Georgia Health Insurance

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Georgia Health Insurance Plans

Georgia is known as the Peach State and its terrain spans coastal beaches, farmland and mountains. This state uses the federally run health insurance exchange where enrollments are completed through HealthCare.gov.

Georgia currently doesn’t have a state-run health exchange from where one can directly get quotes, so the federal health exchange direct people seeking information and quotes on health insurance plans to different approved insurance brokers and exchanges. As per early 2019, enrollments in health insurance in Georgia’s exchange were more than 417,000 people. Georgia healthcare exchange is an online insurance marketplace operating for individuals and families residing in this state. For 2020 health plan enrollments in Georgia, the open enrollment period starts November 1, 2019 and ends on December 15, 2019.

Latest news and updates from Georgia Insurance Marketplace

  • Open enrollment period for 2020 insurance plan coverage will start from November 1 and end on December 15, 2019.
  • In 2019 the average rate increase was less than 4% and the insurance companies have proposed an average rate increase of just 2.4% in 2020.
  • The four participating insurers of 2019 will be joined by two more insurers, Oscar Health and CareSource.
  • Short-term health plans are available in the state with initial plan terms of up to 364 days.

Individuals and Family Health Insurance in Georgia

After several years of substantial rate increases, Georgia’s individual health insurance market now seems to be stabilizing. In 2019 the average rate increase was less than 4 percent, and insurers have proposed an average rate increase of just 2.4 percent for 2020. In individuals and families plans in 2019 there was addition of short-term plans and Christian Medi-Share coverage. Purchasing health insurance might often seem a challenge for most individuals and families in Georgia. Individual and family health insurance plans in Georgia that comply with the Affordable Care Act are usually expensive, though the price of the plans mostly depend on the county you live in. ACA compliant individual and family plans are expensive because these plans have comprehensive coverage and include benefits like maternity, prescription drugs and mental health services and also include expenses for pre-existing conditions and it ensures that no one is denied insurance based on their pre-existing health conditions. Since, everyone cannot afford to pay the hefty premium amount so government has introduced programs such as subsidies to help residents offset the costs. Individuals who do not qualify for a subsidy can look for a plan with a high deductible. People of some counties in Georgia can obtain a Catastrophic level health plan that has the lowest premiums and also cover less.

Georgia has following types of Individual and Family health insurance plans available through the marketplace:

Health Maintenance Organization

In this plan beneficiaries have access to a network of doctors who are in contract with the HMO. It does not cover out-of-network care except in an emergency. These plans provide integrated coverage and focus on prevention and wellness of the individuals.

Point of Service

This is the most affordable plans available to individuals especially if they visit doctors, hospitals and other health care providers that are associated with the plan’s network. In this plan members will require to get a referral from their primary care doctor if they have to see a specialist.

Preferred Provider Organization

Members enrolled in this plan pay less amount from their pocket if they avail healthcare services from the plan’s network doctors. Though, members can avail services from outside network doctors, hospitals and providers without a referral but by paying an additional cost.

Exclusive Provider Organization

Members enrolled in this plan are covered only if they avail services from the network doctors, specialists or hospitals except in an emergency.

Short-term Health Insurance in Georgia

Georgia defaults to the federal regulations, as it does not have state-specific regulations for short-term health insurance plans. Individuals who missed the open enrollment period and even don’t qualify for a special enrollment, then there is a temporary option available in Georgia known as short term health plans. Short-term plans are temporary alternative to the insurance plans which individuals can buy. This plan is ideal for all those individuals who missed the window to sign for ACA compliant plan, or were dropped from an employer or parent’s plan, or who are retired and waiting for Medicare benefits to start because it covers the basics like unforeseen accidents, illness and hospital visits. The short-term health insurance plan in Georgia can be purchased at any time from the private insurance carrier. Individuals can purchase this plan in Georgia for up to 364 days and can also obtain back-to-back policies for up to 36 months. Every policy constitutes a new term and individuals need to reapply for it and they can even be denied. These plans offers just a basic coverage and are more limited form of health insurance and only offer a layer of financial protection for unforeseen accidents and illness and are not comprehensive health insurance.

Dental Plans in Georgia

Leading insurance carriers provide different types of dental insurance plans in Georgia that mainly differs in terms of price, and coverage. Dental insurance in Georgia works in similar manner as health insurance. Individuals with dental insurance pay a monthly premium for which they are entitled of certain dental benefits like regular checkups, cleanings, x-rays and services to promote general dental health. In Georgia both Indemnity and managed care dental plans are available.

Managed-care plans maintain networks of dental care providers and the participating dentist in the network agree to render dental are services at pre-negotiated rates and bill is submitted to the insurance carrier by the dentists. Individuals usually have lower out-of-pocket costs with a managed care dental plan.

Indemnity plans offer a broader selection of dental care and carrier pays for the covered dental services only after receiving a bill. Indemnity plan provides broader choice of dentists to people of Georgia.

Georgia Vision Plans

Vision insurance in Georgia can be availed through private insurance carrier that offers coverage for the eye-care services rendered by ophthalmologists and optometrists. The vision insurance plans in Georgia generally provide coverage for eye examination along with partial or full coverage of eyeglasses, sunglasses, and contact lenses with or without co-pays depending upon the plan chosen by the individual.

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