Health Insurance Advisors will now include the analysis of ACA / Obamacare plans and the Lower Cost Alternative plans during the regular Benefit Review appointment. During the discussion we will identify, evaluate and recommend the best health insurance plan for each individual client’s situation.
Why consider Affordable Alternative Plans for 2018?
Because the ACA / Obamacare plans have smaller providers networks and are more expensive than last year.
The 2018 ACA / Obamacare plans in Georgia overview:
- HMO plans only – smaller provider networks requiring referrals to see a specialist
- No coverage for out of network services or service outside of Georgia, except for emergencies
- There are no plans available with POS networks
- The good news; one of the HMO plans has many of the major hospital systems and doctor groups in their network View Hospital List
Because of the restrictive networks and higher cost of the ACA / Obamacare plans, we have been researching Affordable Alternative Plans.
Lower cost alternative plans (Non – Obamacare compliant plans) are not a viable option for clients who are managing ongoing costly medical conditions.
These lower cost alternative plans are more for catastrophic coverage; no copays benefits for doctor visits – all medical expenses apply to the deductible.
- Cost approximately 50% less than ACA / Obamacare Compliant plans
- Have access to a large quality network of providers in Georgia and nationally
- Require passing a simplified, 5 medical history questionnaire
- Be subject to the ACA tax penalty, although – our office will advise how many of our clients can have it waived.
The Downside of the lower cost alternative plans; they will not cover:
- Pre-existing conditions, Preventative care, Pregnancy or Medications (Rx discount card is available)
There was an executive order from Washington this past week that makes it easier for insurance companies to offer these alternative plans.
We are seeing the insurance companies reacting quickly and scramble to improve and expand their
Non – Obamacare alternative plans for 2018.
The general buzz in the industry is these plans will become more popular due to lower cost and broad national provider networks.
However, the downsides described above will not change.
These plans are not an option for clients managing serious ongoing conditions.
We are continuing to monitor these developments closely.
They will be approximately 12-15 different insurance companies offering Non – Obamacare Affordable Alternative plans. We will complete our analysis and have our recommendations of all plans, ready for our client Benefit Reviews appointments beginning November 9th.
Our recommendations of Non – Obamacare lower cost alternative plans will be based on:
- the most favorable terms; including the easiest pre-existing condition definition for the member
- best value, price vs benefits
- large national provider network
Separately, we will offer an Accident Benefit Plan due the higher deductibles most clients are carrying.
These will pay for the first $5,000 to $10,000 of medical expenses due to an accident of any almost any kind. Even though the client is reimbursed for the accident expenses, it also counts toward meeting the medical plan deductible; more to come.
|Hospital Name||City||Zip Code|
|Emory University Hospital||Atlanta||30309|
|Emory Saint Joseph||Atlanta||30342|
|Emory Johns Creek||Dulutd||30097|
|WellStar Atlanta Medical Center||Atlanta||30312|
|WellStar Windy Hill||Marietta||30067|
|WellStar Nortd Fulton Hospital||Roswell||30076|
|WellStar Sylvan Grove||Jackson||30233|
|WellStar Atlanta Medical Center||East Point||30344|
|Rockdale Medical Center||Conyers||30012|
|Gwinnett Medical Center Duluth||Lawrenceville||30096|
|Southern Regional Medical Center||Riverdale||30274|
|St. Mary’s Hospital||Athens||30306|
|Medical Center of Central GA||Macon||31201|
|Northside Medical Center||Columbus||31008|
|St. Francis Hospital||Columbus||31904|
|Midtown Medical Center||Columbus||31902|
|Doctors Hospital Of Columbus||Columbus||31901|