Georgia Health Insurance Guide

From scenic mountains and charming small towns to the vibrant culture of Atlanta, Georgia, remains a desirable place to live, and understanding your health insurance options here is key to protecting your health and finances.
As of 2025, the uninsured rate in Georgia reflects ongoing efforts to improve access to healthcare coverage. If you’re currently without coverage, here’s what you need to know about getting insured in Georgia.

Health Insurance Options in Georgia

Georgia offers a range of health insurance options tailored to residents’ needs, depending on age, income, employment, and family size. Here are the most common coverage types available:

Employer-Sponsored Insurance

Many Georgians receive health insurance through their employer. If your workplace offers coverage, this is usually the most cost-effective and convenient option.

ACA Marketplace Plans (Georgia Access)

The Affordable Care Act (ACA) allows individuals and families to buy health insurance through the state-run marketplace, Georgia Access. These plans include essential health benefits, free preventive care, and protection for preexisting conditions.

If you don’t have employer coverage, you may qualify for subsidies to lower your premiums. Use our ACA Subsidy Calculator to check your eligibility.

Starting this year, the Centers for Medicare & Medicaid Services (CMS) is requiring income verification to confirm eligibility for premium subsidies. As part of this effort, CMS will reduce the ACA subsidies by $5 per month for individuals who are automatically re-enrolled in fully subsidized plans without verified eligibility.

ACA Plan Types

ACA marketplace plans in Georgia come in Bronze, Silver, Gold, and Platinum tiers, each offering different levels of coverage and cost-sharing. Comparing plans helps ensure you select the right fit for your healthcare needs.

• Bronze: Low monthly premiums, higher out-of-pocket costs; ideal for minimal healthcare usage.
• Silver: Moderate costs; eligible for cost-sharing reductions (CSRs).
• Gold: Higher monthly premiums with lower out-of-pocket costs; best for frequent healthcare users.
• Platinum (if available): Highest premiums, lowest out-of-pocket costs.

Metal Tier Breakdown:

Medicaid

Georgia’s Medicaid program provides free or low-cost health coverage for eligible low-income residents. Benefits typically include preventive care, hospital visits, mental health, prescriptions, and more.

Short-Term Medical Plans

Short-term medical (STM) plans offer temporary health coverage and can be a practical solution for individuals who are between jobs, recently lost employer coverage, waiting for ACA or Medicare eligibility, or need affordable protection during a coverage gap. 

These plans are available in this state and follow federal rules, but they are not regulated by the ACA. That means they can deny coverage based on pre-existing conditions and typically do not include comprehensive benefits like maternity, mental health, or preventive care.

While short-term medical plans are not a substitute for long-term health insurance, they may be ideal in situations where you’re temporarily uninsured—such as after job loss or before new coverage begins—and want short-term protection from unexpected medical events.

STM Plan Enrollment 

Unlike ACA-compliant plans, you can enroll in short-term health plans year-round.

Quick Coverage Start: Many short-term plans can begin as soon as the next day after your application is approved.

Student Health Insurance

College students in any state have multiple health insurance options, including staying on a parent’s plan until age 26, enrolling in a school-sponsored plan, or applying for coverage through the ACA Marketplace. Depending on your income and location, you may also qualify for Medicaid, CHIP, or low-cost catastrophic or short-term plans—making Georgia student health insurance accessible and flexible for a wide range of needs.

Children’s Health Insurance Program (CHIP)

Known in Georgia as PeachCare for Kids, this program provides affordable coverage to children and pregnant women in families who earn too much for Medicaid but need financial assistance.

Medicare

Medicare serves residents aged 65+ and certain younger individuals with disabilities. Coverage options include:

• Medicare Advantage (Part C)
  • Medicare Advantage is an alternative to Original Medicare offered by private insurers to those enrolled in Parts A and B. These plans often include extra benefits and cost protections but typically require using a specific network of providers.
• Prescription Drug Plans (Part D)
  • Medicare Part D provides prescription drug coverage for anyone with Medicare, helping pay for medications and many vaccines. Offered by private insurers, these plans vary in cost and coverage and can be joined during specific enrollment periods.
• Medicare Supplement (Medigap)
  • Medicare Supplement plans, or Medigap policies, help cover the out-of-pocket costs that Medicare Part A and Part B don’t pay. Since Original Medicare (Parts A and B) lacks an out-of-pocket maximum, these plans can limit your expenses for medical services.

COBRA Coverage

If you’ve recently lost employer-sponsored health insurance, COBRA allows you to temporarily continue your previous plan. This can help bridge the gap until new coverage begins.

Enrollment Periods in Georgia

Open Enrollment for 2026 Coverage:

November 1, 2025 – Janaury 15, 2026
During this time, all eligible residents can apply for, renew, or change their marketplace health plans.

Special Enrollment Period

Available year-round for qualifying life events (QLE), including:

• Loss of coverage
• Marriage or divorce
• Birth or adoption of a child
• Relocation
• Major change in income

You typically have 60 days from the event to enroll in a new plan.

Health Insurance Providers in Georgia

As of 2025, these insurers typically offer individual and family plans through Georgia Access:

• Ambetter from Peach State Health Plan
• Blue Cross Blue Shield of Georgia
• CareSource
• Kaiser Permanente
• Oscar Health

Plan availability may vary by county or ZIP code. Some carriers may offer standardized plans if Georgia expands options through a public plan initiative.

Understanding Health Insurance Costs

When selecting a plan, be sure to understand these common terms:

• Premium: Monthly payment to maintain your plan
• Deductible: Amount you pay before your plan starts covering services
• Copayment (Copay): Fixed fee for a service or medication
• Coinsurance: Your share of costs after reaching your deductible
• Out-of-Pocket Maximum: The most you’ll pay in a year for covered services
• In-Network vs. Out-of-Network: Using in-network providers lowers your costs

Understanding health insurance doesn’t have to be overwhelming. This glossary offers clear definitions of key terms—from agents to costs like copayments, coinsurance, and deductibles—to help you make confident coverage decisions.

Bottom Line

Health insurance in Georgia comes with many choices—whether from your employer, through the ACA marketplace, or public programs like Medicaid and Medicare. By staying informed and comparing plans during the right enrollment periods, you can secure reliable coverage that fits your lifestyle and supports your well-being.

Need help choosing a plan?
Use our ACA Subsidy Calculator to see if you are eligible for financial aid or speak with a licensed insurance agent to explore all your coverage options.