Frequently asked questions about short-term health insurance in Georgia
Yes. As of 2022, there were at least seven insurers offering short-term health insurance in Georgia.
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.” The expansion of short-term health insurance is widely viewed as a means of undercutting the ACA, as it allows healthy people an alternative to ACA-compliant coverage — albeit an alternative that might leave them without the coverage they expect if and when they experience a serious health condition.
(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.
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.
As of 2022, there were at least seven insurance companies offering (or approved to offer) short-term health insurance options in Georgia:
- Anthem Enhanced Choice
- Companion Life Insurance Company
- Everest Reinsurance
- Independence American Insurance Company
- National General
- The North River Insurance Company
- UnitedHealthcare (Golden Rule)
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.
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 outside of the annual open enrollment period for ACA-compliant coverage (November 1 to January 15), first determine if you’re eligible for a special enrollment period that would allow you to sign up for an ACA-compliant major medical plan.
Special enrollment periods are generally triggered by a qualifying life event, but there are some that don’t require a specific life event (such as the rule in 2022 that allows a person with income up to 150% of the poverty level to enroll anytime, or the provision that allows Native Americans to enroll anytime).
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 (assuming you have a special enrollment period or are applying during the annual open enrollment period that runs from November 1 to January 15).
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.
The American Rescue Plan has made premium subsidies larger and more widely available through the end of 2022. But there are still people who are ineligible for subsidies and who may not be able to realistically afford unsubsidized coverage in the exchange. They include:
- 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.