Aetna coverage is a hot commodity right now, and with good reason – Aetna coverage is among the most affordable types of health insurance available in Georgia today. There are several different types of Aetna coverage, so let’s have a look at what’s on the market.

Aetna Coverage Option One: Managed Choice Open Access & PPO First Dollar 30

The first thing you’ll notice about Aetna coverage is that the plans have frightfully long names.

The Managed Choice Open Access & PPO First Dollar 30 plans are the top of the line when it comes to Aetna coverage. There’s no deductible on these plans – instead, with this Aetna coverage option, you’ll pay 30% of your bills until $7500 comes out of your pocket. After that point, you’ll pay nothing and your Aetna coverage will pay 100%. Office visits are handled by a $30 copay ($40 for specialists). Visits to an urgent care center will run $50 under this Aetna coverage plan, and visits to the ER will cost you $300 flat-fee (unless you’re admitted, in which case this Aetna coverage waives the $300 and goes back to charging you 30% until you’ve reached your annual $7500 out-of-pocket limit). 

Prescription drugs are subject to a $500 deductible. Generics are a $15 copay (deductible waived), so only preferred drugs ($40 copay) and non-preferred drugs ($60 copay) are subject to the deductible with this Aetna coverage.

The Verdict: This Aetna coverage is pretty magnificent, but it carries a magnificent price tag, too. If you want to spend this much on your health insurance, why not limit your out-of-pocket exposure a little more and get a Copay Select plan with Golden Rule?

Aetna Coverage Option Two: Managed Choice Open Access & PPO First Dollar 40

This Aetna coverage is essentially the same as the first, with the following modifications

• This Aetna coverage pays 40% of your bills, not 30%
• The maximum out-of-pocket is $12,500, not $7500
• Office visit copays are each increased by $10
• Brand name drugs are not covered

The Verdict: The lack of prescription benefits with this Aetna coverage really kills it. As always, I never recommend a plan with less than full prescription benefits.

Aetna Coverage Option Three: Managed Choice Open Access & PPO 1500

This Aetna coverage is more in line with what most people think of when they think “health insurance.” Here, we’ve got a $1500 deductible – once that’s met, this Aetna coverage will pay 80% of your bills and you’ll pay 20% until an additional $1500 comes out of your pocket. At that point, your Aetna coverage will pay 100% of your bills.

Office visits with this Aetna coverage are handled by a $25 copay ($35 for specialists). Generic prescriptions cost $15 without meeting any deductible. After a $250 prescription deductible, preferred drugs cost $35 and non-preferred cost $50. 

The Verdict: This Aetna coverage is just about top-of-the-line and carries Aetna’s trademark affordability. This is an excellent option.

Aetna Coverage Option Four: Managed Choice Open Access & PPO 2500

This Aetna coverage is the same as the PPO 1500 with the following modifications:

• There’s a $2500 deductible, then 20% coinsurance to an additional $2500 out-of-pocket (our previous Aetna coverage had $1500, 20%, and $1500)
• Office visit copays are $30 ($40 for specialists)
• Prescription drugs are handled in the same style, but this Aetna coverage carries a $500 prescription deductible instead of $250.

The Verdict: A more affordable version of the 1500 Aetna coverage without any significant holes. Again, an excellent option.

Aetna Coverage Option Five: Managed Choice Open Access & PPO 3500

Again, this Aetna coverage is the same as the PPO 1500 and 2500 with the following modifications:

• There’s a $3500 deductible, then 20% coinsurance, then a $6500 out-of-pocket limit, making the total liability for this plan $10,000
• Office visit copays are $35 ($45 for specialists). 
• Prescription drugs are handled in the same way as with the PPO 2500 Aetna coverage.

The Verdict: This Aetna coverage includes a $6500 out-of-pocket limit, making the total liability on this plan a little too high. The price difference between this Aetna coverage and the PPO 2500 is not large enough to justify the difference in liability.

Aetna Coverage Option Six: Managed Choice Open Access & PPO 5000

Once again, we have a plan that works the same as our previous few options with a couple of modifications:

• This plan has a $5000 deductible, 20% coinsurance, and then a $5000 out-of-pocket limit. This means that the total liability is the same as with the PPO 3500 option, but the deductible is larger.
• Office visits are handled with a $40 copay ($50 specialist).
• Prescription drugs have a $500 deductible and work the same as our last two Aetna coverage options.

The Verdict: If your budget restricts you to this or the PPO 3500, the 3500 will give you greater flexibility and value. However, it’s very much worth the slight price increase to move up to the PPO 2500 and cut your liability in half.

Aetna Coverage Option Seven: Managed Choice Open Access & PPO Value 2000

This Aetna coverage option has the word “Value” in the name, which loyal readers of Georgia Insurance Options will know is code for “watch out – limited benefits ahead.” However, Aetna breaks the mold a bit by offering a robust coverage option and only limiting unnecessary benefits.

Here, you’ll have a $2000 deductible. Once you meet that, you’ll pay 30% of your bills until an additional $2000 comes out of your pocket. At that point, your Aetna coverage will pay 100%. 

You’ve got six office visits per year covered by a copay ($40, or $50 for specialists). Specialist and non-specialists share those six visits under this Aetna coverage option, so budget those visits wisely.

Generic prescriptions are again a $15 copay, and the deductible is waived. Other prescriptions, however, are subject to a $200 prescription deductible with this Aetna coverage option. After that’s met, you’ll pay a $25 copay for preferred drugs and a $40 copay for non-preferred drugs. 

The Verdict: Extremely affordable with low liability means this Aetna coverage option is a great choice for just about anyone. The only people I wouldn’t recommend this plan to are parents with very young children – those six visits will dry up quickly with them.

Aetna Coverage Option Eight: Managed Choice Open Access & PPO Value 5000

Not to sound like a broken record, but this Aetna coverage option is the same as the previous plan with the following modifications:

• You’ll have a $5000 deductible, then 30% coinsurance to an additional $5000 out-of-pocket.
• The prescription deductible is $500, not $200. 

Aside from that, this Aetna coverage option is identical to the previous plan.

The Verdict: This Aetna coverage option is decent if you’re on a budget, but the Value 2000 is far superior and the prices aren’t that far apart. I suggest looking at the Value 2000 Aetna coverage option more closely if you’re considering the Value 5000 plan.

Aetna Coverage Option Nine: Managed Choice Open Access & Value 10000

This Aetna coverage option is flat-out bad. 

First, you’ve got a $10,000 deductible. Once you meet that, you’ll pay 30% of your bills until you pay an additional $2500 out of pocket for a total liability of $12,500.

You’ve got two office visits per year covered by a $30 copay. After that, under this Aetna coverage option your office visits begin falling to your deductible.

Generic drugs under this Aetna coverage option cost $20, no deductible. After a $500 deductible you can get preferred drugs for $40, but non-preferred drugs aren’t covered. On top of that, there is a maximum prescription benefit of $5000 per year for prescription drugs – meaning if you’re on $8,000 a round outpatient cancer treatment drugs, you’ll be out of pocket for everything after the first round.

As a final straw, this Aetna coverage option has a $1,000,000 lifetime maximum benefit. Seems like a lot until you realize that the standard is usually $5,000,000 and some plans in Georgia go up as high as $25,000,000

The Verdict: This Aetna coverage option is bad, bad, bad. However, admittedly, it’s the cheapest health insurance plan in the state of Georgia. If you absolutely, positively cannot afford anything else, then this Aetna coverage option is technically better than nothing.

Aetna Coverage Option Ten: Managed Choice And Open Access Preventative and Hospital Care 1250

This one’s no good either.

First, you’ll have a $1250 deductible with this Aetna coverage option. After you meet that, you’ll pay 20% until an additional $3000 comes out of pocket. At that point, you’ll be covered at 100%.

Office visits are not covered expenses, meaning that with this Aetna coverage option you’ll not only pay for the entire bill for your doctor’s visits, but that amount won’t apply to your deductible and you won’t get network repricing. Horrible!

Labs and X-Rays aren’t covered either. Neither is physical therapy or durable medical equipment (like wheelchairs, crutches, etc.). Again, “not covered” means you’ll not only pay for them, but the cost won’t apply to your deductible with this Aetna coverage.

Preventative care under this Aetna coverage is handled well, giving you unlimited visits at $25 a pop – but who goes for preventative checks more than once or twice a year?

Finally, you’ll get your generic drugs at $15 each, but brand-name drugs are not covered. That’s the final nail in the coffin of this Aetna coverage.

The Verdict: I sat here for ten minutes trying to think of a reason why you should buy this Aetna coverage, and I didn’t come up with a single one. A resounding “NO.”

Aetna Coverage Option Eleven: Managed Choice Open Access and PPO Preventative & Hospital Care 3000

Somehow, worse than the 1250 Aetna coverage.

This Aetna coverage is probably the single most offensively awful thing I’ve ever come across. You’ve got a $3000 deductible, 20% coinsurance, and then another $2000 out of pocket. Then your Aetna coverage kicks in and pays 100% of your bills.

Again, office visits aren’t covered. Labs and X-Rays aren’t covered. Physical therapy isn’t covered. Durable medical equipment isn’t covered.

Under this Aetna coverage, you don’t even get the $15 generics – there is simply zero prescription drug coverage.

The Verdict: I wouldn’t wish this one on my worst enemy. This Aetna coverage option is the absolute, bottom-of-the-barrel worst health insurance plan offered by any major insurance company in Georgia. It is absolutely, positively unthinkable that there would ever be a situation in which this Aetna coverage option was the right choice for you.

Aetna Coverage Option Twelve: Managed Choice Open Access & PPO High Deductible 3000 (HSA Compatible)

The last two Aetna coverage options are very good and very simple. This Aetna coverage has a $3000 deductible – costs before it come out of pocket, costs after are paid 100% by Aetna. That’s it – doctor’s visits, hospitalizations, prescription drugs, everything. Once you’ve paid $3000, you’re done for the year and your Aetna coverage will pick up the rest. This is an extremely simple HSA style plan with very few moving parts and an integrated prescription deductible.

The Verdict: While this Aetna coverage option is great, it doesn’t offer any advantages over the Humana Autograph Total Rx series of plans. These two often run neck-and-neck as far as pricing goes, so comparison shop. However, as we’ll see in a moment, even if the Humana plan comes out to be $30 a month more expensive I’d probably recommend it over the comparable Aetna coverage.

Aetna Coverage Option Thirteen: Managed Choice Open Access & PPO High Deductible 5000 (HSA Compatible)

This plan is functionally identical to the previous plan – the only difference is that the deductible is $5000 instead of $3000. This, of course, makes the plan slightly more affordable while trading off some of the risk. 

The Verdict: My feelings about this Aetna coverage are the same as they are about its $3000 sister. Compare closely against Humana to see which one works better for you.

Special Considerations

There are a couple of things to consider when you’re looking at an Aetna coverage option. Although the plans are some of the most affordable in the state, Aetna has a reputation for being somewhat difficult to deal with on the billing side. Aetna coverage comes with Aetna bureaucracy, which means increased headaches when it comes to getting bills paid and rates negotiated.

Aetna also has a nasty habit of raising their rates multiple times in the second year of coverage, turning a very affordable Aetna coverage plan into an overpriced bank-drainer. In contrast, Humana and Golden Rule will raise their rates once a year at most, and Assurant will allow you to lock in your rate for up to three years on some plans.

There’s also no option to add maternity to your Aetna coverage, so if you’re planning a family then this isn’t the company for you.

On the positive side, Aetna’s dental coverage is widely regarded as some of the best in the business. It’s accepted across a large range of practitioners and geographic areas and is a very affordable form of dental coverage, too. 

The final verdict on Aetna coverage in general: The plans are affordable (for the first year), but you’ve got to be very careful which one you pick. You could either get awesome Aetna coverage, or be stuck with one of the worst plans in the state – there’s very little middle ground when it comes to Aetna coverage. The company also has a slightly spotted reputation, but it’s still a first-tier carrier and that means it’s miles above no-names like Imerica and World.

In short, Aetna coverage is a good budget option, but probably shouldn’t ever be your first choice. Always compare these plans closely with offerings from Humana and Golden Rule before making your final decision.

Now that you’ve learned more about Aetna coverage than you probably ever wanted to know, it’s time to find out how much it costs! Head on over to our free Georgia insurance quote page to get your instant, personalized proposal now!

Which Aetna Coverage is Right for Me? is a post from: Georgia Insurance Options

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Assurant insurance (you may be more familiar with their old name, Time or Fortis) is a major player in the Georgia insurance scene. Assurant insurance plans are uniquely customizable, ultra-flexible, and offer some of the most individually tuned coverage options available in the private insurance market today. If you’re looking for health insurance, then Assurant insurance is an excellent choice.

Please note: Georgia Insurance Options has access to the “Assurant Insurance Elite Product” line – a group of Assurant insurance plans that few brokers in the state of Georgia are able to offer. For that reason, some of what you’ll read here will hold true only at Georgia Insurance Options. The short version of the difference between an Elite Assurant Insurance Broker and a Standard Assurant Insurance Broker is this: the elite lines have more coverage at the same cost.

Now, let’s compare each and every Assurant insurance plan one-by-one to see which ones shine and which don’t.

Assurant Insurance Plan Number One: MaxPlan

The first Assurant insurance plan is called MaxPlan, and it offers the most comprehensive coverage you can get in an Assurant insurance plan. You can elect an office visit copay of $35 (with unlimited visits), generic drugs are covered by a $15 copay, and brand name drugs are covered with a $25 copay plus 20% of the drug cost after a $500 deductible. That extra 20% can mean drug costs can add up quickly with this Assurant insurance plan.

You can select a deductible ranging from $500 to $25,000, a coinsurance level of 100% to 50%, and a maximum out-of-pocket past the deductible of $0 to $7500. The huge range of mix-and-match options means that this Assurant insurance plan is incredibly customizable to your specific needs.

The Verdict: Unfortunately, this Assurant insurance plan is generally overpriced, and the prescription drug benefit is lacking. If you really love this plan, then I recommend getting very similar benefits at a fraction of the cost with Humana’s Portrait Unlimited Plan.

Assurant Insurance Plan Number Two: CoreMed

Our second Assurant insurance plan is far more reasonably priced. Like Assurant insurance plan number one (MaxPlan), you can elect a $35 office visit copay with this plan. This time, however, this Assurant insurance plan will only cover four office visits per person per year – visit five and up are subject to the deductible and coinsurance.

With this Assurant insurance plan you can again select a deductible anywhere from $500 to $25,000 and a post-deductible out-of-pocket maximum of $0 - $7500. The coinsurance level ranges from 100% to 50% just like with our first Assurant insurance plan, MaxPlan.

Unfortunately, prescription drugs are handled in a similar way to the first Assurant insurance plan: $15 copay for generics, $500 deductible then a $25 copay plus 50% coinsurance. That can get astronomical quickly, and honestly should disqualify this Assurant insurance plan from consideration. When you consider the cost of brand-name cancer treatment drugs alone, this Assurant insurance plan simply doesn’t have the coverage anyone needs.

The Verdict: Assurant insurance almost hit a home run with CoreMed, but the weak prescription drug coverage kills it. Again, if you like the idea of having an office visit copay but saving a little money by having a set number of office visit copays available per year, ditch Assurant insurance and the CoreMed plan and check out Humana’s Autograph Share 80.

Assurant Insurance Plan Three: RightStart

At this point, you may be wondering if Assurant insurance has anything worth buying. They do, but it’s not RightStart.

This Assurant insurance plan is unacceptable. Deductibles range from $500 to $3000, and coinsurance levels go from 75% to 60%. Office visits are covered by a $25 copay and are limited to two per person per year. So far, so good.

However, outpatient benefits are capped at $2500 per year (a single ER visit will usually exceed that – with this Assurant insurance plan, you can buy that up to $5000, but it’s still awful). Annual benefits are capped at $50,000 per year, so this plan will not cover claims above that number in any year (Assurant insurance will let you buy that up to $100,000, which is still unacceptable). 

Prescription drugs under the RightStart Assurant insurance plan are handled in exactly the same way as with the CoreMed Assurant insurance plan, but the RightStart Assurant insurance plan won’t pay more than $2,000 per year in benefits. This, again, is an absolutely unacceptable limitation.

The Verdict: Under no circumstances should you ever consider buying this Assurant insurance plan. There’s a reason that it’s jokingly referred to as “WrongStart” by insurance agents.

Assurant Insurance Plan Four: SaveRight

Here’s a general tip: anytime you see a health insurance plan with the word “value,” “save,” or “budget” in the name, be very careful. The SaveRight Assurant insurance plan is significantly better than RightStart, but it still falls short.

Deductible levels with this Assurant insurance plan range from $2300 to $5100, and coinsurance levels run from 100% to 0%. Maximum post-deductible out-of-pocket levels range from $0 to $3000, and no office visit copay option is available with this Assurant insurance plan.

Prescription drugs don’t have a copay – instead, you pay for drugs out-of-pocket until you hit your deductible, at which point they’re covered at 100%. However, be very careful – with SaveRight, your prescription drug benefits are either capped at $2000 or not subject to an annual maximum. It only costs about nine dollars with this Assurant insurance plan to get full prescription coverage, but many agents fail to include that benefit.

The thing that cripples SaveRight is that outpatient services are capped at a maximum of $25,000 per year. A hole in coverage this huge just isn’t acceptable for true major medical insurance. When you consider that this plan also only covers outpatient physical medicine up to $50 per visit for just two visits, a simple broken arm or leg can completely max out the plan benefits.

The Verdict: The inclusion of an outpatient cap opens you up to too much risk. You can get full benefit plans for the same cost as this Assurant insurance plan, so I don’t recommend it.

Assurant Insurance Plan Five: OneDeductible PPO

This is where Assurant insurance truly shines. The OneDeductible PPO is an excellent plan I’d happily recommend to anyone. With this Assurant insurance plan, you select a deductible of $1200 to $5000 ($2400 to $10000 family). You can set this Assurant insurance plan to pay 100% after the deductible is met, or set an 80% or 20% coinsurance level to a maximum post-deductible out-of-pocket limit of $2000.

There is no office visit copay, so doctor’s office visits come out-of-pocket. Prescription drugs do the same – under this Assurant insurance plan, drugs go towards your deductible and are covered at the level you’ve chosen once you meet it. 

All in all, it’s a simple plan – you’ve got a deductible. Once you meet it, you’re covered at 100% (or at 80% or 50% to a maximum out-of-pocket of $2000, if you chose to save a little on your Assurant insurance premiums).

The Verdict: This Assurant insurance plan is extremely reasonably priced, offers totally comprehensive coverage, and is competitive with products from other carriers. It’s also the best product Assurant insurance offers, so if you’ve got your heart set on Assurant insurance, then this is the plan for you.

Assurant Insurance: The Add-Ons and Optional Benefits

Assurant insurance has a ton of optional benefits that you can add. Let’s go through each Assurant insurance optional benefit one-by-one.

Health Savings Accounts

We’ve talked about HSA’s elsewhere, so instead of rehashing that here we’ll just note that SaveRight and OneDeductible PPO are both HSA eligible plans.

RightStart Cancer Benefit

If you, for some unknown reason, simply must go with RightStart Assurant insurance, then you can increase the annual outpatient maximum of $5,000 by $25,000, but only for cancer treatments.

Preventative Care Benefit

If you chose the OneDeductible Assurant insurance plan, you can get $500 of first-dollar coverage for preventative care by adding on this benefit. This means that well-care visits, physicals, mammograms, etc. are covered up to $500 per person per year (total) before you have to pay a dime. You must have this Assurant insurance plan with this add-on for one year before using this benefit, though.

Maternity Benefit

We’ve discussed the Assurant insurance maternity benefit in depth already, so we won’t go through it all again here. One thing to keep in mind is that Assurant insurance has the shortest waiting period of all Georgia insurance carriers for maternity benefits: there’s only a ninety-day waiting period. 

Dental-Vision Discount Plan

Adding on the dental-vision discount plan to any Assurant insurance plan provides discounts on services from dental and eyewear providers. Savings range from 15% – 50% on dental services and 10% to 60% on eyewear. This is a discount plan rather than true insurance, but it’s a nice add-on to an Assurant insurance plan.

Dental Insurance

You can add dental insurance to the health part of any Assurant insurance plan. However, the dental insurance add-on to Assurant insurance plans is less attractive than the full dental coverage discussed in our earlier article on the subject because of the fee-for-service nature of the program. Basically, instead of being guaranteed coverage, you have to compare your procedures to a checklist and determine what the coverage level is with this add-on benefit. 

Accidental Medical Expense Benefit

With Assurant insurance, you can add a first-dollar benefit of $500, $1000, or $2500 that will cover any accidental injuries you might have. No matter what your deductible or how close you are to meeting it, Assurant insurance will pay your selected amount off the top of your bill before you ever pay a penny.

SuiteSolution – SecureSolution Level

SuiteSolutions is a “benefit package” you can add on to any Assurant insurance plan that will provide you with some extra optional benefits to reduce your risk. The first level available to you is the SecureSolution level. You get an Accident Medical Expense Benefit like the one described above, but with two modifications: the benefit level can be $2500, $5000, or $10000 and there’s a $250 deductible per insured, per accident. Secondly, you get an accidental death and dismemberment benefit of up to $10000 for the primary insured and up to $1000 for the spouse and each child (essentially, this is a life insurance policy that pays in the event of accidental death, or pays a reduced benefit in the event of severe dismemberment or deformation). Lastly, adding SecureSolutions to your Assurant insurance will pay 70% of your weekly salary to a maximum of $250 per week for the primary insured if the primary insured is forced out of work due to an accidental injury.

SuiteSolution – SelectSolution Level

With the SelectSolution add-on to any Assurant insurance plan, you get all the SecureSolution benefits plus a critical illness expense benefit. Adding this to any Assurant insurance plan will provide $2500, $5000, or $10000 (your choice) in the event of life-threatening cancer, heart attack, stroke, renal failure, coma, organ transplant, loss of sight, loss of hearing, loss of speech, or paralysis. A critical illness add-on to any Assurant insurance plan can really help you out in a time of sudden need.

OneDecreasingDeductible

With the OneDeductible Assurant insurance plan, your deductible will gradually decrease over time if you don’t have any claims on your policy. You have to elect a higher deductible, and there’s a waiting period before your deductible will begin decreasing but a full outline of just how the OneDecreasingDeductible works would take another five pages and is beyond the scope of this article. Note that you must elect to make this plan HSA eligible for your deductible to gradually decrease.

We’ve gone over a ton of options relating to Assurant insurance in this article, and it’s probably a little overwhelming. Assurant insurance offers more options to its clients than any other insurance company in Georgia, and for that reason it’s exceptionally important that you work with an agent to get your Assurant insurance plan.

Now that you know how the plans work, get a free, instant Assurant insurance quote on our Georgia insurance quote page! There’s no obligation, no cost, and the quotes are instant. And remember, if you ever have any questions about Assurant insurance, or any other insurance, Georgia Insurance Options is here to help!

Which Assurant Insurance Plan is Right For Me? is a post from: Georgia Insurance Options

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United Healthcare is one of the biggest and best known insurers in the USA today. Their individual division, Golden Rule, is responsible for insuring individuals and families who don’t have insurance through a group plan. For ease of reference throughout this article, please note that when we say UHC insurance, we mean United Healthcare insurance, and that their individual division goes by the name Golden Rule.

There are a variety of UHC insurance plans you can choose from when you’re getting private health insurance. Let’s go through each UHC insurance plan one-by-one and look at the benefits of each.

UHC Insurance Plan One: Copay Select

The first UHC insurance plan we’ll look at is the robust Copay Select. This is a plan structure you’re probably very familiar with by now: you select a deductible of $500, $1000, $1500, or $2500. Once you meet that deductible, this UHC insurance plan will pay 80% of your bills until an additional $2000 comes out of your pocket. At that point, this UHC insurance plan will begin to pay 100% of your bills.

Doctor’s office visits are handled by a $25 copay with this UHC insurance plan. Well child care and immunizations (for children 6-18) are covered with that same $25 copay, but labs and x-rays performed outside of the doctor’s office are subject to the deductible (which means you’ll pay for that service out-of-pocket under this UHC insurance plan until you’ve met your deductible). With this UHC insurance you’ll pay $15 for generic prescriptions, and (after a $100 prescription deductible) $30 for preferred and $60 for non-preferred medications.

The verdict: This UHC insurance plan is for the people who want the best of the best and don’t care about cost. The $500 deductible plus a few optional benefits (discussed later) make this UHC insurance plan one of the strongest available on the private market – but it comes with a strong price tag, too.

UHC Insurance Plan Two: Copay Saver

UHC insurance plans are all like this: a great plan, and then a more stripped down “saver” version of the same plan. The Copay Saver UHC insurance plan is identical to the Copay Select with the following changes:

• There’s a $3000 out-of-pocket after the deductible instead of a $2000 out-of-pocket
• You can only select a deductible level of $2500
• Outpatient x-rays and labs are only covered if performed within 14 days of surgery or medical confinement – a gap that severely weakens this UHC insurance plan
• $35 copay instead of $25, and each person on the plan only has two visits per year
• If you go to the ER with this UHC insurance plan but aren’t admitted, you’ll have a $500 copay to contend with
• There are no preventative care benefits with the Copay Saver UHC Insurance plan, but you can add them on again later.
• Several outpatient procedures aren’t covered – listing them all is beyond the scope of this article, but they’re outlined in the policy brochure available for download at the free health insurance quote page.
• There is no name-brand prescription drug coverage, only $15 generics

The verdict: I strongly recommend against this plan. The gaps in coverage are too great to justify the savings on monthly premiums. If you really want a more affordable copay plan, then instead of this UHC insurance plan check out the Autograph Share 80 Humana Plan.

UHC Insurance Plan Three: HSA 100

HSA 100 is the number two most-loved UHC Insurance plan according to client satisfaction surveys. With it, you’ve got your choice of deductible ($1150, $1900, $2900, $3500, or $5000 for individuals; $2300, $3850, $5800, $7500, or $10000 for families). Under this UHC Insurance plan, once you meet that deductible the rest of your expenses for the remainder of the year will be paid at 100%. Prescription drug costs also apply to the deductible, and this UHC insurance plan is HSA eligible. The preventative benefits aren’t great unless you add the preventative care package, which is cheap and very robust.

The Verdict: the second best UHC insurance plan you can get, and a great price tag, too. If you’re in love with the HSA concept then this UHC insurance plan is the one for you – otherwise, hold out for Plan 100.

UHC Insurance Plan Four: HSA Saver

It’s set up again with a standard UHC insurance plan and then a stripped-down saver version. Again, the coverage for this UHC insurance plan is identical to HSA 100 with the following exceptions:

• Outpatient x-rays and labs aren’t covered unless they’re within 14 days of surgery or confinement under this UHC insurance plan.
• Doctor’s office visits aren’t a covered expense, a huge gap in this UHC insurance plan.
• Emergency room fees are covered normally if you’re admitted to the hospital, but with this UHC insurance plan if you’re not admitted then you’re limited to $250 per person per year in benefits.
• Outpatient prescription drugs, adult preventative care, and childhood immunizations are all not covered under this UHC insurance plan.

The Verdict: I don’t recommend this plan – the gaps in coverage are just too great.

UHC Insurance Plan Five: Plan 100

When it comes to UHC insurance, Plan 100 is where it’s at. This is the most popular UHC insurance plan by far and enjoys the highest customer satisfaction rating of all UHC insurance plans.

Plan 100 has a choice of a $2500, $3500, or $5000 deductible. These are individual deductibles, and the family deductible is always twice the chosen individual deductible. That means that even if you have twenty children, if you have the $2500 deductible level then your entire family’s medical bills for the rest of the year will be paid at 100% once the family’s medical costs reach $5000. Everything applies to the deductible – doctor’s visits, prescription drugs, hospitalizations, everything. Well care for the kids up to age five is covered at 100% before the deductible (in other words, under this UHC insurance plan it’s free). 

The Verdict: This plan is not HSA eligible, so if you love the HSA concept then you’ll like HSA 100 better. Personally, I prefer Plan 100 for the more competitive price and the fact that this UHC insurance plan has more optional benefits (discussed later) available.

UHC Insurance Plan Six: HSA 80

This UHC insurance plan is identical in every way to HSA 100 in terms of what’s covered. The deductible levels are the same, the coverage is the same, everything is the same – the only difference is that this UHC insurance plan pays 80% once you meet the deductible instead of the 100% that HSA 100 pays. Once $3000 comes out of your pocket after the deductible is met, then this UHC insurance plan will pay 100% of your medical costs. 

The Verdict: This is the only “budget” UHC insurance plan I’m comfortable recommending to any of my clients. There aren’t any gaps in coverage – it’s just a little cheaper and your benefits are a little slower to kick in. If you’re on a budget and don’t like the Monogram Humana Plan, then this is what you should have.

UHC Insurance Plan Seven: Saver 80

The cheapest UHC insurance plan is, of course, the one with the fewest benefits. Saver 80 has deductible levels of $500, $1000, $1500, $2500, $3500, and $5000. Once you meet your deductible, this UHC insurance plan will pay 80% of your medical costs until another $3000 comes out of your pocket. Then, this UHC insurance plan will pay 100%. 

This plan has some pretty hefty gaps in coverage, though:

• Doctor’s office visits aren’t covered
• Outpatient x-rays and labs are only covered if performed within 14 days of surgery or confinement
• Outpatient prescription drugs aren’t covered (this alone makes this UHC insurance plan not worth having)

The Verdict: Plan 80 is only a few dollars more, so if you’re really on a budget then that’s where you should be looking. I would shy away from Saver 80

UHC Insurance: Optional Benefits

There are a number of optional benefits available for add-on to some UHC insurance plans. Let’s look at them one-by-one:

UHC Insurance Preventative Care Package:

Note: this benefit isn’t available with the Copay Select plan. 

The preventative care add-on gets you free well-child visits up to age 18, free childhood immunizations, free mammograms, free pap smears, and free PSA tests (all one per year). Also, after a twelve-month wait, adults can get preventative care for just a $35 copay. This is a no-brainer, a great add-on to any UHC insurance plan.

UHC Maternity Insurance:

We go over this one in pretty great detail at How Maternity Insurance Works, so we won’t re-hash it here. Just keep in mind that this benefit isn’t available with either HSA 100 or HSA 80 – most people like to add this to their Plan 100.

UHC Prescription Drug Card Benefit:

This one is available with Plan 100 and Plan 80 and it allows you to get any generic prescription for only $20. Name brand drugs can be had for a $50 copay, but you’ve got to meed at $250 per year, per person deductible first.

UHC Supplemental Accident Benefit:

This one isn’t available with the HSA plans, but if you add it on to any other UHC insurance plan you’ll get first-dollar coverage up to $500 for the treatment of an injury resulting from an accident. This is an awesome add-on to any UHC insurance plan, it’s super cheap, and can save you a bundle when you need it.

UHC HSA Hospital Indemnity Rider

With the two HSA plans, you can add on a hospital indemnity rider to help protect you against major hospitalization expenses before you’ve built up cash in your HSA. Basically, on the third day of hospital confinement, this UHC insurance add-on will pay you a lump sum of cash to help offset the hospital costs. There’s a one-time additional premium payment of $40 ($150 family), and the benefit will pay $1500 ($3200 family) if the hospitalization occurs in the first month of coverage. The benefit then slowly decreases until finally it disappears at month sixteen. This is a great add-on to a HSA eligible UHC insurance plan because it provides significant, early-on protection and buys you time to build up your HSA.

Now that you’ve learned more than you ever wanted to know about how UHC insurance plans work, you’re probably dying to know how much they cost. Well, Georgia Insurance Options has you covered there, too. Head up to our free, instant Georgia health insurance quote page where you’ll receive an instant, personalized proposal telling you just how much you can save and how you can get protection for your family today!

Which UHC Insurance Plan Is Right For Me? is a post from: Georgia Insurance Options

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When it comes to individual insurance in Georgia, Humana is one of the best choices you can make. Each and every Humana plan offers excellent coverage, and there’s really no such thing as an unaffordable Humana plan. Let’s go over each Humana plan one by one and see what each one has to offer.

Humana Plan One: Autograph Total HSA

The first Humana plan is called the Autograph Total HSA, and this particular Humana plan comes in two flavors (integrated and non-integrated prescription deductible). The Autograph Total HSA Humana plan has a set deductible for the individual (for single person coverage) or for the family ranging from $1500 – $5000 ($3000 – $10000 for a family). Once that deductible is met, then this Humana plan will pay 100% of your medical costs for the rest of the year. 

With the integrated prescription deductible, any prescription drugs you buy will chip away at that total deductible. With the non-integrated prescription deductible, all of your prescriptions are handled with a discount card, meaning a percentage of your prescription costs are knocked off. The Autograph Total Humana Plan with the discount card also has a slightly different deductible structure ($2000-$5200 individual, $4000-$10400 family). Of these two, I strongly recommend getting the full prescription benefit offered by the Autograph Total Humana plan with an integrated prescription deductible.

Also, it’s worth noting that once the Autograph Total Humana plan has been effective for 90 days, everyone on the plan can get a routine annual physical, mammogram, pap smear, colorectal cancer screen, chlamydia screen, and transvaginal ultrasound totally free of charge. Child wellness visits up to age five are also free, and immunizations from age six to eighteen are free as well under this Humana plan.

Finally, as the name implies, this Humana plan is HSA (health savings account) eligible. 

The verdict: this Humana plan (with the integrated prescription deductible) provides the best combination of comprehensive coverage and affordable premiums on the market today. I like this plan for anyone ready to ditch the office visit copay.

Humana Plan Two: Portrait Unlimited 80

The second Humana plan is the one that probably looks a bit more like what you’re used to. With this Humana plan, you’ve got a $35 office visit copay ($50 for specialists), and then your medical deductible of either $1000 or $2500. Once you meet your medical deductible with this Humana plan, Humana will pay 80% of your bills until an additional $2000 comes out of your pocket. At that point, this Humana plan will start to pay 100% of your bills.

When it comes to prescriptions, this Humana plan divides things into four tiers. Tier one prescriptions are your basic generics (you can often get these at Wal-Mart for $4) and cost $15 if you can’t find them cheaper elsewhere. Tiers two through four are subject to a prescription deductible of $500 (you can buy this deductible down to $0, but it’s not really worth it). Once you’ve met the $500 prescription deductible under this Humana plan, tier two drugs (high-cost generics and brand-name drugs) have a $35 copay, tier three drugs (higher-cost brand name drugs) have a $55 copay, and tier four drugs (biotechnology drugs, self-administered injectables) have a 25% copay up to a maximum out-of-pocket of $2500 (then, this Humana plan will pay 100%). 

This Humana plan is the sort of health insurance that most people have at work and are most comfortable with. However, the vast majority of people will never take advantage of the unlimited office visit copays offered by this Humana plan – and that means that they’re paying for a benefit that they’re not using. 

The verdict: Get this Humana plan if you’re not ready to ditch the office visit copays yet, but be aware that you’re going to pay slightly more than you would for other any other Humana plan.

Humana Plan Three: Autograph Share 80

This Humana plan is the budget-conscious version of the Portrait Unlimited Humana plan. Here, you’ve got the $35 doctor visit copays ($50 for specialists), but under this Humana plan each family member only has six copays per year. The seventh visit onward will be billed to your medical deductible (either $5000 or $6000). Once you meet your deductible, this Humana plan will again pay 80% of your bills until you have another $2000 come out of your pocket – then, this Humana plan will pay 100%.

Prescription drugs are handled just like the Portrait Unlimited Humana plan, but the prescription deductible choices are $500 and $1000 instead of $0 and $500.

The verdict: This Humana plan is right for someone who really wants that office visit copay, but is on a tighter budget. However, if you’re looking at this Humana plan, then you’re almost certainly going to be better off with the Autograph Total Humana plan.

Humana Plan Four: Monogram

The fourth and final Humana plan is the Monogram. This is the lowest-cost Humana plan available, making it very attractive for the most budget-conscious shoppers. With the Monogram Humana plan, you have a $7500 medical deductible. Once that deductible is met, this Humana plan will pay 100% of your costs. Additionally, you’ve got a $1000 prescription deductible. Tier one drugs still cost $15 and aren’t subject to that deductible, but under this Humana plan tier two drugs are $40 and tier three drugs are $65 after the prescription deductible is met. Tier four drugs are still a 25% copay to a maximum out-of-pocket of $2500.

Child wellness services up to age five, routine annual physicals, routine immunizations from age six to eighteen, routine pap smears, routine mamograms, routine colorectal cancer screens, routine transvaginal ultrasounds, and chlamydia screening tests are all paid at 100% before the deductible with this Humana plan, meaning that they’re totally free. The only catch is that you must wait ninety days to take advantage of these benefits.

The verdict: The lowest-cost Humana plan still has comprehensive benefits, but they won’t kick in until quite a bit of medical expenses have already been incurred. This is a great plan if you don’t have room in your budget for the Autograph Total.

Optional Beneifts: Make Your Humana Plan Shine

You can add a few optional benefits to your Humana plan to really beef it up. First, consider adding a Supplemental Accident Benefit (SAB) to your Humana plan to protect you more completely against accidental injury. With this benefit added (for about $8-$12 per month extra), you can have the first $500 or $1000 of your medical bills resulting from the emergency treatment of an accident paid in full, regardless of what your deductible is. So if you trip and break your wrist, and you’ve added a SAB to your Humana plan, the first $500 or $1000 worth of care will be paid in full at no additional cost to you.

You can also add dental insurance to any Humana plan. We talk about the dental available with any Humana plan in great length over at our full dental coverage article.

Lastly, getting life insurance bundled with your Humana plan is as easy as can be. There are no additional questions, no physical exams required, nothing – if you’re approved to get a Humana plan discussed above, then you’re approved to get term life insurance through Humana as well. However, I recommend against this for two reasons: one, since this is a “non-med term” policy, it’s slightly overpriced. And two, tying your life and health insurance plans together isn’t a great idea – rate increases are much more common in the health insurance world, and you’re not going to keep your individual health insurance when you enter the Medicare years. Because of that, I recommend getting your life insurance through a company that makes life insurance their primary focus. Don’t worry, as an agent, I’m able to help you with that, too!

Now that you’ve seen how each and every Humana plan works and you’ve got a good idea of which one you think you want, head over to our free, instant Georgia insurance quote page and find out just how affordable these plans really are!

Which Humana Plan Is Right For Me? is a post from: Georgia Insurance Options

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“Is health care the same as health insurance?”

This question is making health care the hot-button issue these days, and it’s also making health care the most misunderstood thing around. There’s a major difference between the two, and we’re going to take a short look at what makes health care the target of so much attention in Washington today.

The short answer: health insurance is what pays for heath care. Health insurance, held by individuals or groups, is a system into which the policy holder pays so that when a medical problem arises there’s someone to pay the comparably larger bill, making health care the recipient of health insurance dollars and provider of medical care.

Now, a lot of people lately are mixing up universal health care and universal health insurance – but these are two vastly different things. Universal health insurance refers to a system in which absolutely everyone would be able to get health insurance on a guaranteed-issue basis, regardless of pre-existing conditions. The result of this is that costs would rise for insurance companies (because those insurance will have to pay the medical bills of less healthy people, and with health care the prices for treatment are obviously higher for the more critically ill) and that premiums would rise across the board for insured persons.

Universal health care refers to extending health care coverage to everyone, making health care the step-brother of health insurance in a way. Universal health care is related to universal health insurance, but that doesn’t make health care the same as health insurance by any stretch.

Here at Georgia Insurance Options, we strive to bring impartial views on industry trends and to correct misconceptions such as this without bias. While I publicly neither support nor decry universal health insurance or universal health care, I realize that our current political climate has made health care the issue on everyone’s mind. I hope that this short article has made this issue somewhat more understandable and has answered the question that we set out to address: “Is health care the same as health insurance?” While they’re related, and are becoming more and more intertwined at the governmental level, for now we still have a private system, making health care the realm of the doctors  and insurance the realm of the agents and insurers.

If you have any questions or concerns about this article, or you just want some help making health care the topic of your next talk with your agent, please feel free to contact me. And, since you’re here already, why not make saving on health insurance a priority like you’ve made learning about health care the focus of the past few minutes? You can get a free, personalized insurance quote right here at Georgia Insurance Options – we’re still in a private health insurance system, why not save a little money?

Health Insurance and Health Care – The Difference is a post from: Georgia Insurance Options

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