Georgia



 

About Health Insurance in Georgia

Georgia residents have access to a variety of companies in the US for health insurance. East Coast Health Insurance connects you to the best of Georgia’s medical care options with Aetna, Humana, United, HMOs from Kaiser Permanente, Coventry, Blue Cross Blue Shield of Georgia, and Cigna.

Statistics

  • Total Population: 9,671,400
  • Total Uninsured Population: 1,942,600 (16%)
  • Typical Cost of Inpatient Hospital Visit Per Day: $1,338
  • Average State Premium for Individual Health Insurance: $220

Information provided by Kaiser Family Foundation, 2010.

Choosing a Plan in Georgia

East Coast Health Insurance simplifies the process of getting a quote. Start by entering your zip code above, or for extra assistance you can speak with one of our Georgia experts to find the best rates for you over the phone at 888-803-5917.

Georgia Medicaid by the Department of Community Health provides many programs that benefit the citizens in our state. In this section, you’ll find direct links to some of the most widely-used programs.

Medicaid

  • Georgia Medicaid Application
  • PeachCare for Kids® –  PeachCare for Kids® is a comprehensive health care program for uninsured children living in Georgia. The health benefits include primary, preventive, specialist, dental care and vision care. PeachCare for Kids® also covers hospitalization, emergency room services, prescription medications and mental health care. Each child in the program has a Georgia Healthy Families Care Management Organization (CMO) who is responsible for coordinating the child’s care.  Downlaod the PeachCare English Application and apply now.
  • Georgia Families (Managed Care) Georgia Families is a program that delivers health care services to members of Medicaid and PeachCare for Kids®. The program is a partnership between the Department of Community Health and private care management organizations (CMOs). By providing a choice of health plans, Georgia Families allows members to select a health care plan that fits their needs.  Enroll here.
  • Pharmacy Program – More than 1.26 million enrollees receive prescription drug benefits through DCH’s Medicaid and PeachCare for Kids® programs and through the State Health Benefit Plan. Medicaid and PeachCare for Kids® cover all rebated outpatient drugs from participating manufacturers with some exceptions. Regular retail pharmacies and some specialty pharmacies are reimbursed for prescriptions at a rate set by the department.
  • Georgia Health Insurance Program Matrix

 

Georgia Health Insurance Market & Laws

Georgia’s regulations on health insurance are similar to other states, with important provisions such as guaranteed renewability, which protects the consumer from losing their policy at the end of a term. As long as you have not violated your policy terms, missed any premium payments, or had any lapses in coverage, your insurer must renew the same plan you had previously.

In Georgia, pre-existing condition laws are fairly lenient, to the benefit of insurance companies. Pre-existing conditions are not defined in the state of Georgia, therefore there is no limit on exclusion periods. Because the insurer can decide what a pre-existing condition entails, they can also choose the length of an exclusion period for what they consider an illness for which they do not wish to provide coverage. Though the exclusion period can be however long the insurance company decides, it will not exceed two years.

Regulations in Georgia for health insurance also mandate that newborns and adoptees are placed on their parents’ individual insurance plan for the first 31 days after birth or adoption. If your insurance plan has the capability of coverage for dependents, then this law applies.

Insurance companies in Georgia have many liberties with what they can decide in terms of costs and eligibility for coverage. In order to not get overcharged or not get the medical coverage you need, it is necessary to understand what the insurance companies are allowed to do and how you can be proactive. For one, being in as good of health as possible is always a safe plan of action when applying for health insurance. Laws in Georgia allow health insurers to set your premium cost according to your health and age, as well as being able to deny you insurance altogether.

Coverage

For individuals who live in Georgia, health insurance is required to cover the following medical expenses:

  •  Treatment for some diabetes-related illnesses
  • Breast, cervical, colorectal, ovarian, and prostate cancer screenings
  • Cancer clinical trials for children under age 19
  • Immunizations for children

For more information on covered services and other questions regarding health insurance laws, contact the Georgia Office of Insurance.

 

Sources:

1. Kaiser Family Foundation, “Georgia – State Health Facts”. www.statehealthfacts.org

2. Georgia Department of Community Health, “Medicaid”. dch.georgia.gov/

3. Georgia Office of Insurance. www.gainsurance.org/

4. Health Insurance In-Depth, “Georgia Health Insurance”. http://www.healthinsuranceindepth.com/health-insurance-Georgia.html