Availability of short-term health insurance in Georgia

Yes. As of 2024, at least six insurers were offering short-term health insurance in Georgia.

Because Georgia does not limit short-term plan duration, the 2018 federal regulations apply in the state. Insurers can offer short-term health insurance in Georgia with initial terms of up to 364 days and the option to renew for a total duration of up to 36 months.

However, those federal limits will change in 2024 under new Biden administration rules for short-term health plans. Short-term plans issued or sold on or after September 1, 2024 will be limited to total durations of no more than four months, including renewals. Initial terms will be limited to no more than three months.

Insurers can offer plans with shorter maximum durations, however, and prohibit renewal if they choose to do so.

Short-term health insurance in Georgia can be purchased by those who meet the underwriting guidelines the insurer uses, and each insurer sets it own underwriting rules.

In general, people can qualify for short-term health plans if they’re under 65 years old and don’t have any of the medical conditions that will result in a declined application.¹ But again, the specific requirements vary from one insurance company to another.

Short-term health insurance plans generally exclude coverage for pre-existing conditions, and they often use post-claims underwriting. This means that if a claim is filed, the insurer can go back through the person’s medical records to make sure the claim isn’t related to a pre-existing medical condition.²

Short-term health plans also generally exclude coverage for some of the ACA’s essential health benefits (most commonly, maternity care, prescription drugs, and mental health care),¹ and impose dollar limits on the coverage they do provide.

So if you’re purchasing a short-term policy, it’s important to read all the plan details and make sure you understand the limitations of the plan.

If you need 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 some don’t require a specific life event (such as the rule that allows a person with income up to 150% of the poverty level to enroll anytime, or the provision that allows American Indians and Alaska Natives to enroll anytime).

If you have a special enrollment period, you can sign up through the health insurance Marketplace in Georgia (HealthCare.gov). 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, and the Inflation Reduction Act extended those provisions through 2025.

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 people stuck in the coverage gap in Georgia.

The coverage gap stems from Georgia’s refusal to accept federal funding to expand Medicaid under the ACA. Adults with income under the poverty level are ineligible for Medicaid unless they can comply with the state’s work requirement, including work reporting. But they’re also ineligible for premium subsidies in the Marketplace/exchange.