your specific life situation.

The most comprehensive health insurance for the money may be through your job so be sure to ask your employer what’s available.

For those whose employers don’t offer those benefits, uninsured individuals and families with chronic conditions, ACA plans through the Georgia health exchange marketplace may be your best option.

You may end up paying more monthly, but at least all your conditions will be covered. If the out of pocket costs of those policies are too expensive for your budget or you are outside the 2019 open enrollment period, look into ways to help with the cost such as the government subsidies available and/or Medicaid programs.

If you have a clean bill of health and only want to be covered in case of unforeseen accidents and illnesses, consider purchasing short term insurance.

There are many short term plans available in Georgia that can work for certain situations like if you are between jobs, or just need temporary health insurance coverage to bridge the gap until the next Open Enrollment Period.