Your Trusted Resource for ACA Health Insurance (Obamacare) and Medicare Plans in Georgia (Updated 11/20/2013)
ACA health insurance in Georgia, also known as Obamacare, represents a major overhaul of the underlying health care system as well as the way consumers will find and purchase health insurance in the future. Everyone is impacted in some way by Obamacare.
Bob Vineyard and Georgia Insurance Shop hope you find our site to be helpful.
Individuals that purchase their own coverage will see plans with higher deductibles, higher out of pocket and higher premiums. So-called “low income” individuals and families may qualify for premium subsidies. Employers are required to change their plans to comply with the EHB (essential health benefit) rules or face a fine. Seniors on Medicare will see changes in their coverage as well, especially if they have Medicare Part D or a Medicare Advantage plan.
How Does ACA Health Insurance Impact Individuals?
If you are self employed, or work for a company that does not provide health insurance beginning in 2014 you are required to have health insurance or pay a tax penalty.
Low income individuals and families MAY qualify for a taxpayer funded premium subsidy which will reduce your monthly premium to what the government considers affordable. If you think you qualify for a subsidy you MUST apply for coverage (directly or indirectly) through healthcare.gov, a federal website.
Obamacare ACA health insurance plans sold on the federal exchange in Georgia are almost exclusively HMO plans with limited doctor and hospital networks. Georgia is subdivided into 16 cost regions for pricing purposes. In some regions your only choice will be Blue Cross and maybe one other carrier.
Most HMO plans will give you a list of doctors and tell you to pick one. If you currently have a regular doctor, they may not be on the list. Even if they are on the approved list, many doctors are refusing to accept patients that have ACA health insurance purchased from the exchange.
What you may not know is there is a vibrant market OFF the exchange with more carriers, more plan choices and mostly broad PPO networks that are identical to those offered before 2014.
When you buy a policy OFF the exchange you should be able to keep your doctor and use any of a number of local hospitals. In some cases, premiums for plans sold OFF the exchange are similar or even less than comparable plans sold on the exchange.
Georgia Insurance Shop represents multiple carriers off the exchange but we have found Humana to be consistently more competitive than carriers such as Blue Cross, Ambetter or Aliant.
ACA Health Insurance Affects Employer Group Insurance
If you are an employer with fewer than 50 full time employees you are not required to provide health insurance for your employees. If you do make health insurance available, you will find that small group health insurance plans must comply with all aspects of the ACA health insurance rules.
Beginning in 2014 (or your next renewal that falls in 2014) small group health plans must provide the EHB (essential health benefits) as set forth in the Affordable Care Act. Plan design must comply with the standards set for “metallic” plans (bronze, silver, gold, platinum) and the premiums can no longer be blended by average age.
In many cases, employers will find it more economical to drop existing health insurance coverage and allow employees to find coverage on their own. Ask your tax advisor before dropping coverage or making any changes in coverage. In some cases, providing employees a bonus to help offset the cost of insurance may be a consideration.
Georgia Insurance Shop is willing to work with employers and employees in securing health insurance OUTSIDE of the exchange.
How Does Obamacare Affect Seniors on Medicare?
Georgia seniors on Medicare will see few changes if they are still in original Medicare and have a Medigap (Medicare supplement) plan. Georgia Medicare Plans is an outstanding resource for information on Medicare and our quote engine (Georgia Medigap Quotes) provides you with Medigap rates on up to 40 plans in 60 seconds or less.
If you are a Georgia senior and have Part D or a Medicare Advantage plan, you will see more changes as a result of the ACA health insurance law.
First the good news.
The Medicare Part D “donut hole” will be gradually closed between now and 2020, but this is not all good news. The donut hole was designed to make your prescription drug plan affordable. Closing the hole will mean higher premiums, higher drug copay’s and fewer drugs covered under the plan formulary. Now more than ever you need to check your plan every year to make sure you have the right plan for your needs and budget.
Bob Vineyard at Georgia Medicare plans is always willing to work with new and existing Medigap clients to help them find the right Part D plan in their area. We are not compensated in any way for this advice but we must limit this service to our Medigap clients only.
Medicare Advantage plans will also change as a result of the ACA health insurance law. Doctor and hospital networks will shrink. PPO plans will be replaced with HMO designs which means fewer doctors accepting your Advantage plan. Premiums will increase under Obamacare as will deductibles, copay’s and out of pocket limits.
Every year 10 – 15% of our new clients are seniors who are tired of the hassle associated with Advantage plans and they want stability and predictability in their lives. About half our new Medicare clients come from other carriers that have priced themselves out of the range for seniors on a fixed income. Most of them have Medicare supplement plan F through Blue Cross, Mutual of Omaha or AARP (United Healthcare). They don’t know they can usually get the same plan for a lot less than they are paying now and put that savings in their pocket rather than the insurance carriers account.
Most seniors I know want to pick their own doctor rather than choosing from a list that changes every year. When you have original Medicare and a Medigap plan YOU choose your doctor.
Regardless of your needs. If you are an individual or family searching for ACA health insurance, a business owner or a senior, we are here to help.
“I will be sure to pass along your name to anyone looking to buy health care coverage in Atlanta. You have been so kind and helpful. We really appreciate it!” Kristy G.
“Just want to thank you so much for your help. I will refer you to everyone I know that own their own business and has an individual health policy. You were great! – Natalie C.
“Thanks so much Bob! I will try to send you business from all of my healthy friends, and I appreciate all of your help.”-Debbie B.
Child Only Health Insurance
Just as Obamacare did away with child only health insurance we now are in a position to offer child only plans for 2014 effective dates. Parents can often save a lot of money by taking their children off their group health plan and purchasing a stand alone, child only health insurance plan through Georgia Insurance Shop.
Children written on a stand alone basis cannot qualify for a subsidy under ACA health insurance rules. Child only plans should be purchased OUTSIDE the exchange to insure a broad network that includes your child’s pediatrician or specialist.
Follow this link for more information on child only health insurance in Georgia.
Self Employed Medical Insurance Plans in Georgia
Self employed individuals and those who own a small business in Georgia have several options available to them. Most business owners that call me ask about affordable group medical rates for themselves and their employees.
For many self employed business owners, group health plans are not the best answer. Many owners and their employees can find more affordable Obamacare health insurance plans and better value with individual or family major medical coverage.
If it is determined that a group major medical plan in GA plan is in your best interest, here are some things you will need to know.
Your self employed business does not need to be incorporated but you will need evidence you have a legitimate business. Income tax and payroll records will usually suffice but some may also need a valid business license.
Some Georgia group health companies require at least 6 months of records while others will accept less. Some Georgia group health companies will allow a husband and wife to count as a legitimate business group while others do not.
If you have prior creditable coverage, a group medical plan is required to cover any pre-existing conditions. If you do not have creditable coverage, the insurance company may make you wait for up to 6 months before any pre-existing medical conditions are covered.
Ask us about affordable health insurance quotes for the self employed now.
Georgia Health Savings Accounts (HSA’s)
Georgia Health Savings Accounts (HSA) are a great way to provide medical coverage for individuals, families and the self employed.
The U.S. Treasury requires you to have a qualified high deductible health insurance plan (QHDHIP) in place before you can establish a Health Savings Account. Such high deductible plans are not allowed to have copay’s for anything other than annual wellness exams. All covered expenses are used to satisfy the individual or family deductible before the health insurance company pays any claims.
Most of my clients (roughly 90% of them) find the HSA to provide exactly the major medical coverage they need at an affordable premium. The HSA is a great option for the self employed business owner
Medical Insurance Plans Are not Created Equal
Many Atlanta GA Health Plans (including some Health Savings Accounts) fall short when you need them the most. Research ALL of the major medical insurance companies including Blue Cross, Cigna, Humana, Kaiser Permanente. Look at their plans in detail. Get a free Atlanta GA Health Insurance Quote with Rates from us today. Some medical insurance plans in Georgia, and many HSA’s, only provide a discount on prescription drugs. Many of today’s medications run in excess of $300 per month and some cancer medications are $2,000 to $6,000 per dose. We have a moral and ethical obligation to only recommend FULL PRESCRIPTION DRUG COVERAGE Atlanta Georgia Health Insurance plans so our clients will not come up short when they need it the most.
Georgia Medicare Plans, Medicare Supplement Insurance (Medigap Insurance)
Medicare supplement insurance, Medigap policies, Medicare Advantage Plans, or simply Med supp . . . all of this can be quite confusing. As part of the baby boomer generation, I know how challenging it can be if you are trying to decide which Medicare plan is right for you.
Medicare Supplement coverage (or Medigap) is designed to fill the gaps in coverage left by Medicare. It is sold by private insurance companies, not the government. Advantage plans replace Medicare.
When you choose the right Medicare supplement insurance plan in Georgia you can sleep well at night knowing you will not have to worry about unexpected medical expenses. Your Medicare approved doctor, not some insurance company, decides what treatment is right for you. Since 1965 people just like you have trusted Medicare to pay their bills.
We have put together several pages with information on Medicare and Medicare supplement plans in Georgia that we hope will be helpful. Several of the pages contain short 3 minute video’s to further explain your Medicare supplement options in plain language.
How does Medicare part A work? What is Medicare part B, part C and part D? What is the difference in a Medicare supplement plan and a Medicare Advantage Plan? Is a Medigap insurance plan the same as a Medicare supplement plan? If I have Medicare isn’t that enough or do I need to supplement this coverage? Do most doctors take Medicare? Do some doctors refuse to treat Medicare Advantage patients? Is Medicare Part A and Part B plus a supplement enough or do I need a Medicare Part D plan? Can I be turned down for Medicare? When should I sign up for Medicare and a supplement?
We will strive to do our best to answer these questions about Medicare supplement and more to your satisfaction.
Compare Medicare SupplementPlans and view rates from BCBSGA (Blue Cross), Gerber, Mutual of Omaha. More Medigap rates available offline on request.
Affordable ACA Health Insurance in Georgia and Instant Health Insurance Quotes
You will find many affordable health insurance plans for individuals, families and the self employed in the market place. Many are available online at Georgia Insurance Shop. It is not hard to find health insurance plans that meet your needs and budget as long as you know where to look and how to effectively shop for good coverage. All the major health insurance companies in Georgia offer low cost, affordable health insurance plans to cover the most basic needs as well as catastrophic coverage. You can find affordable medical insurance plans from Blue Cross Blue Shield (BCBSGA), Cigna, Humana One and more. Here are just a few major medical plans to consider.