Navigating the Georgia health insurance marketplace can be quite challenging. Where to start? Below are 3 tips you should follow to help find a top quality health insurance plan for you and your family.
1: Determining your marketplace
In many cases, you only need to look as far as your employer to obtain a health insurance plan. If you fall into this category, then you need not look into marketplaces or government insurance exchanges.
However, if your employer does not offer health insurance benefits, or if for some reason, you do not qualify, you will likely be able to qualify for a plan under the Affordable Care Act.
You may also qualify for a short-term health insurance plan. Short-term plans are not what they used to be. For one thing, the the amount of time
you may be covered under a short term plan is not so "short" anymore. In some cases, you can keep the same plan for up to 3 years. Benefits have significantly improved as well. Such coverage can now be reasonably compared with traditional health insurance plans.
You may also want to take a look at Faith-based health care plans, (also known as health care sharing plans). They are the fastest growing health care plan option in Georgia and the country.
2: Compare The Plan Types Available In Georgia.
The plan structure or plan type, is one of the most important items to consider. The most common plan types are EPOs, HMOs, PPOs or POS plans. The plan type you choose will determine, among other things, your out-of-pocket costs, as well as which doctors and hospitials are in-network.
While evaluating plans, search for a summary of benefits. You can get links to plan summaries via most online marketplaces. If you are applying for coverage through an employer, you should ask your workplace administrator for an outline of benefits.
When comparing various plans, pay serious consideration to your family's medical needs. Take a good look at the cost and manner of treatment you have gotten in the past. Though it is not possible to foretell every medical expenditure, being current about what is going on can assist you in making the right decision.
HMO and POS plans may be preferable if you are not concerned about your primary doctor picking a specialist for you If you do select a HMO or POS plan and opt out of the network, make every effort to get a referral from your primary physician to avoid excess out-of-pocket expenses.
If you prefer to select your own specialists, you might be more suited with an EPO or PPO plan. Also, a PPO could be better if you reside in a local or rural area with restricted access to doctors and care, because you will have access to a larger group of physicians.
3: Closely Review Physician Networks.
It is cheaper when you visit an in-network doctor because insurance firms get more reasonable rates with an in-network provider. When you opt out of the network, those doctors are not obligated to accept contracted rates. You are responsible for paying the additional amount.
If you have personal doctors and you want to keep visiting them, endeavor to make sure they are listed in the provider directories for the plan you are considering. You can also ask your doctors if they are in-network providers.
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