quick look: best health insurance in georgia
- allied health plans
- blue cross blue shield of georgia
- ambetter of peach state health plan
- united health
- Kaiser Permanent
- Bronze: Your insurance covers 60% of your medical costs on average. you pay 40%.
- silver: your insurance covers 70% of your medical costs on average. you pay 30%.
- gold: your insurance covers 80% of your medical costs on average. you pay 20%.
- Platinum: Your insurance covers 90% of your medical costs on average. you pay 10%.
- Catastrophic: These are high-deductible plans designed for people age 30 and younger. catastrophic plans are required to cover preventive care and the first 3 primary care visits at no cost to you, even if you haven’t met your deductible.
- Health Maintenance Organizations (HMOs): An HMO offers health care services through a network of doctors and facilities. You’ll need to choose a primary care doctor who can refer you to a specialist when you need one. hmo plans generally offer the least amount of freedom to see the doctor you want and require the least amount of paperwork to complete.
- preferred provider organizations (ppos): A ppo also offers health care services through a network of health care providers and offers members lower out-of-pocket rates to see providers within of the network. if you see an in-network doctor, you’ll pay a $10 copay, for example. but if you see an out-of-network doctor, you’ll need to pay the entire bill up front and get 80% reimbursement from the insurance company or pay a deductible. but you can see a specialist without a referral if the specialist is in the network.
- Point of Service (POS) plans: A POS gives you time to choose a primary care physician from a list of POS plan providers. You can get some out-of-network coverage, but you must get a referral from your doctor to see a specialist. POS plans may offer more educational and health improvement programs, such as nutrition, smoking cessation, weight loss, diabetes management workshops, and cover more preventive care services.
- Traditional health insurance: These plans are also called fee-for-service plans and are similar to car insurance, in that you pay upfront for a certain amount of your health care services such as deductible. then the insurance company pays most of the bill.
- exclusive provider organization (epo): An epo is a managed care plan that only covers services when you use doctors, specialists, or hospitals in the plan’s network, except in emergency situations.
- Outpatient Service: Your insurance covers outpatient care you get without a hospital stay, like visiting a doctor or visiting an urgent care center.
- Emergency services: If you are rushed to the hospital by ambulance or receive emergency care, your insurance will cover it.
- Hospitalization: Your insurance will cover overnight hospital stays and surgeries while you are admitted to the hospital.
- pregnancy, maternity and newborn care: your insurance covers prenatal check-ups, care during childbirth and the check-ups and care your baby needs. In addition, your insurance coverage includes services you may need for birth control and lactation.
- Mental Health and Substance Use Disorder Services: If you need inpatient or outpatient counseling, psychotherapy, or behavioral treatment for drug and alcohol addiction, your insurance will cover the services.
- Rehabilitation and Habilitation Services and Devices: Your insurance will pay for your rehabilitation and devices you may need to gain or regain skills for injuries, disabilities, or chronic conditions.
- Lab services: Your insurance will cover the cost of lab samples, such as blood draws.
- Preventive and wellness services: In addition to chronic disease management, your insurance will pay for services such as weight loss management, blood pressure monitoring, and nutrition and smoking cessation workshops .
- Pediatric Services: Your insurance will cover eye exams and dental treatment when your child needs oral and vision care. these services are not considered essential for adults.
- cancer screenings
- diabetic supplies
- bone marrow transplants
- heart transplants
- Adult Dental Services: If you need to see a dentist, consider investing in a dental insurance plan. Your health insurance company may also offer a dental plan that you can bundle at a discount, or you can find an affordable plan independently of your company.
- Vision services for adults: Other than eye exams, your health insurance will not cover glasses or contact lenses. If you need these services, you can buy a vision plan or pay out of pocket at a low-cost vision center.
- Hearing Aids: Most health insurance companies won’t pay for hearing aids, but you can find help through organizations like AARP, which has a program for hearing loss. You can find financial assistance programs through the Hearing Loss Association of America.
- Non-Covered Prescription Drugs: If your insurance won’t pay for your prescription drugs, you can ask your doctor for a covered substitute drug or request that your insurer make an exception for your situation. if you are denied, you can file an appeal with your provider. consider contacting the drug manufacturer to request a free drug.
- Acupuncture and Alternative Therapies: If your insurance company deems reflexology, massage, and other therapies experimental or non-essential, you can appeal to try to cover them.
- Weight-loss surgery: Your insurance may cover weight-loss counseling or nutrition workshops, but it probably won’t cover bariatric surgery or other weight-loss surgeries.
- Cosmetic Surgery: Health insurance companies will cover plastic surgery only as a medical necessity.
- infertility treatment: in georgia, coverage for fertility testing and treatment is based on your insurance plan. many services, like in vitro fertilization, are not covered, but some are.
- sterilization reversal: Most insurance plans will not reverse a vasectomy.
- private duty nursing: most insurance plans do not cover private duty nursing.
- Travel vaccinations: Travel vaccinations are considered non-essential and something you choose by most companies, so they are not covered.
- Lasik: This type of corrective eye surgery is considered elective and non-essential by companies, so your health insurance may not pay for it.
georgia governor brian kemp says health insurance in georgia is ‘too high’. therefore, he is reviewing the individual health insurance market to lower premiums. but first, the federal government has to approve his proposal. Until then, Benzinga will help you find affordable plans and review the top 5 health insurance companies in Georgia. We’ve done the research to make it easier for you to navigate the health insurance market and find the most affordable health insurance in Georgia.
best health insurance in georgia
When shopping for health insurance in ga, you have fewer options compared to the rest of the country. Most providers don’t cover the entire state, but these are the best health insurance providers in Georgia.
1. allied health plans
alliant health plans offers health insurance coverage for individuals, families, and groups in select georgia counties. alliant health plans is expanding its coverage for individual and group health plans.
You can also add dental benefits to your coverage through an association with National Domain, a dental insurer and provider of dental and vision benefits. The association offers access to over 9,000 listings for PPO dentists in Georgia. Call 866-403-2785 to purchase a plan or ask more questions.
2. blue cross blue shield of georgia
One of the oldest and largest health insurance companies in the state, BCBSGA, also known as Anthem, serves more than 3.2 million members in GA. that number includes more than 235,000 people who are not covered by an employer plan.
In addition to offering plans for employers and individuals, the company also serves seniors with medicare supplemental insurance, group life and disability insurance, as well as 360° health, vision and dental services. its network includes 192 hospitals and more than 16,000 primary care physicians and specialists. For more information, call 1-800-331-1476.
3. ambetter of peach state health plan
ambetter is known for its affordable health insurance: it beats the rates of other providers in georgia and has lower premiums than alliant for each of its plans. In 2020, Ambetter Balanced Care 12, a silver HMO, stands out, offering $10 copays for primary care physicians, $20 copays for emergency room visits, and $30 copays for specialist visits. an individual deductible is $950. To shop for a plan or for more information, call 877-687-1180.
4. united health
united is one of the largest and most well-known insurance providers in america. united policies can be found on the aca marketplace, and there are several levels you can choose from. review the options available to you in the part of georgia where you live. Also remember that joint plans may be named after a secondary insurer.
With coverage for doctor and hospital visits, accidents and short-term policies, you can easily find something that works for you. You can also choose a joint plan that reflects the insurance you had with the company in the past.
5. permanent kaiser
When you use Kaiser Permanente, you get more than just a health insurance provider. kaiser has health care centers throughout georgia that offer a wide range of services. You can visit an urgent care center, a general practitioner, a hospital, or even a center that hosts a yoga class or community program aimed at promoting healthy living.
Consider kaiser when you live in atlanta and athens, and check rates for additional services offered to members. Among the top 5 health insurance companies in Georgia, Kaiser is the most likely to offer unique services that you wouldn’t expect from your health insurance company.
In Georgia, 49% of state residents have health insurance through employers. In that case, your employer pays for some of your insurance, most often through a managed care plan. those plans have an agreement with health care provider networks to serve members at lower rates.
but you can buy health insurance through a spouse’s plan, independently through a broker, collect, or directly from an insurance company.
Depending on your income, you may qualify for insurance through the federal and state government with medicare and medicaid. Medicare helps residents age 65 and older with health care costs, and Medicaid helps low-income families and children.
average cost of health insurance in georgia
the average cost of a bronze plan is $354, $460 for a silver plan and $538 for a gold plan in 2019. however, remember that the best cheap health insurance in georgia may not work for you if need extended coverage. consider shopping for affordable coverage that gives you what you need.
Georgian residents spent an average of $6,587 per year on health care expenses in 2014, which is less than the national average, according to a report from the Kaiser Family Foundation. these were the latest data available.
types of health coverage
Whether you buy health insurance in ga through a broker or in the georgia marketplace, you can choose from health insurance plans from major brands with 5 benefit tiers. include:
Health insurance brands offer these types of plans:
what does health insurance cover?
Insurance plans sold in the marketplace must cover 10 essential benefits under the Affordable Care Act. include:
These essential health benefits are comprehensive and are considered minimum requirements for all plans in the marketplace, but covered services in georgia may vary depending on state requirements. The GA Department of Insurance also requires insurance companies to provide services for:
what does health insurance not cover?
Your health insurance won’t pay for cosmetic surgery, new glasses, or even dental care unless it’s medically necessary. Here’s a list of other services and treatments your health insurance probably won’t cover:
choosing a health plan in georgia
If you’ve been wondering how to get health insurance in georgia, it’s available through the georgia marketplace at healthcare.gov, but the governor recommends you go directly to providers until marketplace rates are reduced. Working with one of the top 5 health insurance companies in GA ensures you are covered and save money.
Also understand that the health plan you choose will vary by county. no carrier covers the entire state and in many counties only 1 carrier is offered on the state exchange. not all levels are necessarily offered in every county, so ask lots of questions before choosing a plan.