Most Affordable Health Insurance Options In Georgia

Around 1.2 million people under 65, including 171,000 children, are uninsured across the state—this shortage of affordable options forces many to choose between high premiums or going without insurance altogether. In response, Georgia has introduced reforms to expand access to more affordable health plans.

This article reviews the available low-cost health insurance options in Georgia and examines recent efforts to improve access to coverage for residents.

Affordable Health Insurance Plans in Georgia

Various health insurance plans in Georgia cater to individuals, families, and small businesses with affordability in mind. Here are some options to consider for accessible coverage across the state:

1. Small Business Health Insurance Options (SHOP)

Georgia’s SHOP program offers affordable health insurance options for small business owners and business employees with 1 to 50 full-time equivalent employees. These plans vary in premium levels based on age and "metal" tier.

• Bronze Plans: The lowest-cost option, starting at $200.98 for enrollees up to age 20. For those aged 21, the premium is $220.13, and for age 40, it’s $281.33.
• Silver Plans: Offering more coverage with moderate premiums, starting at $249.08 for enrollees up to age 20. A 21-year-old pays $272.81, while a 40-year-old’s premium is $348.65.
• Gold Plans: Lower deductibles and broader coverage come with higher premiums, starting at $284.46 for enrollees up to age 20, $311.57 for age 21, and $398.18 for age 40.
• Platinum Plans: The most comprehensive and costly, with premiums starting at $306.00 for those up to age 20, increasing to $481.89 for age 21 and $615.86 for age 40.

2. Health Maintenance Organization (HMO) and Preferred Provider Organization (PPO) Plans

In addition to SHOP plans, Georgia residents can choose from HMO and PPO plans, each catering to different healthcare priorities.

• HMO Plans: Typically lower-cost, these plans offer reduced premiums but limit care to in-network providers. Members need a primary care physician for specialist referrals.
• PPO Plans: More flexible, allowing access to out-of-network providers at a higher cost. Referrals aren’t needed for specialist visits, making PPOs a good fit for those seeking more freedom in healthcare choices.

Short-Term Medical Insurance

Short-Term Medical Insurance offers a temporary option for Georgia residents, suitable for those between jobs, waiting for employer-sponsored coverage to start, or transitioning off a parent's plan. These plans generally come at a lower cost but provide more limited coverage than traditional health insurance.

Another option for Georgia residents is the HSA Plan, which saves them pre-tax dollars for healthcare expenses. Paired with a High Deductible Health Plan (HDHP), it combines lower premiums with higher deductibles.

HSA funds can be used for out-of-pocket costs, including deductibles, offering flexibility for those looking to manage their healthcare spending directly.

Most Affordable Health Insurance Providers in Georgia

Major providers now offer a range of options to suit various needs and financial situations. Here are some of the health insurance providers:

1. Kaiser Permanente

Kaiser Permanente offers some of Georgia's top health insurance plans, with Silver plans starting at $478 monthly. These plans provide extensive benefits and high ratings in customer service and healthcare quality.

2. Ambetter

Ambetter from Peach State Health Plan is among the most affordable options in Georgia, with Silver plans beginning at $358 per month. About 45% of the state’s residents choose Ambetter for its cost-effective coverage and essential benefits.

3. Oscar

Oscar provides the cheapest Silver plan in Atlanta, starting at $473 monthly. Its competitive pricing in metro areas appeals to city residents seeking comprehensive coverage with lower premiums.

4. Alliant Health Plans

Starting at $405 per month, Alliant Health Plans’ Silver-tier offerings include the only PPO plans in Georgia, offering flexibility in choosing providers both in- and out-of-network, suitable for those needing specialized care or traveling frequently.

5. Aetna

Aetna’s Silver-tier plans, starting at $429 per month, offer moderate premiums and broad availability across Georgia. Aetna suits families and individuals seeking wide coverage, although it has no ACA star rating.

6. Cigna

Cigna’s Silver plans start at $464 monthly, blending affordability with comprehensive benefits. Known for mental health and wellness support, Cigna is ideal for those focusing on preventive care.

Health Insurance Savings and Subsidies in Georgia

Georgia residents have several options to reduce health insurance costs, primarily through premium tax credits, cost-sharing reductions (CSRs), and Georgia pathway. These assistance programs lower the overall expenses of marketplace plans, offering more affordable options for individuals and families with low to moderate incomes.

1. Premium Tax Credits

The Affordable Care Act (ACA) offers premium tax credits to make health insurance more affordable. In Georgia, individuals with incomes between 100% and 400% of the federal poverty level (FPL) qualify for these credits, which reduce monthly premium costs.

Eligibility for premium tax credits in Georgia requires:

• An income between 100% and 400% of the FPL.
• Enrollment in a bronze, silver, gold, or platinum plan from the Health Insurance Marketplace.
• Ineligibility for government health programs like Medicaid, Medicare, or TRICARE.

Once approved, the Marketplace sends the credit directly to the insurance company, lowering the monthly premium.

2. Cost-Sharing Reductions

Some Georgia residents may also qualify for CSRs, which reduce out-of-pocket expenses like deductibles, copayments, and coinsurance. Eligibility for CSRs requires an income between 100% and 250% of the FPL and enrollment in a Silver-tier plan.

Georgia Pathways to Coverage

The Georgia Pathways to Coverage program extends Medicaid coverage to particular residents who don’t qualify for traditional Medicaid. It includes adults aged 19-64 with household incomes up to 100% of the FPL. For 2024, this income limit is $15,060 annually (about $1,255 per month) for an individual and $25,820 per year (around $2,151 monthly) for a family of three.

Eligibility for Georgia Pathways to Coverage requires that individuals:

• Are Georgia residents and U.S. citizens or legally residing non-citizens.
• Have a household income at or below 100% of the FPL.
• Complete at least 80 hours of qualifying activities monthly, such as work, job training, or education.

Children’s Health Insurance Options in Georgia

PeachCare for Kids, a key program in Georgia, provides affordable health insurance to uninsured children. As part of the State Children’s Health Insurance Program (S-CHIP), it aims to expand access to affordable healthcare for children in families who may not qualify for Medicaid but need support with insurance costs.

PeachCare for Kids

Established in 1998, PeachCare for Kids provides comprehensive healthcare coverage for uninsured children under 19 in Georgia, offering essential medical services at affordable rates.

Services covered under PeachCare for Kids include:

• Sick visits with a doctor
• Preventive care, like immunizations and check-ups
• Specialist consultations
• Dental care, including check-ups and treatments
• Vision care, including screenings and eyeglasses
• Hospital stays
• Emergency room visits
• Prescription medications
• Mental health services

This coverage ensures that children can access a wide range of medical care.

Costs of PeachCare for Kids

PeachCare for Kids offers affordable healthcare with low premiums and copayments. Starting in October 2024, the program will reinstate premium and copayment requirements for families. Copayments vary by service, typically from $0.50 to $12.50, with most around $2 or $3 per visit.

Exemptions apply to children under six, children in foster care, and American Indian or Alaskan Native children, who are not required to pay premiums or copayments.

Families will not pay more than 5% of their annual income on premiums or copayments. Once this limit is reached, no additional payments are required for the rest of the year.

Postpartum Care Benefits

PeachCare for Kids includes 12 months of postpartum care for mothers. Families can access this benefit by reporting the expected or actual delivery date through Georgia Gateway or by calling the designated service line.

Wrap Up

Georgia provides affordable health insurance options for individuals, families, and small businesses. Options range from SHOP plans for small businesses, HMO and PPO plans, short-term medical insurance, and HSA-compatible plans.

Major providers like Kaiser Permanente, Ambetter, Oscar, and Cigna offer competitive Silver-tier plans. At the same time, financial support is available through premium tax credits, cost-sharing reductions, and Georgia Pathways to Coverage.

Programs like PeachCare for Kids and postpartum care benefits help ensure children and mothers receive necessary healthcare at affordable costs.

FAQs on Health Insurance Options In Georgia

Is there affordable dental insurance in Georgia?

Yes, affordable dental insurance ranges from $15 to $102 monthly in Georgia.

What are the benefits of enrolling in a Silver plan in Georgia?

The benefits of enrolling in a Silver plan in Georgia include having a lower deductible, reduced copays or coinsurance payments, and a lower out-of-pocket maximum. These features help lower your healthcare costs, making the Silver plan more affordable for those who qualify.

Can undocumented immigrants get health insurance in Georgia?

Undocumented immigrants in Georgia cannot obtain full Medicaid benefits, as these are reserved for US citizens and legally residing non-citizens. However, undocumented immigrants can qualify for Medicaid coverage in emergencies, including labor and delivery services, provided they meet the necessary income requirements.