Best Health Insurance Plans in Georgia

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Compare Health Insurance Plans in Georgia

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.

Health Care Choices in Georgia

According to Georgia's Office of Insurance, residents can get health care several ways:

  1. Employer-provided
    1. From your employer
    2. Through your spouse's employer
    3. Through COBRA
  2. Individual or family plans
    1. Through HealthCare.gov
    2. Directly from a health insurance company
  3. Government-assisted
    1. Medicare
    2. Medicaid

Where do Georgians get their health insurance coverage?

Georgia Health Insurance Sources
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 Health Insurance Costs and Rate Factors

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:

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Body Mass Index

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 31.4 percent obesity rate, the 20th highest in the country. 31 percent of Georgians who used QuoteWizard to compare health insurance plans have a BMI in the obese range.

Tobacco Use

If you smoke, your rates could skyrocket. There are several substantial risks that come from smoking, and insurers know that. 17.9 percent of Georgians are smokers, the 23rd highest rate in the country.

Age

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.

Plan Type

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 2018:

Georgia Martketplace Plan Rates
Bronze Silver Gold
$410 $470 $587
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.

Location

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.

Georgia Health Insurance Companies

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.

Georgia Health Insurance Laws

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:

  • Mastectomy
  • Maternity
  • Treatment of mental disorders
  • Birth control
  • Cancer screenings
  • Diabetic supplies
  • Bone marrow transplant
  • Heart transplant

There are more services that providers need to offer some coverage for. Find the entire list here.

Medicare and Medicaid in Georgia

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.

Medicare

Those over 65 qualify for Medicare, a federally-funded health care program. You may also qualify for one of these four Medicare Savings Programs:

Qualified Medicare Beneficiary (QMB)

  • Single person with a monthly income lower than $1,032.
  • Couple with a monthly income lower than $1,392.

Specified Low-Income Medicare Beneficiary (SLMB)

  • Single person with a monthly income lower than $1,234.
  • Couple with a monthly income lower than $1,666.

Qualifying Individual (QI)

  • Single person with a monthly income lower than $1,386.
  • Couple with a monthly income lower than $1,872.

Qualified Disabled and Working Individuals (QDWI)

  • Single person with a monthly income lower than $4,132.
  • Couple with a monthly income lower than $5,572.

Medicaid

Here are Georgia's Medicaid financial requirements:

Georgia Medicaid Financial Requirements
Household Size Maximum Yearly Income
1 $29,986
2 $40,656
3 $51,327
4 $61,997
5 $72,667
6 $83,338
7 $94,008
8 $104,679

Georgia Office of the Insurance Commissioner

Website:
Homepage
Insurance Commissioner:
Ralph T. Hudgens
Insurance Hotline:
(800) 656 – 2298
Office Hours:
Monday - Friday
9:00 am to 5:00 pm
File a Consumer Insurance Complaint
Complaint Page

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