Health insurance in Georgia, made simple.
Updated · Reviewed by Pranav Desai, licensed agent
The short answer: Most Georgians under 65 who aren’t on Medicare can buy a plan through Georgia Access. Open enrollment for 2027 runs November 1, 2026 to January 15, 2027 (enroll by December 15 for coverage on January 1). Households from 100% to 400% of the poverty level may get help with the premium.
For Georgians under 65. Plain English, real 2027 numbers. Start with the one that fits you:
An independent guide from Finspire Solutions. We are not Georgia Access, HealthCare.gov or any government agency.
How it works
What the metal levels mean, the words on every bill, and who can buy a plan.
Plans come in four metals. The metal tells you how costs are split.
A higher metal usually means a higher monthly premium and less to pay when you get care.
Averages across all covered care, not for every bill. Silver is the only level that can come with extra savings (see chapter 2). A Catastrophic plan is also sold to people under 30 or with a hardship exemption.
Four words decide what you pay.
Every plan lists these. Compare them, not just the monthly price.
- Premium
- The monthly bill to keep your plan, even if you never use it.
- Deductible
- What you pay for care first, before the plan starts sharing the cost.
- Copay
- A flat fee for a visit or prescription, like $30.
- Out-of-pocket maximum
- The most you pay in a year for covered, in-network care. After that, the plan pays 100%. For 2027 it can’t be more than $12,000 for one person or $24,000 for a family.
Why does the out-of-pocket maximum matter most?
Imagine a surgery and hospital stay that costs $60,000.
Example only. Many plans set a lower maximum. Monthly premiums are not counted, and care outside the plan’s network may cost more.
Who can buy a plan through the marketplace?
- You live in Georgia.
- You’re a U.S. citizen or national, or lawfully present.
- You’re not in prison or jail.
- You’re not on Medicare. Turning 65 or on Medicare? Read the Medicare guide.
Help with your costs
Two kinds of help, the income limits, and a quick check of where you may fit.
Who can get help with the cost?
Help is based on your household income, measured against the federal poverty level. The lower your income, the more help you may get.
Help with the monthly premium
- For household income from 100% to 400% of the poverty level
- Lowers your monthly bill right away, or comes back at tax time
- Works with Bronze, Silver, Gold and Platinum plans
Extra savings on Silver plans
- For household income from 100% to 250% of the poverty level
- Lower deductibles and copays
- Only on Silver plans
The yearly income lines for 2027 help.
Above 400% of the poverty level there is no help with the premium. You can still buy a plan at full price.
| People | No help above400% | Help from100% | Silver extra up to250% |
|---|---|---|---|
| 1 | $63,840 | $15,960 | $39,900 |
| 2 | $86,560 | $21,640 | $54,100 |
| 3 | $109,280 | $27,320 | $68,300 |
| 4 | $132,000 | $33,000 | $82,500 |
Yearly household income. Uses the 2026 federal poverty guidelines, which set help for 2027 coverage. Bigger household? Add $5,680 to the 100% line for each extra person.
See where you may fit, in 10 seconds.
Nothing you type is saved or sent. It’s an estimate only: Georgia Access decides when you apply.
Household: you, your spouse and anyone you claim on your taxes. Income: your best guess for the whole year, for everyone on that tax return, before taxes.
Tell me more
Offered insurance at work? If that coverage counts as affordable for you (for 2027, your share costs no more than 10.22% of household income), you can still buy a marketplace plan, but without help with the premium. Family members are checked against the cost of family coverage.
Married? You usually need to file your taxes jointly to get help.
At tax time you get Form 1095-A and settle up. If your income ends up higher than you guessed, you may have to pay back some or all of the help, and there’s no cap on how much. Report income changes during the year to keep it right.
Kids and families
Who in your family may be covered where, from one application.
Kids and parents can end up on different coverage. That’s normal.
You fill in one application for the whole household. It checks everyone at once.
Children under 19
- May qualify for PeachCare for Kids or Medicaid with household income up to 247% of the poverty level
- A child who qualifies for PeachCare for Kids can’t also get help with a marketplace premium
Parents and other adults
- Usually a marketplace plan
- May get help with the premium at 100% to 400% of the poverty level
- Under 100%: may qualify for Georgia Medicaid (some groups) or Georgia Pathways, which has a work requirement
When the application shows someone may qualify for Medicaid or PeachCare for Kids, Georgia Access sends their details to the Georgia Division of Family & Children Services (DFCS), which decides.
Signing up, step by step
Five steps, what to have ready, and two ways to do it with me.
From account to coverage.
- Create an accountYou’ll need an email address.
- Apply, and ask for help with costsAnswer the questions about your household and income.
- Compare and pick a planCheck the deductible, the out-of-pocket maximum, and that your doctors and prescriptions are covered.
- Pay your first premiumPay the insurance company by its deadline, or the plan is cancelled.
- Send any documents asked forIf Georgia Access asks for proof of income or status, send it by the deadline to keep your coverage and your help.
Ten minutes of gathering saves an hour.
- Social Security numbers, or immigration documents, for everyone applying
- Your best guess of 2027 income (pay stubs or last year’s tax return help)
- Details of any coverage you have now, including job coverage you’re offered
- Your doctors and prescriptions
On your own, or together.
All plan prices are the same however you enroll.
Enroll yourself
- Compare plans and sign up online, on your own schedule (during open enrollment, or after a life event)
- I’m listed as your agent if you need help later
Do it with me
- We go through it together by phone
- I check your doctors and prescriptions with you
After you enroll
Keeping your plan, changing it mid-year, and what’s different for 2027.
Three habits keep your coverage and your help.
- Pay every month. Missed payments can end your coverage.
- Report changes in income or household (a new job, a marriage, a baby) to Georgia Access, so your help stays right.
- Keep Form 1095-A. You need it for your taxes.
Changing plans mid-year
Outside open enrollment, you can change plans only after certain life events, such as moving, losing other coverage, getting married, or having or adopting a child. You usually have 60 days from the event, and in a few cases 90.
Already have a plan: what should you check before Dec 15?
- Prices change every year. Look at your 2027 premium and deductible before you let your plan renew.
- Some insurers are leaving Georgia Access for 2027. If yours is, pick a new plan by the deadline: Dec 15 for coverage on Jan 1. What to do if your plan is ending.
- Update your income. Your 2027 help is based on your 2027 income, not last year’s.
- Expect a text before we update your plan. Each plan year, you approve your agent before they can renew or change your plan for you through HealthSherpa, the enrollment site we use. The request comes as a text from (628) 222-2905 or an email from no_reply@healthsherpa.com (HealthSherpa’s details as of October 2026). Open it on your own phone and tap Authorize. The link works for 15 minutes. If it runs out, tap Get new link. It may ask a few questions to confirm it’s you. We will never ask for your Georgia Access or HealthCare.gov password.
Reviewed by Pranav Desai, licensed agent, on October 21, 2026.
Sources
- Georgia Access: renew or update coverage (2027 dates)
- Georgia Access: financial assistance
- HHS: federal poverty guidelines
- CMS: 2027 out-of-pocket maximum
- IRS: 2027 affordability percentage (Rev. Proc. 2026-26)
- Georgia Access: PeachCare for Kids
- Georgia Pathways: eligibility
- HealthSherpa: agent authorization
Hi, I’m Pranav.
I’m a licensed agent and a Georgia Access Certified Agent (NPN 20732306) in metro Atlanta. I help Georgians under 65 find health insurance and the help they may qualify for.
- Talking with me costs nothing
- You pay the same premium with or without an agent
- I’ll check your doctors and prescriptions with you
Reading this guide asks nothing of you. I’ll never call you unless you ask.
Enroll yourselfOpens HealthSherpa’s secure siteOr call Pranav: (912) 659-7813
For health insurance (under 65)
Turning 65 or on Medicare? Read the Medicare guide.
Outside Georgia? I also help with health insurance in Florida, South Carolina and Virginia. See how it works there.