More than a year after the state launched the Pathways to Coverage program, offering Medicaid in exchange for work or other state-approved activities, advocates say the program is too difficult…
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More than 1 million Georgians have lost their health coverage due to job loss during the COVID-19 pandemic. If this is your situation, you can keep yourself and your family covered during this health crisis.
You have three main pathways to coverage:
- Affordable Care Act
- With financial assistance—half of Georgians who lose their insurance will qualify for ACA coverage with financial help to lower the premium they pay each month. In some cases, you may see lower deductibles & co-pays too.
- Without financial assistance—some Georgians, despite a job loss, will still make too much for financial help but you should still shop for coverage to see if there’s a plan that fits your new budget.
- Medicaid & PeachCare for Kids—About 25% of Georgians losing their health coverage may qualify for Medicaid. Georgians most likely to qualify for Medicaid coverage include children, low-income pregnant women, and very low-income parents. Other Georgians who qualify for Medicaid are people with disabilities, seniors, and low-income women with breast or cervical cancer.
- COBRA—in most cases, you will be able to find less expensive coverage from the ACA marketplace. COBRA may be the best option for you if it is important that you maintain a consistent provider (pregnant women, people with chronic or complex conditions).
Some Georgians who have lost their health coverage due to job loss will fall in Georgia’s coverage gap because the state has not expanded Medicaid. That means they can’t get financial help through the ACA and they also don’t qualify for Medicaid.
If you are in the coverage gap because you lost your job, please read the If you are uninsured section (click to go directly there). Then contact Georgians for a Healthy Future at 404-567-5016 x 4 to learn how you can share your story and help fix the problem!
Affordable Care Act (ACA) coverage
You may be eligible for a Special Enrollment Period up to 60 days after losing your job-based health insurance. You only qualify for coverage for 60 days after you lose your health coverage, so shop and enroll as soon as possible. Visit healthcare.gov to shop and enroll.
Financial assistance is available!
When you begin the shopping/enrollment process, healthcare.gov will ask you about your estimated income for 2020. With that information healthcare.gov will let you know if you qualify for financial help to lower your premiums and other costs. Most Georgians qualify for financial help!
When you estimate your income, include the money you made from your job before you were laid off, any unemployment checks that you expect to receive, and any money that you expect to make from getting re-hired/a new job later in the year. Do not count your stimulus check as income!
For free help with the enrollment process, contact Insure Georgia at insurega.org or 866-988-8246.
Coverage through the ACA marketplace covers testing for COVID-19. It will also cover part or all of the costs related to COVID-19 treatment. Contact your insurance company for more information.
Medicaid & PeachCare for Kids
You can enroll yourself, your family, or your children in Medicaid or PeachCare for Kids at any time, if you qualify. Enroll at gateway.ga.gov.
Children are most likely to quality for Medicaid and PeachCare. Pregnant women and some parents may be eligible for Medicaid coverage depending on your monthly income. (The amount of unemployment you get from Georgia counts as income but the additional $600 per week from the federal government does not.)
Click here to see if you can qualify as a parent and to see if your kids qualify. If you are pregnant, you must make less than these amounts to qualify for Medicaid:
Medicaid is required to cover COVID-19 testing and treatment for free. In addition, you do not have to pay any Medicaid or PeachCare premiums or co-pays during the COVID-19 national emergency.
If you have or enroll in Medicaid coverage, you cannot be disenrolled (kicked off) during the COVID-19 national emergency.
If you have questions about Medicaid and whether you qualify, call the Georgia Division for Family & Children Services at 877-423-4746.
You may also contact Atlanta Legal Aid (find the phone number for your county here) or Georgia Legal Services Program at 1-800-498-9469 with questions or concerns.
If you are uninsured/unable to get health coverage
Do not skip or avoid health care just because you are uninsured! You can get free or low-cost health services at:
- Community Health Centers—find the clinics closest to you here
- Charity Care Clinics—find the clinic closest to you here
- Health care over the phone/online (telehealth)—Giving Health offers free telehealth services to people who are uninsured. Visit givinghealth.org/how-it-works or call 866-662-1923.
- Check with your local hospital to see what financial assistance programs you may qualify for
References & resources
COVID-19 Town Hall PowerPoint slides by Center on Budget & Policy Priorities
Frequently Asked Questions by Center on Budget & Policy Priorities
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