Georgia Individual Health Insurance options in 2015 On and Off Exchange
Written by Bobby Huffaker
Competition Available On and Off the Exchange in Georgia for 2015 plan year
There are two different markets in the Georgia health insurance marketplace that we refer to in order to easily differentiate: On Exchange and Off Exchange. On Exchange is for individuals that qualify for advanced premium tax credits or subsidies (tax credits are available from 100% of the federal poverty level to 400% of the federal poverty level; that’s roughly $12,000 in monthly income for an individual to $94,000 for a family of four). Off Exchange is for individuals that do not qualify for advanced premium tax credits. There are different carriers that decide to compete only off exchange, while some compete in both.
In Georgia, there were 9 carriers that competed On Exchange for 2015. Ambetter for Peach State Health Plan, Assurant Health, Blue Cross Blue Shield Healthcare Plan of Georgia, Cigna Healthcare, Coventry Healthcare of Georgia, Humana, Kaiser Permanente, UnitedHealthcare, and Alliant Health Plans.
Ambetter for Peach State Health Plan
Ambetter for Peach State Health Plan is a private insurance company that was only competitive around Atlanta, Georgia. They only had a HMO network, which requires you to see a primary care physician before visiting any other specialist providers. Think of your primary care physician as a gatekeeper, who then allows you to go see any recommended specialist. If used properly, HMO networks do a good job of keeping unnecessary medical costs at bay. Ambetter for the Peach State did not service North Georgia, where health insurance costs are some of the highest in the country. To view a provider list visit http://apps.pshpgeorgia.com/findadoc/showNetwork?prodId=916.
Alliant Health Plans
Alliant Health Plans is the dominant health insurance carrier in North Georgia. They were a great solution for people that live in North Georgia as they were the lowest cost option and had the best network in that area. They also provide a great network that extends into Tennessee, so if you live in Georgia and seek care in Chattanooga or other bordering towns in Tennessee it is a great option. To view the provider list go to http://www.ahpassist.com/.
Blue Cross Blue Shield Healthcare Plan of Georgia
Blue Cross Blue Shield of Georgia was priced very competitive for 2014. Having the lowest cost option in a few service areas, Blue Cross Blue Shield of Georgia offered HMO health insurance plans only on exchange this year. The network was sufficient in most cities, however in North Georgia and smaller populations the provider network was much more limited. To view a provider list go to https://www.bcbsga.com/health-insurance/provider-directory/searchcriteria?alphaprefix=JRA.
Cigna offered competitive health insurance rates in 2015 On Exchange with several options on all metal levels except for the platinum level plan. They were only competitive in the Atlanta area, not having great rates in North and South Georgia. In the Atlanta area, the plans available were for the PPO network, which is a great network across Georgia and nationwide. To view the Cigna network go to http://ifphcpdir.cigna.com/web/public/ifpproviders?.
Coventry Healthcare of Georgia
Coventry Healthcare of Georgia was only offered in the Atlanta area on exchange. In the Atlanta area it was an HMO network, but has quite a large offering of providers in that area. Outside of the Atlanta area, Coventry was not very competitive from a price standpoint. To view their network go to http://www.providerlookuponline.com/coventry/po7/Search.aspx.
Humana was a competitive plan in and around the Atlanta area in Georgia. They serviced a large area around Atlanta but were non existent in other parts of the state. They offered their PPO network in Atlanta which was attractive to many of our clients. To view the Humana network go to https://www.humana.com/finder/medical?pageId=c4c1e0fa2e39464da707916a4a8349f1.
Like Humana, Coventry, and Cigna; Kaiser Permanente’s focus was on the Atlanta area on the individual health exchange market and has always had a strong presence in the Atlanta area in the employer market. The only network available on exchange was an HMO network. With a wide range of providers in the Atlanta area, it is a solid choice among carriers. To view the Kaiser network go to: https://healthy.kaiserpermanente.org/health/care/consumer/locate-our-services/doctors-and-locations.
United Health Care
UnitedHealthCare had a very large presence in Georgia this year. Behind Anthem Blue Cross Blue Shield of Georgia, it was available in more territories than any other plan. Their HMO network was more narrow in the northern part of Georgia, however in Atlanta and southern cities, there were plenty of options to choose from. To view the United Health Care network go to http://xga.welcometouhc.com/find-a-doctor.
In Georgia, the same health insurance carriers competed Off exchange that were offered on exchange. Health Insurance carriers in North Georgia are a little more willing to participate off exchange in certain areas that they are on exchange. For the most part, Aetna, Alliant, Anthem, Humana, Ambetter for the Peach State Health Plan, and Blue Cross Blue Shield of Georgia were offering their products state-wide.
For more information about how Off Exchange or On Exchange options may affect you, give us a call at 888.995.1674 to speak with a licensed enrollment specialist or you can email us at info@AmericanExchange.com
About American Exchange
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