Common Pitfalls

In the past, some people found it impossible to find health coverage that was affordable and met their needs. Now, there are more options, and you may qualify for more affordable coverage than you realize.

The exact health coverage that will be right for you will depend on things like your family’s income, whether you have access to employer-sponsored coverage, your age, where you live, and whether you have a disability.

If you do not have the option of affordable employer-sponsored coverage, you may be able to get government help to pay for an individual plan on Georgia Access. If you cannot afford individual coverage, your best options will be public programs, like Medicaid or Medicare, if you qualify.

Medicaid used to be mainly for people with disabilities, seniors, children, and pregnant women. Now, there is a program called Georgia Pathways to Coverage, which is for any adult with low income (at or below 100% of the Federal Poverty Guidelines (FPG), $1,305 per month for an individual in 2025, $2,679 for a family of four). No matter how much money you have in the bank or what your health situation is, you could qualify.

It is easy to check if you can get Medicaid: just go online to Georgia Gateway and fill out an application. You can also talk to your local Division of Family and Children Services (DFCS) office. They’ll let you know whether you qualify and help you sign up.

If you can’t get Medicaid, you can get private coverage through Georgia Access, and the government may help you pay for it with subsidies.

You may think that you won't be able to get Medicaid through Georgia Pathways to Coverage because of the requirement to do 80 hours of qualifying activities each month. However, there are options that may help you meet this requirement.

Working at a full-time or part-time job counts as a qualifying activity. So does going to school, volunteering, taking care of a child under six years old, and doing vocational rehabilitation with the Georgia Vocational Rehabilitation Agency (GVRA). You don't have to do 80 hours of the same activity. For example, you could work 60 hours each month and volunteer for 20 hours. Or, you could be a part-time student and work part time.

If you have a disability and need help meeting this requirement, the Georgia Vocational Rehabilitation Agency (GVRA) can help you. You can work with GVRA instead of doing 80 hours of other activities, and your vocational counselor will take care of confirming your qualifying activities to Pathways.

In the past, people feared that if they got a job while they were on Medicaid, they’d lose their health coverage, because they would no longer have low enough income to qualify for Medicaid.

Now, if you lose one health coverage option, there will be another one you can get. If you lose your Medicaid coverage, you will either become eligible for employer-sponsored coverage or private individual coverage. And if you can’t afford the individual coverage, the government may help you pay for it.

The bottom line: There may be an affordable health coverage option for you, even if you start working and lose your Medicaid coverage.