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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1. Should you buy health insurance from an agent, or directly from the company?

This one’s easy: use an independent health insurance agent. The rates are the same since they’re set by law, and agents don’t charge any sort of “broker’s fees” or anything to use their service. Agents tend to know a lot more about your options than your average call center employee, and they’ll work with you for the life of your policy.

2. What are the top five health insurance companies in Georgia?

Based on my personal experiences (level of client service, ease of application, claims payment record, etc.), I’d say that the top five individual health insurance companies in Georgia are:

1. Golden Rule (the individual division of United Health Care)
2. Humana
3. Assurant
4. Aetna
5. Kaiser Permanente

Each company has its quirks, of course – Golden Rule is great if you’re in perfect health, but they love to issue riders. Assurant is more expensive, but they are more lenient in their underwriting. Aetna will decline anyone with three prescriptions. Humana doesn’t offer maternity benefits, and Kaiser requires you to stay within Kaiser facilities with most of their plans. Every company is different.

3. Can I still get COBRA if I was fired?

In most cases, yes. There is a provision in the COBRA law that says you are ineligible for COBRA if you were “terminated for gross misconduct,” but that has never been tested in court. Generally, if you leave a company (either voluntarily or involuntarily) and that company stays in business and keeps the group plan that you were on in force, you can get COBRA.

4. Is there such a thing as emergency maternity coverage?

No. If you’re already pregnant, no major medical insurer will issue a policy to you. Now, there are some guaranteed issue policies that will cover you, but you must be extremely careful with those – oftentimes, you’ll either end up paying more for the policy than you would for the pregnancy, or you’ll get stuck with a bill that the insurer will weasel out of. Never purchase a policy like that without consulting with an agent, preferably an independent agent who can compare it with true major medical plans.

5. How do I get my pre-existing conditions covered with an individual health insurance policy?

Depending on the condition, it’s possible that you can just apply for coverage and have it covered. Things like high blood pressure, cholesterol, and most allergies aren’t generally excluded from coverage under individual health insurance policies (however, the rates to cover these conditions may be higher). If you have a more serious condition, like diabetes or Crohn’s Disease, your options are more limited. In Georgia, there’s no state risk pool, so if you’re above the income level for Medicaid then you’re not eligible for state assistance. Your best bet is to find employment with benefits, or, if you’re self employed, talk with an agent about going on a small group plan. That’s a tricky option, but it can be done. There are some guaranteed issue plans in Georgia that will cover pre-existing conditions, but like with question four, you must be extremely careful with those. You can wind up losing a lot of money if you’re not. 

6. What does maternity insurance cover?

Maternity insurance covers the costs associated with a normal pregnancy. Depending on how your specific maternity benefits are structured, you may either have a set amount of money to apply to maternity costs or your maternity costs may apply to a separate deductible. It’s worth noting that true emergency c-sections are covered by your normal health insurance plan.

7. What do I do when my COBRA runs out?

When your COBRA eligibility runs out, you can do one of two things. You can either purchase an individual policy, or you can elect to use a HIPAA conversion option. With HIPAA conversion, the health insurance company that administered your COBRA plan will switch you over to an individual plan, and you can’t be turned down for coverage. HIPAA conversions aren’t available until you have used up your entire COBRA eligibility period.

8. How does my deductible work?

Your deductible is the amount of money in medical costs you’ll be responsible for before your insurance company starts picking up part of the bill. If you have a copay plan, your copays generally will not apply to the deductible. Once you meet your deductible, then (depending on your plan) your insurance company will either pay 100% of the rest of your bills, or you’ll pay a small percentage until you reach your out-of-pocket limit. That small percentage is usually 20%, but some plans do increase that amount.

9. How did the new stimulus package change COBRA?

Previously, if you wanted to go on COBRA then you had to pay 102% of your health insurance premiums. That came as a shock to many people who went on COBRA, because they were used to paying only a portion of the full premium while their employer picked up the rest of the tab. Now, for the first nine months of COBRA eligibility, you’ll only pay 35% of your premiums and your former employer will pick up the other 65% (they’ll be reimbursed in the form of a payroll tax credit). At the end of those nine months, things go back to the way they used to be and you’ll start paying 102%.

10. What’s the best life insurance option for me?

Most people are best served with simple term life insurance. Get a policy that’s guaranteed renewable so that you never have to worry about being uninsurable, a face value that will provide for your loved ones (don’t forget to pay off debt and account for lost income when you’re figuring out how much you should get), and discuss the various riders available with your agent. In my humble opinion, variable life, universal life, and whole life are just not worth it for the vast majority of people. Term is simple, term is easy, and term is what you need. There are a ton of life insurance options out there, and with all the riders available you can really customize your term life insurance to fit your needs.

Bonus!

11. What does “no-stone-unturned” quote mean, anyway?

I get asked this one a lot, so I thought I’d toss it in there. I’m an independent agent, so when you come to me with a health or life insurance question I work with a bunch of different companies to make sure you’re getting the best deal on the market. Instead of just sticking you with an easy-to-issue policy, I leave no stone unturned to make sure that when I run a quote and write an application with you that I’m doing what’s in your best interest. 

Did I miss any burning questions? Anything you’re absolutely dying to know? Then feel free to comment on this post, use the contact link at the top of the page to email me, or just call me up at 404-660-1020 and I’ll be happy to answer any questions you might have. Who knows, your question might make it into the next edition of this article! Or if this cleared up all of your questions and you’re ready to see how much you could be saving on your insurance, then head to our free insurance quote page and get a no-obligation, personalized quote!

Reader’s Choice: Top Ten Health and Life Insurance Questions is a post from: Georgia Insurance Options

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You can find affordable health insurance in the private market!

In fact, let’s repeat that one, because a lot of people find it hard to believe: you can find affordable health insurance in the private market! Just because you’re getting health insurance as an individual instead of part of a group doesn’t mean you have to destroy your bank account every month. The secret is to realize that there’s not one magic bullet that can take health insurance from a giant money sink to just a small portion of your budget, but instead that there are a number of factors that will work together to make your health insurance affordable.

The first thing you should do is look into high deductible health plans. These insurance plans are a lot more simple than most types of health insurance: you have a deductible, and that’s about it. Before your deductible, you’re responsible for your medical costs. After your deductible, your insurance company will pay your bills. Simple! Because these plans don’t include a lot of bells and whistles (either you’re working on meeting your deductible or your insurance company is paying for everything), they’re affordable for the health insurance company – there’s just not a lot of stuff for them to worry about. That means that the savings are passed on to you, making high deductible health plans a very affordable form of health insurance.

If you decide to go with a high deductible health plan, making your health insurance more affordable is pretty simple. Raising your deductible will lower your monthly premiums, and lowering your deductible will raise them. One thing that you should always keep in mind when you’re looking at deductibles is how your particular insurance company defines a “family deductible.” Some companies will assign every family member an individual deductible, some will assign the family as a whole a deductible, and others will give individual deductibles but say that when either two or three family members meet them then the entire family’s deductible is considered met. Your agent will know how each individual company handles family deductibles.

The major thing that people worry about with high deductible health plans is the fact that office visits aren’t covered by a copay. In our dedicated article about HDHP’s we discuss why this isn’t as big an issue as many people think, but if an office visit copay is something you feel like you can’t live without then you still have ways to find affordable health insurance.

The first of these is to ask yourself how many times a year you actually go to the doctor. If it’s only three or four times, but you still really want a copay for those visits, then consider looking at limited copay plans. These plans offer comprehensive benefits and a copay for a certain number of office visits a year (usually two to six). The first few visits are covered by a copay, but after that you’ll be responsible for the full amount of your medical bills until you meet your deductible. Having a limited number of copays a year instead of an unlimited number will make your health insurance significantly more affordable.

The second big thing you can do is to raise your deductible. Having a slightly higher deductible can drastically lower your monthly premiums. This one is pretty self-explanatory: raising your deductible lowers the amount of financial risk the insurance company takes on, saving them money. Those savings are passed on to you in the form of more affordable health insurance.

The last thing is something you should do no matter what: work with an independent agent. There are no “broker’s fees” or anything like that when you work with an agent, so you’ll end up paying the same in premiums that you would going directly to the insurance company. And since independent agents work with several insurance companies, we know who has the best rates and best coverage for various situations. For instance, for the majority of people in Georgia, maybe Carrier A is the most affordable. But perhaps for people in a certain age range Carrier B has better rates, and for people with high blood pressure Carrier C has the most affordable premiums. Your agent, who will have the ability to shop around and work the system in your favor, will be able to find the most affordable health insurance premiums while not sacrificing coverage.

Affordable health insurance is out there, and now you know the easiest way to find it is to use an independent health insurance agent. Luckily, you’ve got an independent agent at your disposal right now! Head on over to our free health insurance quote page and find out just how much you could be saving!

Getting Affordable Health Insurance is a post from: Georgia Insurance Options

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This economy is rough, no doubt about it. Lots of people are suddenly finding themselves laid off, unemployed, and without the group health insurance benefits they had come to rely on. The transition out of the active job market can be rough, and the last thing most people want to think about is finding new private health insurance (not to mention private health insurance that is also affordable health insurance)! Unfortunately, that’s one of the first and most important things you’ll have to worry about.

The first thing to do is to figure out if COBRA health insurance is right for you. Since we’ve discussed how to do that at length in another article, there’s no need to repeat the entire topic here. If you’ve read that article and determined that you need to look for affordable health insurance on your own, then read on.

You’re probably used to group health insurance, but now you’re looking for private health insurance – and those are two very different animals. There are a few key differences between the two types of insurance that you’re going to want to be aware of:

• A private health insurance policy with the same benefits as a group policy will be more expensive than that group coverage. This is unfortunate, but it is a reality of private health insurance. This isn’t to say that private health insurance can’t be affordable, but you should be ready to either pay a little more for the same coverage or investigate a somewhat higher deductible.
• Group insurance is, by law, required to provide certain maternity benefits. Private health insurance is not bound by that same requirement, so maternity benefits aren’t automatically included. Check out our article on how maternity benefits work in the private market for more details.
• If you have any pre-existing medical conditions (you’ve had cancer or open heart surgery in the past, currently have Crohn’s disease, currently have diabetes, etc.), your options for private health insurance are going to be severely limited. In this case, COBRA is probably your best option.

If COBRA isn’t right for you, then your next step is to think about how long you’re likely to be unemployed. If your prospects for employment look good and you think you might be back in the workforce in six months or so, then a short-term health insurance policy might be right for you.

However, if you think it’s going to take more than six months to get back into the workforce, or if you are considering taking advantage of your newfound unemployment to explore the possibility of becoming self-employed, then a normal full-term private health insurance policy will be your better option.

The sudden loss of income that comes with unemployment means that finding an affordable health insurance plan is important to your budget. However, it’s very, very important to remember the following: an affordable health insurance plan can still provide comprehensive benefits. There are cheap health plans that offer limited benefits, leaving gaping holes in your coverage – avoid these at all costs! Remember, that plan that seems too good to be true probably is – the ten bucks a month you can save on your premiums by buying a limited benefit plan will quickly be wiped out when you find out you need surgery or major medical treatment that your limited benefit plan won’t cover.

Now, you’ve learned about the difference between private health insurance and group health insurance, you’ve seen how to determine if COBRA, short-term medical, or full-term health insurance is the best choice for you, and you know that you need to make sure to buy a comprehensive health insurance plan instead of a limited-benefit policy. There’s only one more thing you need to know before you start looking for your new private health insurance plan:

DON’T HESITATE!

When you find yourself suddenly unemployed, you’re working against the clock. If you immediately purchase private health insurance, so long as you don’t have any pre-existing conditions, your new insurance company will see that you just got off of a group plan and won’t have any trouble issuing you a policy. That’s because they know that if one insurance company had you as a client, then you’re probably okay to be a client of theirs, too. However, if you wait too long (about three weeks) to purchase a private health insurance policy, you’ll have what’s known as a “gap in coverage.” When you go that long without health insurance and then go to buy a new private policy, your new insurance company will generally make you pick a policy effective date 30-45 days from the date of your application. That way, they’ll have time to review your medical records and make sure that you’re an “acceptable risk” – a process that can be avoided entirely by not having a gap in coverage in the first place.

Now that you know the most important points about moving from a group to a private health insurance policy, the last step is to contact an independent insurance agent and work with them to find the best policy for your needs. Let that agent know that you’re newly unemployed and that finding an affordable health insurance policy is important to you, but that you don’t want a limited benefit policy. Since independent agents represent many health insurance companies, you’ll have a lot of options open to you. Your agent will know the best ways to narrow them down and help you find the policy that’s right for you!

I know that finding private health insurance when you’re unemployed is a hard thing to think about. It’s easy to feel like everything is piling up on top of you, and it can get a little overwhelming. However, I’m really glad that you’ve taken the time to read this post and learn more about how to protect your family’s health no matter what. The last step is to get your free health insurance quote so that you can find a plan that will protect you, your family, and your bank account. Don’t worry – I’ve been in your situation before, too, and I’ve already learned from my mistakes. But you can protect your family, even when the economy is down – and I can help!

Finding Private Health Insurance When You’re Unemployed is a post from: Georgia Insurance Options

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If you look around this website, you’ll find pages and pages of information about how wonderful it is to use an independent agent, how having an expert on your side can save you time and money when dealing with health insurance companies, and how having your own, personal agent on call to address your insurance needs can truly save you. But, there is one downside to using an independent insurance agent: we’ve got access to hundreds of different policies.

Now usually that’s a good thing. It means that you have a great deal of choice, that you’re not tied down to any one company or product line, and that your agent can just about always find a policy that offers the right combination of protection and monthly cost for your needs. However, that amount of choice can also get a little overwhelming and can make the task of narrowing things down to just one plan seem slightly daunting. Imagine walking onto the lot at a Carmax and just telling a salesman “I want a car.” He’d probably look at you blankly and have no idea where to get started, right? Even though that car salesman knows where everything is on the lot and knows the details and specs for all of his cars, he still needs you to let him know a little about what you want in order to help you find the right vehicle for you. So you go to the dealership armed with a little information, like how many passengers you want to be able to seat, what color you want, what kind of interior, and so on and so forth. Health insurance works in a very similar way – there are hundreds of plans out there, and the benefits are very different with all of them. Some cover well-care for children, while some have excellent accident benefits. Some have better copay structures, while some have an awesome health savings account component. If you know a little bit about what you want, you and your agent can work together much more effectively to find the policy that will work best for you.

So, how do you do that? How do you go about figuring out what type of policy is best for you and your family? You don’t have to have all of the answers, of course, since you’ll be working closely with an independent agent and he’ll be able to help you figure that out, but like we discussed a moment ago, it’s a good plan to have a basic idea of what your needs regarding health insurance will be.

In my experience, the best way to get started is to ask yourself three questions:

1. What do I like about your current policy?
2. What don’t I like about your current policy?
3. If I could design a policy from the ground up for yourself, what would you put in it?

Answering these three questions will just about always point you towards the right policy for you. There are a few things to keep in mind when you’re asking yourself these things.

When you’re thinking about what you like about your current health insurance plan, think about the past few times you’ve had to use it. Have you been to the doctor’s office or emergency room lately? Did you have a copay for either visit? Have you had to call your insurance company recently, and if so, were you satisfied with the level of customer service you received? What kind of deductible do you have now? How are your prescription drugs handled?

Thinking about these things will also probably reveal what you don’t like about your current plan. Maybe your current deductible is too high, or your prescriptions aren’t covered like you want them to be. Maybe you don’t have a copay and you want one – or maybe you do have a copay, but you never use it and want to lower your premiums by doing away with it.

When you get through thinking about what you like and don’t like about your current insurance policy, you should have a decent idea about how you feel about your deductible, your copay, and your premiums. Additionally, if you’ve had to use your health insurance lately, you’ll probably have an idea about any special circumstances you want your policy to cover (for instance, if chiropractic care is covered, if wellness benefits are included, and so on).

Now with that information, you’re ready to tackle the third question: if you could design a policy from the ground up, what would you put in it? This is where you get to make sure any special considerations you may have are taken care of. For example, do you want to make sure that your child under age five will have free well-care checkups? Do you want to make sure a certain prescription drug is covered? Do you want to have extra coverage if you have some kind of accident (known as a supplemental accident benefit)?

The next step is to take this idealized plan you’ve built and give it an unfortunate “reality check.” Personally, I want a health insurance plan that has a $10/year deductible, covers all of my office visits with a $2 copay, gives me free prescription drugs whenever they’re prescribed, sends me Chinese food on Fridays, and does it all for under $5 a month. That plan, however, doesn’t exist, which means you’ll need to identify which category you have more flexibility in: are you more willing to let your premiums go up a little to get the coverage you want, or do you want to increase your deductible and maybe eliminate your copay to get down to the monthly premiums you can afford?

Think about this: the difference between a $1500 and a $2500 deductible is $1000 a year, but if you save $84 a month by moving to a higher deductible, then you’ll have made up that difference just from your premium savings. That means you have that money in your pocket instead of sending it to the insurance company – and believe me, if you don’t meet that $1500 deductible, they’re not going to send any of your money back for “overpaying” them. Raising your deductible can put extra money in your pocket while still giving you comprehensive coverage, and is probably the area you should look at when you’re trying to figure out how to fit health insurance into your monthly budget.

Now, you’ve identified what you like about your current policy, what you don’t, and what you would change. On top of that, you’ve figured out what sort of deductible you’d like to look at, if you want an office visit copay, and any special things you want included in your new health insurance policy. Furthermore, you’ve figured where you can be flexible if you have to be: benefits, or premiums. The only thing that’s left is to sit down and start looking at policies until you find one that matches what you want.

Everything up to now has sounded harder than it really is. Unfortunately, this last part flips that on its head by sounding significantly easier than it is. There’s much more to the final step than writing down a deductible, copay, and premium amount and just looking at plans until one matches up. This is where your independent agent comes in. With access to hundreds of different policies, that choice that earlier looked overwhelming now just looks welcoming.

With the knowledge you’ve gained from reading and applying the techniques outlined in this article, you and your independent agent are now ready to sit down and figure out the exact policy that will work best for you. And remember, working with your independent agent to select your personal health insurance policy isn’t just a one-time interaction – you’ll be getting an expert on your side who will work for you for the life of your policy. But you’ve already read the article about Why You Should Use an Independent Agent, right?

When you’re ready to start working with your own independent agent, visit our free Georgia insurance quote center. You’ll be shocked at how easy it is to work with an independent insurance agent, and even more shocked at how affordable insurance can be!

How To Choose The Right Health Insurance Policy is a post from: Georgia Insurance Options

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You’ve put your gender, date of birth, and desired date of coverage into a website. Then you’ve been shown three or four plans, each with different premiums and levels of coverage. Even though these plans are backed by contracts which range anywhere from fifteen to a hundred pages in length, the only information you’re given about your options is summed up in three or four bullet points. Do you know exactly what these plans cover? No – at best, you know the office copay, deductible, out-of-pocket limit, coinsurance, and monthly premium. Let’s say you select one of these plans – now they ask you for more information. Height, weight, medical conditions, a few other personal questions, and contact information. Now the fun begins. If you’ve put this information into a carrier’s website, you might get one or two agents from that insurance company calling you to talk to you about what sort of coverage you want. If you’ve put this information into a website offering “Free Instant Quotes From All Major Carriers!!!” then you’re likely about to be in for a shock. That information is instantly sold to anywhere from one to twenty-five agents who will immediately jump on their phone to try to get at you first – you’ve just become a “hot lead,” not a “person” with a “family” who has “insurance needs.” Whether you used an insurance company’s website or a “quote warehouse,” you’ve got problems.

If you used an insurance company’s website, you’re going to be contacted by “captive agents.” Now I’ll give them credit, captive agents usually know their products inside and out. If you have an Aetna captive agent on the other end of the phone trying to sell you an Aetna policy, then he’s going to know just about everything there is to know about that policy. Problem is, he’s not going to know about what Golden Rule, Humana, Assurant, or anyone else has to offer, and he’s certainly not going to encourage you to find out. It’s sort of like going to buy a new car – the Ford salesman is going to try to sell you a Ford, and if he mentions a Chevrolet at all it’s just going to be to tell you how much better his products are. If you get an Aetna agent on one line and a Humana agent on the other, they’re both going to tell you that their policies are the best fit for you. More importantly, they’re not going to highlight the same things about their policies, meaning you’re not going to be able to make an informed and complete comparison. That’s why shopping the major carriers direct just doesn’t work – it results in you being forced to compare apples to oranges when what you really wanted was a banana, anyway.

Things are worse if you enter your information into a quote warehouse site. The agents that will contact you regarding these plans are agents that have bought your information as a “lead” from a website like www.prospectzone.com. More likely than not, your information was sold to at least three agents (sometimes, significantly more – up to twenty-five in some cases) who will all fall all over themselves to get to you before the others do. Then, knowing that there are other agents hitting their redial button, these agents go for the high-pressure quick close. Usually, this means putting you into the cheapest policy they can – the commission check might be lower, but it’s a volume game at this point – regardless of whether or not the benefits suit your needs. These agents assume that if they can quote you a cheaper premium than anyone else, then they’ll make the sale – the quality of the coverage is hardly even a concern! There’s no personal attention, there’s no comparison of policies, there’s no dedication to client service; there’s only trying to pressure you into the sale and, if you don’t feel comfortable buying right away, dumping you and moving on to the next lead that hits their email inbox.

There is one problem common to both of these scenarios, and it’s a big one. When you apply for health or life insurance, your application goes through what’s called an “underwriting process.” During this time, your application is evaluated to make sure the insurance company knows just what it’s getting into when they agree to insure you (this is also the time during which your premiums might be adjusted based on the level of risk you present to the company, or when certain conditions may be “ridered out” as uninsurable). One of the tools underwriters use to evaluate what level of risk you present to the company comes from information made available by the Medical Information Bureau. The MIB, according to their website, alerts its member insurance companies to omissions and fraud during the underwriting of life, health, and other types of insurance. One of the things that will show up in your MIB report is if you’ve ever been declined for health or life insurance coverage before. If you show a decline in your record, it becomes much more difficult for you to be considered an acceptable risk by the company with which you presently want to get insurance. Now, the quickest way for an agent to get a commission check is to get your application out of the door as quickly as possible. Sometimes, agents will send your application to multiple insurance companies at the same time just in case one or two don’t go through. The problem here is this: if these applications get declined, you’re going to have a much more difficult time getting health or life insurance. Since you’re just another “hot lead,” though, and not a person with a family and needs, that doesn’t matter – the goal here is to get your application out as quickly as possible and move on to the next target.

Now tell me: Do either of these scenarios sound like they’re going to result in you getting the policy that’s best suited to your needs? Do you think either scenario ends with you having an agent that remembers your name, your needs, and will still be there to help you in three months when you have a question about your policy?

You have another option – find your local independent agent! Now of course, I’m a little biased (after all, I’m hoping that when you go looking for that independent agent, you’ll find me), but things really are different when you go this route. Shopping for insurance becomes a stress-free, hassle-free experience. When you pick up the phone and call me, or send me an email, message me on Facebook, or even DM me on Twitter, our business is strictly between the two of us. Your information isn’t shared with other agents, sold to mailing lists, or put in some online database so that other people can see your private information. You’re not a lead, you’re not a deal, you’re not an appointment – you’re a client, and you’re someone whose health and life coverage I take personal responsibility for.

Your local independent agent has access to more than just one carrier – not like the captive agents that work directly for the major insurance companies. For instance, I currently offer products from Humana, Aetna, Assurant, Golden Rule, GTL, Imerica, Madison National, World Insurance, Genworth, Colorado Banker’s Life, and AIG, as well as a nifty standalone dental plan through AHCP. And guess what – I have no reason to sell one of these carriers over the other! That means you get a fair and balanced comparison of these major insurance companies and the policies that they offer with no hidden agenda. That also means that you get access to a LOT more options than you would have with a captive agent.

You also get the personal touch. If my email inbox filled up with fifty purchased “hot leads” a day and I called each and every one of them, there’s no way I could remember all the names of the people I called by the end of the day. By the end of the week, forget it! But when you contact your local independent agent directly, you have the chance to have an expert in your corner working for you, not for an insurance company. Now think about this: seven months down the line, when you have a question about your policy, who do you want to call? The giant call-center at the insurance company? The agent that bought your information and a hundred others online and forgot who you were the second his commission check came in? Or would you rather call your local independent agent who went over your policy with you, took the time to shop for you and, out of a sea of options, found the policy that best protects you and your family? The answer to this one should be obvious!

And remember a few paragraphs ago when we were talking about how each and every time your application is declined by an insurance company it gets harder and harder – and eventually impossible – for you to get coverage? Well, that’s only a problem when you deal with someone in a captive agency or someone who has a hundred phone calls to make by the end of the day. Your local agent, who works for you, can call the insurance company before sending your application in. I can call up an underwriter at any of my carriers, give them my agent ID, give them a little information and find out if that policy will be issued, issued with an increased premium, or cancelled. But since I can do that without giving away who is applying, if they tell me the application will be declined then I never even have to send it in. That means there’s no black mark on your MIB records, and that means you still have a chance to get coverage with another company.

There’s one more thing about having your own local independent agent, which almost makes the arrangement too good to be true. We’ve already discussed the fact that your local independent agent will be someone you have the chance to have a personal relationship with and who will always be available to help you with your policy questions. And we’ve already discussed the fact that this local independent agent works for you, not for the insurance company. And we’ve discussed the fact that with a local independent agent you can, at any time, pick up the phone or write an email and have an on-call expert to answer your insurance questions. But here’s the best part. Ready?

It’s all at no additional charge.

You can pay your insurance premiums and have a faceless company that doesn’t know who you are and what your situation is. You can pay your insurance premiums and have a “churn and burn” agent who is interested only in selling you a policy as fast as possible and moving on to the next mark. Or, for the same price, you can have a local independent agent working to protect your family 24/7. Your premiums are going to be the same in every case (and this is by law – insurance companies aren’t allowed to charge different premiums based on who you buy your policy from). The only difference is in the level of service and personalized attention you’ll receive.

Now, there are three ways to buy life and/or health insurance: direct from the company, online through a quote warehouse, or through your local independent agent. The price will be the same for all of them. Knowing what you now know, which one do you think is the right choice?

I think the answer is obvious. Using an independent agent is easy, it’s free, and it’s the surest way to guarantee that you’re getting the best, most affordable policy for your needs. To enlist the help of an independent agent, head up to our free Georgia insurance quote page and get ready to see what it’s like to have a true expert working for you! And by the way, filling our that free quote form is perfectly safe and completely private – I’m the only person who will see the information you submit, and I will never share it with or sell it to anyone. Your privacy is my priority – trust me!

Why You Should Use an Independent Agent is a post from: Georgia Insurance Options

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“I can’t afford health insurance!”

I can’t tell you how many times I heard that when I used to work in a doctor’s office as an insurance benefits specialist. Know what else I can’t tell you? How many people walked out of our doors followed by phone calls, letters, and eventually collections agents and bankruptcy attorneys. What these people truly couldn’t afford was to not have health insurance.

The cost of health care can be astronomical. Accidents happen, critical illness strike, and they generally don’t have the manners to call a week ahead of time to let you know they’ll be visiting. Are you one of the people who says they don’t have health insurance because they can’t afford it – but hey, it’s not like you plan on getting sick anytime soon, right?

Stop reading this article right now. Get in your car, go to the nearest hospital emergency room, and ask how many people there were planning on getting sick. Ask how many of them were planning on having an accident that day. See the guy with the appendix that’s about to rupture? He’ll be getting a bill for over ten thousand dollars in the mail before too long. The kid in the corner who fell off of his bike and whose parents don’t have health insurance coverage? That broken arm is going to cost at least a hundred bucks to evaluate, plus another $175 per x-ray (and they’ll probably do two or three), plus casting fees (triple the cost if the doctor deems a waterproof cast necessary), plus follow-up visits (at least one, at at least $125), plus cast removal (another $150 or more), plus physical therapy if he needs it. The thirty-five year old guy who didn’t realize he had an almost complete arterial blockage until he had a heart attack – forget it. If he survives, he’s bankrupt. If he doesn’t make it, his family will be.

If your budget is truly so tight that you don’t think you can afford health insurance, then take a close look at where your money is going. Ask yourself this: what is going to truly ruin our family, an extra set, steady charge each month that we can plan and budget for, or a sudden crush of medical bills?

I can’t emphasize this enough. You should be looking to save money on the cost of your health care, not your health insurance. Sure, you can adjust your deductible and coinsurance levels. You can eliminate a copay from your plan, like we talked about in another article. But you simply cannot afford to go without health insurance – it’s a gamble, and it’s one that may work for a while, but it’ll get you in the end. The bottom line is this: no matter your situation, you need health insurance. If you’re self employed or own your own business, the costs of a medical emergency can cripple your financial infrastructure and run your business into the ground. If you have a family, you owe it to your children and your spouse to protect them from financial devastation. Even if it’s just you, modern day hero, a healthy young man or woman going it alone, bankruptcy can ground your dreams and take years to claw your way out of. You don’t go broke because you have a monthly premium to pay. You don’t go broke because you’ve factored a set, predictable monthly cost into your budget. If you go broke, it’s going to be because you got slammed with a hundred thousand dollar medical bill and don’t have insurance coverage that will pay for it.

The reason many people think they can’t afford insurance is because they think health insurance is an all-or-nothing proposition. Either you get the $750 a month policy that covers absolutely everything at no cost past premiums or it’s just not worth paying for. This simply isn’t the case. Now, don’t get me wrong; if you have room in your budget for the high-end policy and you, with the counsel of your local independent agent, decide that that’s the level of coverage you need, then that’s what you should buy. But for the vast majority of people, a policy that robust simply isn’t necessary. What’s the point of paying for coverage you simply don’t need? Think about it this way: what’s the point of buying a Hummer with Swarovski crystal rims and velvet airbags when all you want to do is drive to McDonalds?

The reality is, you probably don’t need a plan that has a $10 co-pay for all services with no deductible, no out-of-pocket cost, and 100% coverage. The reality is, you can probably get the coverage you need at a lower price than you think! Your local independent agent will know what plans offer the proper level of coverage while still bringing an affordable price to the table. The fact is, no matter what your budget, there’s a health plan out there that will work for you. Think about your car insurance. It covers you in the event of an accident, right? Do you have car insurance for that day you have an accident, or do you have car insurance to cover your oil changes, new wiper blades, air in the tires, and the occasional wash? Can you imagine how much more expensive your car insurance would be if it covered those things? Health insurance works the same way! Eliminate the benefits you don’t need, put the money you save on premiums away, improve your financial situation, enjoy the peace of mind that comes with comprehensive coverage, and everybody wins.

Save money on the cost of health care, not by eliminating health insurance from your budget. It’s a gamble that you, your business, and your loved ones will pay for when – not if – you lose. Georgia Insurance Options is 100% dedicated to getting you the coverage you need at the price you can afford, so when you’re ready to protect your family head on over to our free Georgia insurance quote page and get your personalized health insurance proposal today.

The Unaffordable Health Insurance Myth is a post from: Georgia Insurance Options

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We all know that health insurance is important – without it, we’re open to an unacceptable level of risk from unforeseeable, unavoidable health problems. But we know too that sometimes it can be tough to fit health insurance into our budgets. Trust me, I know – long ago, my family thought that we were spending a little too much money each month and thought it might be a good idea to save by cancelling our family health insurance policy. Well, after a while, my parents realized that perhaps this wasn’t the best idea – my mother hasn’t ever been the gambling sort, and she was worrying constantly about what might happen if one of us got sick without coverage. So my parents sat back down and decided that we’d just skip eating out a few times a month, maybe give up some of the premium channels in our cable package, and perhaps I didn’t really need to be taken to Toys R Us quite so often (I realize now that they made the right decision, but there’s no way you could have convinced me of that then!).

That was probably about fifteen or sixteen years ago. Since then, my parents’ combined medical bills have totaled in the millions of dollars. A fourteen year battle with Ménière’s Disease for my mother and a failed struggle with cancer for my father meant the bills rolled in fast and hard – and we didn’t see the onset of either one coming. Looking back now, I almost have to laugh. The amount we’ve paid in premiums is negligible compared to what the cost of her streptomycin injections and brain surgery would have been out-of-pocket. Paying for health insurance instead of HBO doesn’t seem like such a sacrifice when I realize it bought me a few extra weeks with my dad. The point is, I know it can be tough to find room in the monthly budget for health insurance coverage – but it can frequently be absolutely impossible to find room for those medical bills once they hit you.

We’ve used this example in another article, but it’s a good one that bears repeating. What do you use your car insurance for: to cover your expenses in the event of a wreck, or to cover the expenses associated with oil changes, new windshield wipers, fresh air filters, and a wash and wax every weekend? Of course, your car insurance is there to cover the big things – not the little tiny things like the ones we just listed. But if your car insurance did cover those little things, can you imagine how expensive your premiums would be?

Health insurance works the same way! If you want your health insurance to cover every bump and scrape, then your premiums are going to be higher. If, however, you are willing to take responsibility for some of the minor costs of your medical care, then your premiums are going to be much, much lower. There’s a way to do this, and it’s called a High Deductible Health Plan. Remember the story I told you at the beginning of this article about my own life experiences with the health care industry from the consumer’s perspective? Those bills didn’t come from check-ins with our pediatrician, or from a case of the sniffles. They came from surgeries, tests, and esoteric procedures – and those are the crucial risks you can’t afford to not be protected from.

A High Deductible Health Plan, or HDHP, is defined as any health insurance plan with a single-person deductible of $1100 or more (or a family deductible of $2200 or more) and a maximum out-of-pocket limit of $5600 or more (or a family out-of-pocket maximum of $11200). Usually, however, a HDHP is set up with a straight deductible around $2500 to $5000. You are responsible for your medical costs up to that point – after that, you’re covered at 100% of allowable charges.

What does this mean? Well, first off, it means your premiums are lower. Since you’re assuming more responsibility for the little costs of your personal healthcare, the insurance company doesn’t need to take as much money in the form of premiums to cover that risk.

Secondly, it means that your insurance is covering the things you truly need. If you have a cold, sure, you’re going to have to pay for that visit to the doctor out of your own pocket. The average visit to a primary care physician costs about $60, not including any labs or diagnostics that might need to be done. Think about it though, how many times in the past year have you gone to the doctor? Say you went three times, and each visit cost you that $60 – that’s $180 in doctor’s office charges for the year. So for the year, you’ve spent the same as $15 every month ($15 a month X 12 months = $180). But if you’ve saved $30 a month by switching to a high deductible health plan, then you’re still ahead of the game! Not only that, but you’ve still got quality insurance to protect your assets in the event something happened.

Now, keep in mind, we’re not talking about limited benefit plans. A high deductible health plan isn’t a plan that has a ton of limitations, riders, exclusions, and confusing clauses. The premiums for a HDHP aren’t lower because the plan doesn’t cover cancer, or won’t pay on claims related to high blood pressure – if it’s a covered expense under one of the $1000 a month policies, then it’s a covered expense under a HDHP. The only difference is that you have to meet a higher deductible before your benefits kick in and, usually, that you won’t have a copay for your smaller health care concerns.

There’s one more thing about high deductible health plans that makes them an excellent solution for your health insurance needs: HDHP’s are the only type of plan qualified for health savings accounts.

A health savings account is a tax-advantaged medical savings account. Any money you place into your health savings account is not subject to federal income tax and can be used for qualified medical expenses at any time without federal tax liability. In other words, if you put money into a health savings account and then pay for a qualified medical expense with funds from that health savings account, then that money is never subjected to federal income tax. You can put up to $3000 a year (for an individual policy, or $5950 a year for a family policy) into your health savings account, and those funds roll over year after year after year. So long as you have a HDHP, you can keep depositing money into your health savings account up to the annual contribution limit. If you cancel your HDHP and move to a plan that doesn’t qualify for a health savings account, you don’t lose your money – you can keep taking it out until the account is depleted, but you can’t put any more in. Furthermore, you can take the money in your health savings account at any time even for non-medical expenses, but the funds you withdraw become subject to income taxation and you incur a 10% penalty.

So basically, with a high deductible health plan, you get the same coverage, a lower premium, qualify for a tax-advantaged health savings account, and have more control over your health care dollars. Sound like a good deal?

High deductible health plans are the hottest product in health insurance these days, and it couldn’t be easier to start saving money with one each and every month. Head over to our free Georgia insurance quote page and find out just how much you’re overpaying now and how to put that money in your pocket, not an insurance company’s!

High Deductible Health Plans is a post from: Georgia Insurance Options

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