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 with a spenddown is very expensive. Look into other options:

• Buying private health coverage on Georgia Access may be less expensive than Medicaid with a spenddown, and the government may help you pay for it with tax subsidies.
• If your income is 100% of FPG or less ($1,305 per month for an individual), you may qualify for Georgia Pathways to Coverage Medicaid. With Pathways, you only have to pay small copayments for certain medical services, so it is a much more affordable way of getting health coverage.

If you are eligible for both Medicaid and Medicare, you should enroll in both. If you have both, you’ll have better health coverage, because Medicaid covers many services that Medicare does not cover. Medicaid may even pay your Medicare Parts A, B, and D premiums, deductibles, and copayments for you.

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

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.