Key Takeaways
- Georgia Medicaid provides health coverage to low-income residents
- PeachCare for Kids is Georgia's CHIP program
- Georgia uses the federal health insurance marketplace (Healthcare.gov)
- The Georgia Life and Health Insurance Guaranty Corporation provides protection
- Georgia participates in the Long-Term Care Partnership Program
Georgia State Insurance Programs
Georgia operates several state programs producers should understand.
Georgia Medicaid
Georgia Medicaid provides coverage to low-income residents:
Who's Covered
| Population | Income Limit |
|---|---|
| Children | Up to 247% FPL |
| Pregnant Women | Up to 220% FPL |
| Parents | Lower limits |
| Seniors/Disabled | SSI-related |
Note: Georgia did NOT expand Medicaid for childless adults.
Benefits
- Doctor visits
- Hospital care
- Prescription drugs
- Mental health
- Long-term care
- Limited dental/vision
Exam Tip: Georgia did not expand Medicaid under ACA for childless adults.
PeachCare for Kids
Georgia's CHIP program:
Eligibility
| Requirement | Details |
|---|---|
| Age | Under 19 |
| Income | Up to 247% FPL |
| Residency | Georgia resident |
| Citizenship | US citizen or qualified |
Benefits
- Comprehensive coverage
- Doctor visits
- Hospital care
- Prescription drugs
- Dental and vision
- Mental health
Health Insurance Marketplace
Georgia uses federal marketplace (Healthcare.gov):
What It Offers
| Feature | Description |
|---|---|
| Individual Plans | Qualified Health Plans |
| Premium Tax Credits | Federal subsidies |
| Cost-Sharing Reductions | For Silver plans |
| Special Enrollment | Qualifying events |
Metal Tiers
| Tier | Actuarial Value |
|---|---|
| Bronze | 60% |
| Silver | 70% |
| Gold | 80% |
| Platinum | 90% |
Note: Georgia uses Healthcare.gov, not a state marketplace.
Georgia LTC Partnership
Georgia participates in LTC Partnership:
How It Works
- Purchase Partnership-qualified policy
- Use benefits for care
- If exhausted, apply for Medicaid
- Keep assets equal to benefits
Benefits
| Without Partnership | With Partnership |
|---|---|
| Spend to $2,000 | Protect assets |
| May lose home | Keep home/assets |
| Standard rules | Enhanced protection |
Georgia Guaranty Corporation
Georgia Life and Health Insurance Guaranty Corporation protects policyholders:
Coverage Limits
| Policy Type | Maximum |
|---|---|
| Life Death Benefit | $300,000 |
| Life Cash Value | $300,000 |
| Annuity Present Value | $250,000 |
| Health Insurance | $500,000 |
| Disability Income | $300,000 |
| Long-Term Care | $300,000 |
What's Covered
- Individual life insurance
- Group life (Georgia residents)
- Annuities
- Health insurance
- Disability
- Long-term care
What's NOT Covered
- Surplus lines
- Self-funded plans
- Variable investment portions
- Amounts above limits
- Unlicensed insurers
Producer Restrictions
Producers CANNOT:
- Use as selling point
- Advertise guaranty coverage
- Compare to FDIC
- Imply "guaranteed"
Exam Tip: Georgia's $300,000 life death benefit limit. Producers cannot advertise guaranty coverage.
GeorgiaCares
Georgia's SHIP program:
Services
- Free Medicare counseling
- Help with decisions
- Understanding benefits
- Available statewide
Exam Tip: GeorgiaCares is Georgia's SHIP Medicare counseling program.
Does Georgia operate its own marketplace?
Georgia guaranty limit for life death benefits?
What is PeachCare for Kids?
Did Georgia expand Medicaid under ACA?
Can producers advertise guaranty coverage?
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