The Cheapest Georgia Health Insurance for Individuals and Families

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Individuals who cannot acquire health insurance through their employer or who don’t qualify for government health insurance, such as Medicare or Medicaid, can apply for private plans listed online on the Georgia insurance exchange.

This Post: The Cheapest Georgia Health Insurance for Individuals and Families

When exploring the exchange and looking for a suitable healthcare insurance plan, consider finding a balance between the maximum medical coverage that suits your needs and an affordable monthly premium. Note, however, that the cheaper the plan’s premium per month, the more you will have to pay out-of-pocket. This is because the more affordable plans have higher deductibles and out-of-pocket costs.

MoneyGeek listed the cheapest plans that can be purchased through Georgia’s insurance marketplace based on age and different plan types that are suitable for the amount of medical coverage you’re looking for.

The Cheapest Health Insurance in Georgia by Metal Tier

Health insurance plans are presented and offered in different “metal” tiers in which monthly premiums, deductibles and out-of-pocket expenses vary. The current metal tiers offered in Georgia’s insurance marketplace consist of Catastrophic, Bronze, Expanded Bronze, Silver, Gold and Platinum.

The average monthly costs in Georgia for each tier are:

  • Catastrophic: $350 per month
  • Bronze: $416 per month
  • Expanded Bronze: $440 per month
  • Silver: $525 per month
  • Gold: $532 per month
  • Platinum: $681 per month

Choosing an insurance plan that has lower monthly premiums might be the best option if you’re less likely to be sick. However, cheaper plans often come with high out-of-pocket expenses. On the other hand, plans with higher premiums have lower deductibles and overhead costs, which may be more beneficial and cost-efficient for those who have a lot of medical needs.

The cheapest plan by monthly premiums for each metal tier is listed in the table below. In Georgia’s insurance exchange, the premiums, deductibles and out-of-pocket costs may vary within a metal tier.

Individuals with low income may be eligible for cost-sharing reductions. This is advantageous when you’re looking at a Silver plan because you will have lower deductibles than usual.

The insurance plan premiums listed above are the plans available for a 40-year-old male. The rates above are for HMO or PPO plan types, with the former being the most common plan type in the state of Georgia.

Cheapest Health Insurance in Georgia by Metal Tier

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  • Metal Tier

    Plan

    Company

    Monthly Cost

    OOP Max

  • Catastrophic

    Anthem Catastrophic Pathway X Guided Access HMO 8550

    Blue Cross Blue Shield Healthcare Plan of Georgia, Inc

    $284

    $8,550

  • Bronze

    Ambetter Essential Care 1 (2021)

    Ambetter from Peach State Health Plan

    $370

    $8,300

  • Expanded Bronze

    CareSource Marketplace Bronze

    CareSource

    $331

    $8,550

  • Silver

    KP Silver HDHP 5000/20/S8

    Kaiser Permanente

    $391

    $6,000

  • Gold

    KP GA Signature Gold 1700/25

    Kaiser Permanente

    $449

    $8,500

  • Platinum

    SoloCare Platinum Copay 40184 Area 1

    Alliant Health Plans

    $603

    $8,550

The Cheapest Health Insurance in Georgia by Age and Metal Tier

Older individuals may see that their monthly premiums cost more than younger individuals pay. This is because they are likely to need more medical attention. For example, a 26-year-old individual only has an average monthly premium of $420 for a Silver HMO plan, while a 60-year-old individual needs to pay roughly $1,114.

Health Insurance Costs in Georgia by Age and Metal Tier

An individual’s health insurance costs increase as they age. This is because health insurance providers know that healthcare needs and their associated expenses tend to increase with age. Considering low monthly premium insurance plans may be possible, but this means that you will need to pay more of the medical costs. This might not be ideal.

Note that the following data provided does not account for how your age and income can affect premiums. For instance, monthly premiums may be less for older individuals in Georgia because of tax premiums or other regulations that can help make you eligible for discounts. In general, keep in mind that you won’t be able to know your exact quote until you apply for an insurance plan.

The table below shows how the cost of metal tiers plans differs based on age. Should you decide to explore more about the metal tiers and need help in choosing the best health insurance in Georgia, take a look at our guide on health insurance options in the state.

Cheapest Health Insurance in Georgia by Age And Metal Tier

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The Cheapest Health Insurance in Georgia by County

Health insurance premiums vary depending on where you live in Georgia. In Georgia and each state, rating areas are put in place so that insurers can have a standard of calculating the premiums that they will charge.

Georgia has 159 counties, which are divided into 16 rating areas. The most populous county is Fulton county, with the most affordable Silver plan in the area being the KP Silver HDHP 5000/20/S8, offered by Kaiser Permanente at an average monthly premium of $391.

You can use the table provided below to view the most affordable plans in each metal tier for your respective county.

The average rates provided are health insurance plans in that county for a 40-year old male in Georgia.

Cheapest Health Insurance Plans in Georgia by County

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The Cheapest Health Insurance in Georgia With High Out-of-Pocket Maxes

A relatively young individual with low medical needs could choose a health insurance plan with a low monthly premium. However, they would have to pay more medical expenses as it often comes with high deductibles and out-of-pocket maxes.

The most affordable plan in Georgia with the highest out-of-pocket maxes is the Anthem Catastrophic Pathway X Guided Access HMO 8550 offered by Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. Its monthly premium costs an average of $228 per month for a 26-year-old individual.

MoneyGeek has determined that a plan with a high out-of-pocket maximum is one that crosses $8,250 or higher.

Blue Cross Blue Shield Healthcare Plan of Georgia, Inc

Blue Cross Blue Shield Healthcare Plan of Georgia, Inc.’s plan falls within the Catastrophic tier, which generally offers the lowest monthly premiums compared to all the other tiers. However, you are only eligible for a Catastrophic plan if you are an individual under 30 or someone who qualifies for a hardship or affordability exemption.

The Cheapest Health Insurance in Georgia With Low Out-of-Pocket Maximums

Georgia residents who anticipate having a high degree of medical needs and expenses should consider a health insurance plan with low out-of-pocket maximums. This is often coupled with high premiums, but reaching the out-of-pocket limit sooner through frequent doctor visits and the like can lead to the insurer covering your expense sooner. In turn, this may save you money.

The cheapest health insurance plan in Georgia with a low out-of-pocket maximum is Ambetter Balanced Care 25 HSA (2021) offered by Ambetter from Peach State Health Plan. Its monthly premium is an average of $479 for a 40-year-old individual.

MoneyGeek determined that a low out-of-pocket maximum is one that costs less than $4,250. However, the out-of-pocket maximum of the Ambetter Balanced Care 25 HSA (2021) plan is $4,800. Despite this, it is still the plan with the lowest out-of-pocket max in Georgia and the cheapest premium.

Ambetter from Peach State Health Plan

The Ambetter Balanced Care 25 HSA (2021) plan is in the Silver tier, which means that it may have a higher monthly premium compared to the Bronze and Expanded Bronze tier. However, due to its relatively lower out-of-pocket maximum, you’re likely to reach your limit sooner, which means getting covered by the insurer at an earlier rate.

Cheapest

HMO /

PPO

Health Insurance Plan in Georgia

To determine the type of healthcare insurance plan that you need, it’s important to consider your healthcare needs and preferences. There are two healthcare plan types in Georgia, health maintenance organization (HMO) plans and preferred provider organization (PPO) plans.

HMO plans are the most common plan type in Georgia. These plans are cheaper compared to PPO plans. However, HMO plans commonly require you to stay within your insurance provider’s network and require a referral to see a specialist. While PPO is generally more expensive, you will have a wider network and you don’t need a referral to see a specialist.

MoneyGeek identified the cheapest Silver plans for HMO and PPO plan types on average. They include:

  • HMO: KP Silver HDHP 5000/20/S8 plan from Kaiser Permanente costs at a monthly average of $391 for a 40-year-old.
  • PPO: SoloCare Silver PPO 40017 Area 1 plan from Alliant Health Plans costs at a monthly average of $429 for a 40-year-old.

Cheapest Plan in Georgia With an HSA

You can consider opting for a Health Savings Account (HSA) if you are a healthy individual who is less likely to have many medical needs. HSA plans cost significantly less and also enable you to divert your pre-tax contributions to be used for medical expenses. The biggest advantage of having an HSA is that the money you invest in it can act as your own savings should you not use it for medical expenses.

MoneyGeek has identified the most affordable health insurance plans in Georgia with an HSA option:

  • Expanded Bronze: KP GA Signature Bronze 6500/40%/HSA plan from Kaiser Permanente costs at a monthly average of $345 for a 40-year-old male
  • Silver: KP Silver HDHP 5000/20/S8 plan from Kaiser Permanente costs at a monthly average of $391 for a 40-year-old male

Keep in mind that plans with HSAs have high deductibles. In the event that you have a costly medical emergency, you may have to pay out of your savings.

What to Know About Health Insurance in Georgia

The rates and data that MoneyGeek gathered came straight from Georgia’s insurance exchange. Note that you may be able to find more affordable plans when you actually apply for one, as insurers will be able to provide you a personalized quote. Additionally, lower-income residents or senior citizens in Georgia may qualify for Medicaid or Medicare, which are generally more affordable than private plans listed.

Private Health Insurance on the Georgia Marketplace

Health insurance plans in Georgia and in any state are divided and classified into different metal tiers, which lets you choose the most suitable plan that meets your needs and preferences. Each tier has its own benefits and tradeoffs.

  • Catastrophic: Catastrophic plans have the lowest average monthly premiums but also offer minimal benefits and medical coverage. These plans are only available to individuals who are under 30 or those who have hardship exemptions. The cost is extremely low, but the deductibles and the out-of-pocket expenses are relatively high due to the minimal medical coverage.
  • Bronze: Bronze plans are the most affordable plans for those who are not eligible for Catastrophic plans. They offer more benefits and are the best option for individuals who are relatively healthy and rarely need medical attention who are looking for an affordable policy that can be of assistance in case of an emergency. Bronze plans, however, still have high out-of-pocket expenses.
  • Expanded Bronze: Expanded Bronze plans offer more benefits than Bronze plans, although they are more expensive. These are still considered affordable compared to the tiers above.
  • Silver: Silver plans are considered the middle or balanced choice. They offer a higher range of benefits compared to Catastrophic, Bronze and Expanded Bronze but cost more. However, they have fewer benefits than Gold and Platinum plans while costing less.
  • Gold: Gold plans offer a wide range of benefits and high medical coverage. This means lower deductibles and out-of-pocket costs than any of the plans mentioned earlier. While these are significantly more expensive, this is considered a good option for those who will need major medical coverage in the following year as you may be able to save money overall.
  • Platinum: Platinum plans have the highest average monthly premium but also offer the best benefits and medical coverage compared to all the other tiers. This is best suited for individuals who have extremely high medical expenses.

You may be eligible for more affordable plans or increased coverage based on your income. For example, if your income falls between 100% and 400% of the federal poverty level, you could receive premium tax credits. This applies to a two-person household in Georgia with a combined annual income that falls between $17,420 and $69,680. For more information, visit Healthcare.gov’s calculator to learn more.

Note that there is a period when you can enroll in a new health insurance plan or renew your existing plan. This period is referred to as the “open enrollment” period. This typically falls between November and December, but due to COVID-19, these dates were extended. You may also be eligible for a special enrollment period if you just moved recently or changed your employment status.

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If your income is between 138% and 250% of the federal poverty level, you may receive cost-sharing reductions when purchasing a Silver plan. The reductions help in terms of your deductibles, copayments or coinsurance and out-of-pocket expenses. It is also likely that you may be able to get Gold-tier coverage with Silver plan rates if you qualify for these reductions.

Medicaid in Georgia

Residents of Georgia who are 65 and older or have an illness or disability may be eligible for Medicare, a federal government program. With Medicare, you still may need to pay for some expenses, unlike Medicaid, which is completely free. Fortunately, Medicare plans are still more affordable compared to health insurance plans offered by private insurers.

Medicare breaks down into three parts:

  • Part A: Hospital insurance, which covers in-patient hospital stays as well as stays in a skilled nursing facility, hospice care and some home health care services.

  • Part B: Medical insurance, which covers out-patient medical services such as doctor visits and preventive services.

  • Part D: Prescription drug coverage, which helps cover the cost of prescription drugs, including recommended vaccines.

Medicare in Georgia

Medicaid is free, making it the cheapest option for individuals who are eligible for it. Since Georgia is not a Medicaid expansion state, you can only qualify based on state guidelines. Generally, this includes people with very low family income, low-income children, pregnant women and those with disabilities.

Methodology

MoneyGeek’s research is based on estimates, and the cheapest plan for you will depend on your individual needs and characteristics. This analysis is intended to serve as a guide and no single plan is guaranteed to be the cheapest in Georgia for you

MoneyGeek collected plans and premiums for health insurance in Georgia from the Health Insurance Exchange Public Use Files (Exchange PUFs) for all available metal tiers and across several age groups. 

Health insurance premiums on this page are an estimate and exclude potential premium tax credits and cost-sharing subsidies that users may be eligible for.

About the Author

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Mark Fitzpatrick is a senior content manager with MoneyGeek specializing in insurance. Mark has years of experience analyzing the insurance market and creating original research and content. He graduated from Boston College with a Bachelor of Arts and Johns Hopkins University with a Master of Arts.

Source: https://bloghong.com
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