Obamacare, officially known as the Affordable Care Act (ACA), has a significant impact on healthcare in Georgia. This comprehensive guide provides essential information about Obamacare in Georgia, covering topics such as eligibility, enrollment, subsidies, coverage options, and key considerations for residents seeking health insurance under the ACA.

Overview of Obamacare (Affordable Care Act)

The Affordable Care Act (ACA), often referred to as Obamacare, is a landmark healthcare reform law enacted in 2010. It was designed to make healthcare more accessible and affordable for millions of Americans. The ACA introduced several key provisions, including the expansion of Medicaid, the creation of health insurance marketplaces (also known as exchanges), the requirement for most individuals to have health insurance (the individual mandate, which has since been eliminated), and protections for individuals with pre-existing conditions.

One of the most significant aspects of the ACA is the availability of subsidies that help lower-income individuals and families afford health insurance coverage through the marketplace. These subsidies are designed to reduce monthly premium costs and out-of-pocket expenses, making healthcare more affordable for those who qualify.

For more information on various aspects of the ACA, including eligibility, enrollment, and coverage options, please explore our comprehensive ACA articles.

Healthcare Marketplace in Georgia

The healthcare marketplace in Georgia is a mix of public and private insurance options, primarily facilitated through the federal platform Healthcare.gov. Notably, Georgia had not expanded Medicaid under the Affordable Care Act (ACA). This decision impacted access to Medicaid benefits for low-income individuals and families. The state has faced challenges related to healthcare access and affordability, particularly in rural areas. While Georgia has explored initiatives to address these issues, it’s essential to stay updated on the evolving healthcare landscape and policy changes within the state.

Finding Affordable Health Insurance in Georgia

1. Assess your personal needs: Think about the coverage you have received in the past and think about the healthcare services that you may plan on receiving in the coming year. Ask yourself if you need Rx coverage and if you have a doctor you like. These questions may affect which kind of plan you choose.
2. Research available options in your Georgia:  Compare the available Obamacare in Georgia plans, short-term plans, and other alternatives online. A great place to start is on eHealth.com.
3. Understand which options you can qualify for: You can enroll in any Obamacare plan during open enrollment. When it comes to short-term health insurance or other alternatives to major medical plans, you can generally apply online at anytime. However, unlike Obamacare plans, when applying for short-term plans and other alternatives you may be declined coverage and such short-term plans and alternatives typically provide much less coverage than Obamacare plans (for example, excluding pre-existing conditions, preventive care, and essential benefits under Obamacare).
4. See if you qualify for discounts: Depending on what your yearly salary is in comparison to the Federal Poverty Line, you may qualify for tax credits or extra savings thanks to the ACA. These subsidies can save you hundreds and sometimes thousands of dollars on your monthly premiums and out-of-pocket expenses.
5. Make sure your prescriptions are covered: eHealth.com provides a prescription drug coverage comparison tool that helps you find the plan that covers your drugs with the lowest out-of-pocket cost.
6. Make sure your doctor is covered: Finding a doctor you like and who meets your health care needs can be difficult. But making sure your preferred physician is in-network doesn’t have to be. eHealth has a physician finder tool that lets you compare plans that cover your preferred doctor.
7. Enroll online: You can easily enroll in a health insurance plan online with eHealth, and may even be able to check if you qualify for an ACA subsidy.

The cost of health insurance in Georgia can vary a great deal for several reasons. Costs also change year by year, so it’s best to look for the most recent and up-to-date information. Otherwise, you can window shop and run price comparisons to see what today’s health insurance offerings look like.

The average cost of health insurance in Georgia is $585 per person, but the cost of health insurance can vary depending on several things, such as:

• Age
• Location
• Tobacco usage
• Plan type and tier
• Number of people in plan

Affordable Care Act plans have a tiered system. Four tiers of coverage include bronze, silver, gold, and platinum. The Kaiser Family Foundation (KFF) and eHealth estimated an average premium cost of $456 per month for a 40-year-old purchasing a benchmark “Silver” plan for 2021 coverage. This cost is without a tax credit or subsidy.

Some Obamacare in Georgia plans can come with a subsidy which can drastically reduce costs for qualifying Georgians. Other plans may have a lower cost depending on someone’s status, such as with student health insurance.

Medicaid in Georgia

Medicaid in Georgia provides healthcare coverage for eligible low-income individuals and families, offering essential services such as doctor visits, hospital care, prescription drugs, and more. To qualify for Medicaid in Georgia, you must meet specific income and other criteria set by the state.

Medicare in Georgia

Medicare in Georgia provides health coverage to eligible seniors and individuals with disabilities. It consists of several parts, including hospital insurance (Part A) and medical insurance (Part B). Beneficiaries may also choose to enroll in Medicare Advantage (Part C) or prescription drug coverage (Part D) plans offered by private insurers. Understanding the various options and enrollment requirements is essential for accessing the healthcare services you need in Georgia.

Open Enrollment Period in Georgia

Georgia uses the federally managed health insurance exchange, so enrollment in an ACA-compliant (Obamacare) plan may be performed via Healthcare.gov or via a health insurance broker like eHealth.

During the Georgia Open Enrollment period, you may purchase health insurance regardless of your health condition. Depending upon your income, you may also be eligible for tax credits to reduce your monthly premium costs. The 2022 open enrollment dates in Georgia start on November 1, 2022 and end on January 15, 2023. If you want your coverage to start on January 1, then you must enroll in a health insurance plan before the end of the year. Continue reading to learn more about open enrollment dates in Georgia and how to apply.

How Can I Enroll?

To enroll in health insurance through the Georgia healthcare marketplace with ease and efficiency, consider using the services of eHealth. By visiting our platform, you can effortlessly create an account, complete your application, and explore the available insurance plans. We provide a user-friendly experience tailored to your needs. It’s crucial to be aware of the open enrollment dates, as this is the primary window for signing up for coverage. Additionally, individuals may qualify for special enrollment periods if they experience certain life events, such as marriage, the birth of a child, or the loss of other coverage. For detailed enrollment guidance and to explore plan options specific to Georgia, visit eHealth or seek assistance from our certified enrollment assisters or insurance brokers. We’re here to make the process simple and convenient for you.

 Healthcare Coverage Options

For the first time in several years, Georgians in rural areas will likely find more choice in health insurance policies available through the Georgia marketplace. As of 2023, there are 9 insurers that participate in the Georgia marketplace.

Some of the insurance companies participating in Georgia’s marketplace include:

• Alliant
• Ambetter from Peach State Health Plan (Centene)
• Blue Cross Blue Shield Healthcare Plan of Georgia
• Kaiser
• Oscar
• CareSource
• Aetna/CVS
• UnitedHealthcare
• Cigna

However, you aren’t limited to just Georgia marketplace health insurance. If you anticipate your 2023 income will be too high to qualify for tax credit or subsidy or you aren’t interested in the comprehensive coverage offered by ACA-compliant plans on the exchange, you may want to explore other coverage options from Georgia insurers.

Essential Benefits

In Georgia, as in other states, health insurance plans offered through the Health Insurance Marketplace are required to cover essential health benefits. These essential benefits ensure that individuals and families have access to a range of necessary medical services and treatments. Some of the essential benefits you can typically expect in health insurance plans in Georgia include:

• Ambulatory Patient Services: This covers outpatient care, including doctor’s office visits and outpatient surgeries.
• Emergency Services: Coverage for emergency medical care, which includes services like emergency room visits.
• Hospitalization: Hospital stays and related services are included to ensure coverage for inpatient care.
• Maternity and Newborn Care: This includes prenatal care, labor, delivery, and postnatal care for both mother and baby.
• Mental Health and Substance Use Disorder Services: Coverage for mental health services and treatment for substance use disorders.
• Prescription Drugs: Essential medications are typically covered under health insurance plans.
• Rehabilitative and Habilitative Services and Devices: Coverage for rehabilitation services and devices that help individuals regain or maintain physical and mental skills.
• Laboratory Services: This includes various types of medical tests and screenings.
• Preventive and Wellness Services: Coverage for preventive care like vaccinations, screenings, and annual check-ups.
• Pediatric Services: Essential benefits for children, including dental and vision care.

Open Enrollment in Georgia FAQs

When is open enrollment in Georgia this year?

Open enrollment for 2023 in Georgia begins on November 1, 2023 and ends on January 15, 2024. This is separate from the state’s SHBP open enrollment Georgia plans, which runs from October 17 to November 4. You can shop the insurance marketplace in Georgia for individual and family insurance, but there’s also a special enrollment period for people who qualify because of extenuating circumstances.

How much does health insurance cost during open enrollment in Georgia?

The average cost of health insurance in Georgia changes with each year, and the costs themselves aren’t always set in stone, as they can vary from person to person depending on the criteria set by the insurer. However, services like eHealth can help someone find the lowest possible cost of health insurance for their needs.

Can eHealth help you get enrolled during open enrollment in Georgia?

Yes, you can use eHealth for Georgia health insurance enrollment. For people seeking affordable health care insurance options from reputable insurers in Georgia, eHealth offers a tremendous number of benefits. The insurance options are easy to navigate and personalize so that you can receive a quote suitable to your specific needs. You can compare costs and find the best options for your budget.

Find affordable health insurance in Georgia

Many people find health insurance daunting. At eHealth, we are committed to helping you match health insurance to your personal needs. Not only do we deliver easy-to-use tools to help you research your options online, eHealth licensed insurance agents are available to work with you throughout this confusing process. Our agents can answer questions you may have about ACA plans in the Georgia marketplace, talk with you about ACA-compliant plans off the marketplace as well as other coverage options that may be suitable depending upon your personal situation.  eHealth will always be able to help you find Georgia health insurance plans to suit all your needs.