The top ten consumer Frequently Asked Questions (FAQs) are listed below. If you do not see the answer to your question, click here for a comprehensive list of topics and answers.
What is a Special Enrollment Period?
A Special Enrollment Period (SEP) is a time outside of the yearly Open Enrollment (OE) period when Georgians can enroll in or change coverage due to a change in circumstance or after a life event occurs, referred to as a Qualifying Life Event (QLE). Depending on the type of SEP, consumers have either 60 or 90 days before or after the event occurs to enroll. Consumers can enroll in or change coverage through the Georgia Access consumer portal, or with a certified agent, web broker, or insurance company.
How can Georgians enroll in coverage outside of OE?
Georgians who experience specific Qualifying Life Events (QLEs) can enroll in or change coverage outside of OE, during an SEP. The most common QLEs include:
- Birth or adoption of a child
- Marriage
- Divorce, legal separation, or death in the family resulting in loss of coverage
- Gaining or becoming a dependent due to child support or other court order
- Becoming a U.S. citizen
- Changes in lawful presence
- Leaving incarceration
- Gaining membership in a federally recognized tribe
- Changes in residency
- Loss of Minimum Essential Coverage (MEC)
- Change in financial eligibility or other eligibility status
Please see the SEP page for more information.
Is Georgia Access the same as Georgia Pathways to CoverageTM?
No, Georgia Access is a separate health insurance program. Georgia Pathways to CoverageTM is a Medicaid program. To learn more about Georgia Pathways, Georgians can visit DCH.Georgia.gov/georgiapathways.
Are plan prices the same for Georgians who enroll with an agent or web broker compared to enrolling directly through GeorgiaAccess.gov?
Regardless of how someone enrolls, all plan prices are the same.
Can Georgia Access help Georgians if they recently lost Medicaid?
Before Open Enrollment (OE) 2025, which starts on November 1, Georgians can visit HealthCare.gov to see if they qualify for health coverage through a Special Enrollment Period (SEP). If they qualify, they must enroll before October 31st, 2024. During OE 2025, Georgians can visit GeorgiaAccess.gov to learn more about their coverage options and see if they qualify for financial assistance.
How can Georgians who are currently uninsured get coverage?
Before Open Enrollment (OE) 2025, which starts on November 1, consumers can visit HealthCare.gov to see if they qualify for health coverage through a Special Enrollment Period (SEP). If they qualify, they must enroll before November 30, 2024, for PY 2024 coverage. During OE 2025, consumers can visit GeorgiaAccess.gov to learn more about their coverage options and see if they qualify for financial assistance.
How will a State-based Exchange (SBE) benefit Georgians?
Transitioning to a State-based Exchange (SBE) will enable the state to bring an innovative approach to reducing the number of uninsured Georgians, empower the state to make better decisions to serve Georgians, and, ultimately, improve the shopping and enrollment experience for consumers.
Where should Georgians be directed to if they have questions related to Georgia Access?
For questions about Georgia Access, consumers should contact the Georgia Access contact center at 888-687-1503 (TTY Line 711). During Open Enrollment, the contact center is available Monday – Friday 8 AM – 8 PM ET, and Saturday – Sunday 10 AM – 2 PM ET.
What other health coverage options are available to Georgians who are not eligible for Georgia Access?
Individuals in Georgia who are not eligible for Georgia Access may be eligible for other state health coverage programs such as Medicaid, PeachCare for Kids®, or Georgia Pathways to Coverage™. Georgians may also be eligible for Medicare and/or COBRA.
If individuals already receive insurance through their employer, can they continue to do that through Georgia Access?
Neither Georgia Access nor HealthCare.gov can assist individuals with employer-provided coverage. For questions about coverage options, individuals should contact their employer.
What are Quality Ratings?
Each rated health plan has an overall “star rating” from 1 – 5 stars (5 is the highest performing health plan). A health plan’s overall rating is based on the quality of health care services and members’ experiences with their health plan. You’ll find this overall rating for the health plan and additional ratings for each of these 3 categories:
- Member experiance
- Medical care
- Plan administration
Plan quality ratings and enrollee survey results are calculated by CMS using data provided by health plans in 2024. The ratings are being displayed for health plans for the 2025 plan year. Learn more about these ratings.