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Georgia Health Insurance Guide

Updated on June 25th, 2025

Fact checked by: Colleen McGuire

We want to help you make educated healthcare decisions. While this post may have links to lead generation forms, this won’t influence our writing. We adhere to strict editorial standards to provide the most accurate and unbiased information.

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:

Metal TierInsurance Company PaysConsumer Pays
Bronze60%40%
Silver70%30%
Gold80%20%
Platinum90%10%

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.


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.


Short-Term Plans

Short-term medical (STM) plans offer flexible, low-cost coverage for up to four months, ideal for healthy individuals in transition. However, STM plans aren’t guaranteed issue, lack subsidies, and may exclude key benefits like maternity, mental health, and pre-existing conditions, making them less suitable for long-term or comprehensive needs.

Short-term medical plans in Georgia are available for up to 3 months with limited benefits. Explore all non-ACA health plans that may fit your needs and lifestyle.

Explore all non-ACA health plans that may fit your needs and lifestyle.


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:

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:

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.





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