Cost of Health Insurance in Georgia
Health insurance is a form of insurance that helps you pay for your medical care. When you buy a health insurance plan, also known as a policy, you enter a contract and agree to pay a monthly premium or fee to an insurance carrier.
In Georgia, 49% of the state’s population have health insurance through employers. In that situation, your employer pays part of your insurance, most often through a managed care policy. Those policies have an agreement with health care provider networks to care for members at lower rates.
But you can buy health insurance through a spouse’s plan, independently through a broker, COBRA, or directly from an insurance company.
Based on your income, you may be qualified for insurance through the federal government and the state with Medicare and Medicaid. Medicare helps people 65 and older with health care costs, and Medicaid assists low-income families and children.
Average Cost of Health Insurance in Georgia
The average cost for a Bronze policy is $354, $460 for a Silver plan, and $538 for a Gold plan in 2019.
According to a Kaiser Family Foundation report, Georgia inhabitants spent an average of $6,587 per year on health care expenditures in 2014, which is less than the nationwide average.
Types of Health Insurance Plans
Whether you are shopping for health insurance in Georgia through an insurance carrier broker or on Georgia’s Marketplace, you can select from health insurance plans from major brands with 5 levels of benefits. They consist of:
- Silver: Your insurance covers 70% of your medical expenses on average. You pay 30%.
- Platinum: Your insurance covers 90% of your medical expenses on average. You pay 10%.
- Gold: Your insurance covers 80% of your medical expenses on average. You pay 20%.
- Catastrophic: These are high-deductible plans designed for persons 30 and younger. Catastrophic plans are required to cover preventive care and the 1st 3 primary care visits at no cost to you, even if you have not met your deductible.
- Bronze: Your insurance covers 60% of your medical expenses on average. You pay 40%.
Health insurance brands provide these types of plans:
- Health maintenance organizations (HMOs): An HMO provides healthcare services through a network of physicians and facilities. You will have to pick a primary care doctor who can refer you to a specialist when you need it. HMO plans usually offer the least amount of freedom to see the doctor you want and require the least amount of paperwork.
- Preferred provider organizations (PPOs): A PPO also provides healthcare services through a network of health care providers and gives members lower out-of-pocket fees to see providers within the system. If you see an in-network doctor, you will pay a $10 co-pay, for instance. But if you see an out-of-network doctor, you will have to pay the whole bill upfront and get an 80% reimbursement from the insurance carrier or pay a deductible. But you can visit a specialist without a physician referral if the professional is within the network.
- Point-of-service plans (POS): A POS gives you time to select a primary care doctor from a POS plan provider list. You can get some out-of-network coverage outside the network, but you have to get a referral from your physician to see a specialist. POS plans may provide more health improvement and education programs such as nutrition, smoking cessation, weight loss, diabetes management workshops, and cover more preventive care services.
- Traditional health insurance: These coverages are also called fee-for-service plans and are the same as auto insurance. You pay for a certain amount of your medical care services upfront as a deductible. Then the insurance carrier pays the majority of the bill.
- Exclusive provider organization (EPO): An EPO is a managed care plan that only covers services when you use doctors, experts, or hospitals in the plan’s network, except in emergency cases.
Resources and References: