Terri’s 2020 Open Enrollment Decision Guide for Individual and Family plans

Wondering where to start for the 2020 enrollment? Having trouble finding a reliable source of information? Worry no longer! We have put together a guide with information and our professional options of the different plans available for Georgia’s 2020 open enrollment. We have also included helpful advise on applying for plans. We will be your agent and our help is free! You just have to sign up using our link: View Rates, Benefits and Apply for 2020 Plans HERE

We are a family owned business and we have done Health Insurance in Georgia for over 13 years. The reason for our success is simple, we start every day with the goal of helping our clients find the best insurance possible. Our unwavering commitment to our customers has earned us a reputation as the best choice for individual, family and group health insurance in Georgia. We are a Christian company and we strive everyday to live out the command to treat our neighbors how we want to be treated. Feel free to read some of our Google reviews to get a better of how we help our clients: https://ga-health-insurance.com/reviews/

After reading this blog you should be able to narrow down your choices and apply for a plan though our easy Enhanced Direct Enrollment system, we now use that works in conjunction with the Health Insurance Marketplace. Make sure to use our link if you want us to be your agent so you can benefit from our help.

You can also find the enrollment link at the top of our website: https://ga-health-insurance.com

How to pick the most appropriate plan to meet your needs and Apply:

1. Run your quote HERE.
2. Start with looking up your doctors, remember to call Dr’s as many are not showing up yet.
3. Using My notes Below, focus in on the carrier that has more of your doctors, and preferred hospitals, in network.Choose a plan and click Add to Cart then…
4. Start Application (call us if you run into trouble while applying and tell us you are stuck so we can help right then if possible).
5. Confused, still have questions? email Terri at tpotter@ga-health-insurance.com with your specific questions, you can certainly call us but the list can get long to receive a call back to answer questions, so email is fastest!

Terri’s Pros and Cons of the different Carriers and their 2020 Plans:

Alliant (Alliant Health Plans network)

• Pros
  1. Alliant’s Hospital System includes:
     • Northeast Georgia Medical Center
     • Piedmont Mountainside Hospital, Inc.
     • WellStar Kennestone
     • Emory John’s Creek
  2. Referrals are not required for in-network providers!
     • No Alliant plans require a referral. See any in-network provider without a referral.
• Cons
  1. People complain of the small provider doctor network
  2. Available in only a few northern Georgia counties
• Standout Plans
  1. Their Gold Plan is one of their lower cost plans and has good benefits
  2. Only carrier with Platinum plans (lower out of pocket maximums)

Ambetter (Ambetter network)

• Pros
  1. Ambetter’s Hospital System is large and includes:
     • Emory
     • Piedmont
     • WellStar

• 1. • Grady
     • Children’s HealthCare of Atlanta
  2. Referrals are not required for in-network providers!
     • No Ambetter plans require a referral. See any in-network provider without a referral.
     • Not official or in writing from the carrier-but experience has shown that Ambetter, unlike most carriers, tends to pay claims for prescriptions, lab work and tests ordered or written by an out of network provider. But ONLY IF the service is performed at an in-network pharmacy, lab or imaging center. However, nothing related to a surgery would be paid if the surgeon is not in-network.
  3. They offer Free Telemedicine on all plans except the HSA plan.
  4. I have a lot of experience with Ambetter and have had very few complaints from clients. They have gotten much better over the past couple of years. The key is to confirm that your doctor’s office is in-network before you apply!

• Cons
  1. I had a few complaints that doctors showed as in-network on the carrier website when they were not in-network. So again, check network status with your provider.
• Standout Plans
  1. Lower Deductible Silver Plan Ambetter Balanced Care 15 (2020) with a $2950 Deductible
  2. Richest Gold plan for the money, Ambetter Secure Care 5 (2020)

 Anthem Blue Cross (All Anthem 2020 plans only include the Pathway Networks)

• Pros
  1. The Carrier name popularity of Anthem Blue Cross. That does influence some doctors to join the plan as an HMO in-network Pathway provider.
  2. Some plans do not require a referral.
     • Pathway X plans don’t require a primary care doctor selection or a referral from a primary care doctor to see other network doctors. However, these plans are only available outside of Metro Atlanta, in mostly rural counties.

• Cons
  1. The hospital system in-network is small and only includes:
     • Northside
     • Grady
     • Children’s HealthCare of Atlanta

• 1. The HMO Pathway network is very small compared to all other Anthem Blue Cross networks. You must confirm that your provider is in the Pathway network with Anthem.
  2. Anthem has confusing rules regarding different plan names (based on the plan name shown on your quote, which will be the only plans available in your county with Anthem for 2020).
     • Pathway X Guided Access plans require referrals from your listed PCP to see other in-network doctors. This is the only Anthem option available in most metro counties.

• Standout Plans
  1. Lower Deductible Silver Plan, Anthem Silver Pathway X Guided Access HMO 2000 (deductible)

CareSource (Marketplace Network)

• Pros
  1. CareSource has an impressive list of hospital systems in-network, especially considering this is their first year in Georgia:
     • Northside
     • Piedmont (Hospital not showing up on doc finder yet, but I was assured they have a signed contract with Piedmont hospitals)
     • WellStar (Hospital not showing up on doc finder yet, but I was assured they have a signed contract with Wellstar hospitals)
     • *Grady (I could not get an official confirmation at time of this writing)
     • *Children’s HealthCare of Atlanta (I could not get an official confirmation at time of this writing)

• Cons
  1. As noted, the carrier is brand new to Georgia for 2020
     • This makes it difficult to find out what providers are in-network, since it takes the carrier awhile to get the new, constantly changing, list of providers updated on their Find a Doctor search. It is best to call your doctor and ask if they are in-network.

• Standout Plans
  1. Richest Bronze Plan for the money based on Plan design, Marketplace Bronze
     • Offers the only Bronze plan with office visit co-pays for PCP AND Specialist before deductible is met, with the lowest premium in available counties.

Kaiser (Signature HMO Network Only)

• Pros
  1. Kaiser has a stable network of providers because you mostly see Kaiser Doctors.
  2. They are the only insurance company that is a healthcare provider. Kaiser has their own doctors and facilities; their integrated care model helps drive successful patient outcomes.
  3. Doctors are incentivized based on patient outcomes and patient happiness!
• Cons
  1. The hospital system in-network is small and includes:
     • Emory
     • Northside (for maternity only)
     • Children’s HealthCare of Atlanta
  2. Their premiums are among the highest in the market.
  3. Kaiser will only pay claims if all services are ordered by a network doctor.
• Standout Plans
  1. Only $500 deductible Gold plan, Signature Gold 500/20

Oscar (Oscar Network)**Only available in limited counties for 2020: Butts, Clayton, Cobb, Douglas, Fulton, Paulding, Spalding, and Troup counties.

• Pros
  1. Oscar offers free telemedicine on all plans!
  2. They have a strong emphasis on technology, hopefully this will mean they are easy to work with.
• Cons
  1. The hospital system in-network is small and only includes:
     • WellStar
  2. They are only available in very limited counties for 2020.
     • 1^st year in Georgia. Very limited network of providers (they plan to be stronger and more competitive in 2021)

How to pick the most appropriate plan to meet your needs and Apply:

1. Run your quote HERE.
2. Start with looking up your doctors, remember to call Drs as many are not showing up yet.
3. Using My notes Below, focus in on the carrier that has more of your doctors, and preferred hospitals, in network.
4. Choose a plan and click Add to Cart then Start Application (call us if you run into trouble while applying and tell us you are stuck so we can help right then if possible).

Confused, still have questions? email Terri at tpotter@ga-health-insurance.com with your specific questions, you can certainly call us but the list can get long to receive a call back to answer questions, so email is fastest!

Use the search feature cautiously with the knowledge that not all providers have been updated by the carriers this far ahead of January, so it is best to call your doctor’s office to confirm if they are in network for 2020 if that is really important to you. In particular, the search for CareSource is still not updated with Piedmont and WellStar as in-network hospitals, but they have signed contracts and the system is in the process of adding them. Many other in-network providers are in the process of being uploaded.

If you have questions for me, I am happy to help! Please note that an email will most likely get you the fastest response.

Want to compare group and individual plans in Georgia? Click Here!

 Please visit our Enhanced Direct Enrollment site to View Rates, Benefits and Apply for 2020 Plans HERE.

• Will allow you to access the new enrollment system that works with your existing Marketplace account, but faster and easier (as long as the actual Marketplace is not having another glitch!
• Makes me your agent and costs you nothing! This also allows us to get paid by the insurance company for the help and service we are providing our clients at no charge!
• Or you can apply by logging directly into the Marketplace and then just entering my name: Terri Potter and my NPN #7040882 as someone that is helping you with your application.

If you want to know a little bit more about me please feel free to check out my website https://ga-health-insurance.com/and check out my Google reviews so you can see what people think of my services.

I look forward to working with you this Open Enrollment to help you have a smooth transition into the new plan year 2020!

https://www.healthsherpa.com/?_agent_id=daniel-potter 

Sincerely,

Owner and Lead Agent Terri Potter