Types of Health Insurance in Georgia

Health insurance is a necessary component of life for individuals and families in Georgia. Understanding the different types of health insurance policies that are available is essential in providing the best coverage at a low cost to the consumer. The types of policies that are available to Georgia residents include individual and family, group, public and supplemental policies, as well a policy for the unemployed. Determining which type of policy is best for you and your family depends upon your employment and needs.

Individual Policies

• This type of policy is for consumers that are not provided health insurance by their employer and have to purchase a policy independently. With this type of policy, not everyone that applies will be guaranteed coverage. Those that do obtain coverage may or may not have pre-existing conditions covered. Mandatory benefits are benefits that are guaranteed to be covered by the insurer and can include cancer screening, maternity care and osteoporosis screening. Individual and family health insurance plans is different from self-employed health insurance plans. Self-employed health insurance is for individuals that are entrepreneurs that are looking to provide affordable coverage for themselves and or family. To purchase an individual or family health insurance policy, there are a number of companies that offer various plans that will suit you and your family's needs. Coverage can also be purchased from unions or associations that one is a member of and that offers health care coverage.

Group Policies

• Group health insurance is provided by an employer to its employees. Non-profit organizations and unions also offer coverage to its members. Members and employees can obtain coverage for themselves, as well as their spouse and children. The type of policy that is provided is chosen by the employer or organization. With group health insurance, everyone is guaranteed coverage and pre-existing conditions can be covered as well. The mandatory benefits are the same as the benefits covered by the individual and family health insurance policy. Within group polices, you can select either an HMO, PPO or POS policy. An HMO is one of the least expensive policies offered, but it also has fewer health care providers that are part of the network when compared to a PPO or POS policy. PPOs are more popular because they have a larger base of health care providers and plans are a little bit more expensive than HMOs. A POS policy is the most expensive policy. Unlike HMOs and PPOs, you can see any doctor that is in or out of the POS network. There is also a policy called COBRA that allows employees that are retiring, have been laid off or have reduced their work hours to maintain their and their family's health insurance for a limited amount of time.

Public Policies

• Medicaid coverage is a federal and state funded program that is designed for pregnant women, the disabled, and individuals that are living in poverty and cannot afford health care coverage. To determine if you are eligible for care and the amount Medicaid will pay for certain services, you can contact your county's Department of Family and Children Services Office. You can still work and qualify for Medicaid as long as your income is insufficient to replace the cost of Medicaid services. This coverage will cover the costs for the care of pregnant women, office visits, and other necessary medical care, but may not cover services such as cosmetic surgery, dental, and vision care. Medicare is a health care policy for those that are over the age of 65. You may also qualify for Medicare if you are of any age and have kidney disease or failure or are permanently disabled and cannot work. There are different types of Medicare plans available to Georgia residents and they include HMO, PPO, and a PFFS plan. Individuals that have Medicare often purchase supplemental insurance to help cover costs that Medicare does not cover. The supplemental insurance can help to cover long term care in a nursing home as well as the cost of prescription drugs. The PeachCare for Kids program is a special health insurance program designed for children under the age of eighteen in Georgia. In order to qualify for this program, a child cannot be eligible for Medicaid and must come from a household whose income is 235 percent less than the federal poverty level. This program delivers no cost health care to children under the age of 6 and a low cost premium to those that are 6 and older. PeachCare covers pre-existing conditions a child may have.