georgia

Best Ways To Get Affordable Health Insurance in Georgia

 insurance helps to pay the cost of medical expenses incurred from an ailment or injury. It can as well cover some day-to-day medical expenses such as dental, vision and prescriptions. your age is one of the most important factors in determining wellness insurance prices.

For example, a 40-year-old would pay 28% more per month, on average, for the same health insurance plan than a 21-year-old in Georgia.

What is considered the best health insurance in Georgia for you will vary depending on where you live since this determines the availability of insurers and policies. While the number of insurers available in a county varies, not all metal tiers of coverage are available in each county either.

Georgia uses the federally run health insurance exchange/marketplace. If you are not opportune to have employer-sponsored health insurance, you will need to purchase a health plan through the health insurance marketplace, also called the exchange. 

What Then is The Health Insurance Marketplace?

The Health Insurance Marketplace is a resource where individuals, families, and small businesses can:

  • Compare health insurance plans for coverage and affordability.
  • Questions you have about your health care insurance can be answered.
  • Confirm if you are eligible for tax credits for private insurance or health programs like Medicaid or the Children’s Health Insurance Program (CHIP).
  • Register for a health insurance plan that caters for your needs.

Health plans one can find on the state and federal marketplaces often cover four “metal” categories: Bronze, Silver, Gold and Platinum. The categorization is done by how a health insurer and consumer split health care costs. For instance, a bronze plan will have the lowest monthly premium but higher out-of-pocket costs when a person seeks care. 

A platinum one, however, will have the highest monthly premium but the lowest out-of-pocket costs when a person seeks care. Certain customers may also purchase catastrophic health plans which offer low premiums but very high deductibles.

It is important to note that Metal categories are based on how you and your insurer split the costs of your health care. It is in no way changes or alters the quality of care.

No matter which metal category you pick, you can save a lot of money on your monthly premium based on how much you make at the end of said month. When you fill out a Marketplace insurance application, you’ll find out very quickly if you qualify for these savings.

Higher metal tier policies, such as Gold and Platinum health plans, are usually the best alternative if you expect to have high or consistent medical expenses throughout the year. Although these health insurance plans have more expensive monthly rates, their out-of-pocket expenses, such as deductibles and copays, are much lower.

Therefore if you do need to use your health insurance, you’ll have to pay less yourself before your policy provides coverage.

Contrastingly, Bronze and Catastrophic health insurance policies have the most affordable premiums, but the most expensive cost-sharing features.

For young, healthier customers who don’t expect to use their medical coverage throughout the year, these policies offer the lowest cost. But we would only advise this strategy if you can cover the out-of-pocket costs following an emergency.

Silver health plans, on the other hand, offer the best of both worlds, a middle ground if you expect to have moderate health care expenses, as they balance affordable rates and cost-sharing.

Silver policies are also likely to be the best cheap coverage if you have a low-income household, as these health plans qualify for cost-sharing reduction subsidies, which would lower out-of-pocket expenses. 

Typical Silver plans cover about 70% of your health care costs, while you pay 30%. But under CSR subsidies, you could qualify for a Silver plan that covers up to 94% of your health care costs. For lower-income families, these health policies often offer the best value for money.

Silver plans are best for those looking for a middle ground between the higher monthly premiums in a Gold plan and the lower coverage found in Bronze or Catastrophic metal tiers.

Bronze plans: Best for young, healthy people

Bronze plans present cheaper monthly premiums than higher metal tier plans at the expense of reduced coverage and higher out-of-pocket costs. This would mean paying more out of pocket before your health insurance kicks in. On average, you can expect a Bronze plan to cover about 60% of your health costs, while you pay for the other 40%. Expanded Bronze plans increase coverage to about 65%, while you pay roughly 35%. To lay it simply:

  • Lowest monthly premium
  • Highest costs when you need care
  • Bronze plan deductibles — the amount of medical costs you pay yourself before your insurance plan starts to pay — can be thousands of dollars a year.
  • Great choice if: You want a low-cost way to protect yourself from worst-case medical scenarios, like serious sickness or injury. Your monthly payments also knowns as premium will be low, but you’ll have to pay for most routine care yourself.
Metal TierConsumer paysInsurer pays
Bronze40%60%
Silver30%70%
Gold 20%80%
Platinum10%90%

What Metal Tier Cost-Sharing Means For You

The percentages in the table above are useful because they give you a quick way to compare health plans.

Plans that would require you to pay more of your own money (if you use medical services) most definitely aren’t the smart choice for someone who knows they will need to visit the doctor now and then, but they may be perfect for someone who is fit, healthy and doesn’t expect to go to the doctor very much.

Nonetheless, the cost-sharing percentages are not what you will pay for your health care. They’re calculated based on the total average costs that an insurer will pay over a year for covered services and benefits. (These percentages are called actuarial values. You can read more about them in the next section.)

The real costs that you pay will be defined by which health care services you use during the year and the details of your plan.

Let’s assume you have a Bronze plan, you go a whole year without getting or requiring medical care, and you only see your doctor for an annual physical. You will pay for less than 60% of your care over that year. 

On the other hand, an illness that requires major medical care and surgery could leave you paying more than 60%. (For types of care that aren’t covered by your health plan, such as vision, you may need to purchase a supplemental health insurance plan.)

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