Residents of Georgia have five choices for large health care providers. The largest include United HealthOne, Aetna, Blue Cross and Blue Shield, HumanaOne, and AARP. For those in the market to purchase health insurance, it pays to become an educated consumer.
Of the three insurers mentioned, Blue Cross and Blue Shield is the largest Georgia health insurance company and has been operating since the 1930’s. The original company was called the Atlanta Blue Cross Plan and was founded in 1937. The company went through several transformations until 1985 when it became the Blue Cross and Blue Shield of Georgia/Columbus. Currently the insurer has 3.3 million members. The company takes a firm stand on under-utilization, and maintains a utilization management staff that makes all decisions regarding medical necessity and the appropriateness of care. There are no compensation structures for denials, and there are no performance incentives or job-related evaluation tools that encourage denials.
Another large health insurer in Georgia is HumanaOne. This company markets to self-employed entrepreneurs, students, college graduates, early retirees and those who may be otherwise uninsured. The company is a division of Humana, Inc.; a very large publicly traded Health Insurance Company with over 11 million members. The company offers tailored health insurance plans typically found in larger group plans. There are three types of plans to choose from at three price levels. The more expensive option offers 100% coverage for doctors’ visits, while the other two plans reduce certain coverage to reduce the cost of the plan. Lower priced plans are directed toward younger, healthier people.
AARP is a nonprofit founded in 1958 that is committed to improving the lives of people over the age of 50. The organization has 40 million members and operates throughout the United States. They offer a wide variety of health insurance plans to AARP members who are 50-64, including a major medical health insurance plan which can offer full coverage, as well as basic “fixed-cash” hospital indemnity plans designed as a low cost health insurance alternative. For those aged 65 and older, the non-profit offers plans that supplement Medicare with improved prescription coverage, changes to the pre-existing conditions rules and fitness benefits.
With all of these options, the choice can be difficult. There are some rules to health insurance that you should also consider when choosing a Georgia health insurance provider.
First, make sure you understand what the limit is to the plan. Better plans have no lifetime limit, but lower cost plans may have a maximum payout. Once this maximum is reached, no further payments will be made. This could put your health care in jeopardy in the event of an expensive injury or illness.
Another important aspect of Georgia insurance plans is the deductible and co-pay level. The deductible represents the amount that you have to pay out of pocket before the insurance will pay any benefits. If the deductible is large, you will want to make sure funds are always available to cover this deductible in case of an emergency. A co-pay is an amount that you will have to pay either for doctor’s visits or for prescriptions. These payments typically do not count towards lowering your deductible.
Coinsurance is another factor in making your choice of health care insurance provider. This is represented as a percentage of the total cost. For example, in an 80/20 plan, the insurer will pay 80 percent of the medical bills, and you are responsible for 20 percent of the bills.
Ultimately the cost of a health insurance plan and its availability will govern which insurance plans are available to you. Be sure to research your choices carefully however as lower priced plans may not always be the best choice.
