Short-term health plans in Georgia
- There are no state-specific regulations on short-term health insurance in Georgia, which defaults to federal regs.
- Short-term plan duration can be as long as 364 days in Georgia.
- At least seven insurers offer short-term health insurance in Georgia.
Georgia’s short term health insurance regulations
There are no state-specific regulations for short-term health insurance in Georgia, so the state defaults to the federal regulations. Until October 2, 2018, federal regulations limited short-term health plans to three months in duration and prohibited renewals. But the Trump administration relaxed those rules (unless a state imposes stricter regulations, which Georgia does not).
Georgia’s former Insurance Commissioner, Ralph Hudgens, who had long opposed the ACA, stated in 2013 that “the problem is Obamacare, and we’re doing everything in our power to be an obstructionist.”
[Hudgens was succeeded by Jim Beck, who was elected to be Georgia’s insurance commissioner in November 2018. Beck was suspended by Gov. Brian Kemp in May 2019, after being indicted on federal money laundering and fraud charges. Kemp then appointed John King, who is the current insurance commissioner in Georgia.]
Both chambers of Georgia’s legislature have Republican majorities, and the legislature has been generally opposed to the ACA as well. So it was not surprising that the rules for short-term health insurance in Georgia defaulted to the Trump administration’s less restrictive federal guidelines. The longer short-term policies are often heralded as an alternative to ACA-compliant coverage, with lower monthly premiums. But their relative affordability has to be considered in conjunction with the fact that they also provide less-robust coverage and none of the ACA’s consumer protections.
Short-term plans duration in Georgia
Because Georgia does not limit short-term plan duration, the Trump administration’s regulations apply in the state. Insurers can offer short-term health insurance in Georgia with initial terms up to 364 days and the option to renew for a total duration of up to 36 months.
Insurers can offer plans with shorter maximum durations, however, and prohibit renewal if they choose to do so. Some of the available short-term plans in Georgia have six-month term limits, while others allow for 364-day terms and renewals for up to 36 months.
Which insurers offer short-term plans in Georgia
As of 2020, there were at least seven insurance companies offering (or approved to offer) short-term health insurance options in Georgia:
- Blue Cross Blue Shield Healthcare Plan of Georgia (Anthem Enhanced Choice; approved by the state as of late September 2020, see SERFF filing number ATEM-132381391)
- Everest Reinsurance
- Freedom Life Insurance Company
- Independence American Insurance Company
- National General
- UnitedHealthcare (Golden Rule)
- United States Fire Insurance Company
Some offer plans with 364-day terms and renewals that allow for insurance coverage that spans a three-year total duration, while others cap their plans at six months. There’s variation across the available plans in terms of deductibles, benefit caps, provider networks, covered (and excluded) benefits, and eligibility requirements. Be sure to carefully check the details of any short-term plan you might be considering, as the uniform consumer protection requirements that apply to ACA-compliant plans do not apply to short-term medical plans.
Who can get short-term health insurance in Georgia
Short-term health insurance in Georgia can be purchased by those who meet the underwriting guidelines the insurers use. In general, this means being under 65 years old (some insurers put the age limit at 64 years) and in fairly good health.
But it’s important to understand the limitations of these plans. Short-term health insurance policies generally come with blanket exclusions for pre-existing conditions, so for someone in the Peach State who is in need of on-going medical care and seeking a policy that will cover those needs, be aware that short-term health plans are wholly inadequate. Short-term health insurance plans are not required to cover essential health benefits; it’s common to see these plans exclude coverage for maternity care, mental health care, and prescription drugs, although any of the essential health benefits can be excluded.
If you’re in need of health insurance coverage in Georgia, first determine if you’re eligible for a special enrollment period — triggered by a qualifying life event — that would allow enrollment in an ACA-compliant (Obamacare) major medical plan. If you have a special enrollment period, you can sign up through the health insurance marketplace in Georgia. These marketplace plans are purchased on a month-to-month basis, so you can enroll in one (with a premium subsidy if you’re eligible) even if you’re only going to need it for a few months before another policy takes effect.
So if you’ll soon be enrolled in Medicare or you’ve been hired by a business that provides health benefits but they haven’t started yet, you can still use a marketplace plan to bridge the gap until the new plan starts, although you’ll need a qualifying event in order to enroll in a marketplace plan (or an ACA-compliant individual major medical plan purchased directly from an insurance company) outside of the annual open enrollment period that runs from November 1 through December 15.
When should I consider short-term health insurance in Georgia?
There are times in Georgia when a short-term plan might be the only realistic option, such as:
- If you missed open enrollment for ACA-compliant individual market coverage (ie, Obamacare) or your employer’s healthcare plan, and do not have a qualifying event that would trigger a special enrollment period.
- You’ll soon be enrolled in Medicare or a new employer’s plan, and need a temporary policy to cover you until the Medicare or employer-sponsored coverage takes effect.
- Your employer-sponsored coverage is ending mid-month and your replacement plan (from a new employer or the marketplace) doesn’t start until the first of the following month. Note that COBRA or state continuation might be available as a fall-back option instead, depending on the circumstances.
- If you’re not eligible for Medicaid or a premium subsidy in the exchange, the monthly premiums for an ACA-compliant plan might simply be too costly.
Those ineligible for premium subsidies include:
- Folks who earn in excess of 400% of the poverty level (for 2021 coverage, that’s $51,040 for a single person; if your ACA-specific modified adjusted gross income is just a little above the subsidy-eligible threshold, there are steps you can take to reduce it).
- Families who caught by the ACA’s family glitch and are faced with unaffordable policies in the individual market as well as unaffordable coverage offered by an employer.
- People stuck in the coverage gap in Georgia. The coverage gap was caused by Georgia’s refusal to accept federal funding to expand Medicaid under the ACA. Adults with income under the poverty level are ineligible for Medicaid as a result, but they’re also ineligible for premium subsidies in the marketplace/exchange.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.