The Peach State has a lot of redeeming qualities, but according to a study by US News, health care isn't one of them. Georgia ranks as having the 42nd best health insurance in the country considering health care access, quality, and good public health.
According to Georgia's Office of Insurance, residents can get health care several ways:
Where do Georgians get their health insurance coverage?
| Sources | Percent | ||
|---|---|---|---|
| Employer-Provided | 49% | ||
| Individual or family | 7% | ||
| Medicaid | 17% | ||
| Medicare | 12% | ||
| Other Public Care | 4% | ||
| Uninsured | 12% | ||
| Source: Kaiser Family Foundation, Health Insurance Coverage of the Total Population | |||
12 percent of Georgia residents are uninsured, a few percent above the national average. That doesn’t bode well for policyholders, as the more uninsured people there are, the higher rates are for insured people.
Georgia residents spend an average of $6,587 per year on health care expenditures, less than the national average. Health care prices vary person to person, here are a few of the main factors insurers will use to price your policy:
According to the CDC, a high body mass makes you statistically more likely to suffer from numerous health conditions. Health insurance companies often analyze your BMI to determine your risk-level and price your policy. Often, a higher BMI leads to higher insurance rates.
In 2016, Georgia had a 31.6 percent obesity rate, the 24th highest in the country. 31 percent of Georgians who used QuoteWizard to compare health insurance plans have a BMI in the obese range.
If you smoke, your rates could skyrocket. There are several substantial risks that come from smoking, and insurers know that. 17.5 percent of Georgians are smokers, the 20th highest rate in the country.
According to HealthCare.gov, older people can pay up to three times more for health care than younger people. GA residents who used QuoteWizard to shop for health insurance are, on average, 40 years old.
The more health care coverage you want, the more money it will cost. Marketplace plans are organized into metal tiers: bronze, silver, gold, and platinum.
How much should you expect to pay as a Georgia resident? These are the average prices for a 40-year-old Georgia resident in 2019:
| Bronze | Silver | Gold | |
|---|---|---|---|
| $354 | $460 | $538 | |
| Source: Kaiser Family Foundation, Change in Average Marketplace Premiums by Metal Tier | |||
In Georgia, a gold plan costs about 43 percent more than a bronze plan. Why the massive price increase? Because bronze plans only cover 60 percent of medical costs and gold plans cover 80 percent. If you use your insurance often, a gold plan may be a better investment.
The lowest level of coverage you may qualify for is a catastrophic plan. These types of plans offer low monthly premiums, but a high deductible. For 2017, the deductible for catastrophic plans is $7,150. Purchasing a bronze or silver plan may save you money when you need to use your insurance.
Each state has different rules and laws surrounding the health care marketplace. Your location plays a big role in how much you'll pay.
Also, health care providers base your costs on your community rating. This means if a neighbor files a high number of claims, your premiums will spike.
How health-conscious your state is therefore plays a role in your premiums. According to America's Health Rankings, Georgia is the 41st healthiest state in the US.
There aren't many health care provider options in Georgia, but here are the best providers in the state:
These companies offer both individual and family plans. Check out provider websites to find out more about rates and specific location factors.
The Affordable Care Act makes it so insurance companies can't use certain factors when pricing your policy.
Marketplace plans have maximum limits you can pay out-of-pocket. For 2018, the out-of-pocket maximum is $7,350 for individual plans and $14,700 for family plans.
Georgia requires that insurance companies offer some coverage for these services:
There are more services that providers need to offer some coverage for. Find the entire list here.
Government-funded health care programs Medicare and Medicaid help two different groups. Medicaid helps residents 65 and over with health care costs. Medicaid aids low income families and children.
Those over 65 qualify for Medicare, a federally-funded health care program. You may also qualify for one of these four Medicare Savings Programs:
Here are Georgia's Medicaid financial requirements:
| Household Size | Maximum Yearly Income |
|---|---|
| 1 | $30,851 |
| 2 | $41,768 |
| 3 | $52,686 |
| 4 | $63,603 |
| 5 | $74,520 |
| 6 | $85,438 |
| 7 | $96,355 |
| 8 | $107,273 |
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