Georgia Individual Health Plans

Georgia Individual Health Insurance Rules and Regulations You Should Know

Buying individual health insurance in Georgia is a bit different than buying individual health insurance in other states.  Every state has its own laws about what the health insurance providers do and do not have to cover when it comes to individual health insurance.  If you live in Atlanta, or another part of Georgia, and are unemployed or are otherwise unable to get group health insurance from your employer because they don’t offer it, you will need to know the laws governing Georgia individual health insurance before you search for an individual plan.

In Georgia individual health insurance providers have the right to turn you down for an individual policy based on your health.  If you are currently in very bad health, you will likely be turned down for individual health insurance in Georgia.  If you have had previous health issues, you may qualify for individual health insurance but with special provisions.  You will need to fully understand these special provisions before taking a policy.

If you have just left a job, or have had long term individual health insurance in Georgia and are just thinking about switching policies or insurance providers, you may fall under a guaranteed conversion policy.  A conversion policy is a guaranteed rollover from one policy to an individual health insurance policy regardless of your current or former health conditions if you meet certain criteria.  One of those criteria is the length of time between policies, so don’t wait too long to purchase your individual health insurance.

A preexisting condition is a medical condition that you have or have recently had before your individual health insurance coverage begins.  When it comes to Georgia individual health insurance laws, preexisting conditions, including pregnancy, do not have to be covered under a new policy.  The policy can include an elimination rider, which excludes your preexisting condition from being covered, either for a set period of time or forever.  Coverage for preexisting conditions can vary between insurance providers, so if you have any conditions be sure to shop around for an individual health insurance plan that might cover it at some point.

Some states don’t allow insurance providers to charge more based on the insured person’s health status for individual health insurance.  Georgia is not one of those states.  In Georgia, individual health insurance will cost you more for each condition you have.  These can include non-health related things as well, such as age, gender and lifestyle.  Keep in mind that in Georgia individual health insurance premiums will go up as you get older in most cases.

Once you have individual health insurance in Georgia, you cannot be singled out for rate increases or cancellation of your policy based on your health status.  Georgia law prohibits this, but it does not prohibit an overall rate increase in individual health insurance plans for a particular condition.  For example, if you are already insured and find out that you have diabetes, you cannot be cancelled and your rates cannot be increased because of this fact.  But, if an insurance company sees a significant increase of diabetes in their individual health insurance policyholders, the company can pose a rate increase to all policyholders with diabetes at the same time, not individually.

There are many different types of policies and a lot of provisions to individual health insurance in Georgia, but there are three things that you should be especially aware of.  Managed care plans are insurance policies that only cover a particular area.  For instance, if you have a managed care plan and move outside of Atlanta, your individual health insurance may no longer cover you.

Temporary policies versus guaranteed renewability are two types of policies that you need to know about.  If you find out that you have diabetes and you have a temporary policy, when that policy term is over you will have to reapply for your individual health insurance and you will probably not get it.  In Georgia, individual health insurance policies with guaranteed renewability cannot cancel you if you get sick as long as your premiums are paid and you don’t make an effort to defraud the insurance company.  Make sure you take all of this into consideration when you buy individual health insurance in Georgia.