2024 Guide to Individual and Family Health Insurance in Georgia
Welcome to our 2024 Guide for Health Insurance in Georgia!
We have written this guide to help you make an educated decision about your health insurance plan for the 2024 plan year. It includes information about the carriers, their networks, and guidance for the different plans available in Georgia for the 2024 plan year.
Keep in mind that our services to you are 100% FREE to you! If we are your agent our help extends throughout the year to any issues that may arise with your Health Insurance! We encourage you to check out our Google reviews. We are the highest rated Individual and Family agency in Georgia because we provide expert advice, we are always honest and customer service is our top priority.
There are two ways to get coverage for 2024:
1.) Are you comfortable with selecting a plan and applying yourself? You can read our comprehensive guide below, run your own quotes, and apply for a plan by clicking HERE! If you get stuck on your application you can call us for help.
2.) Do you want more personalized help and guidance? You can schedule a phone or video appointment with us to go over all your options and get help applying, just click HERE!
The Quoting and Enrollment system that we use “Health Sherpa” is directly linked to the Marketplace and automatically pulls pricing and information direct from the Marketplace (so there is no difference in price). It is one of the most secure systems available and is used by millions across the United States. If you sign up through our link, we are your agent! Our link is here: https://www.healthsherpa.com/?_agent_id=daniel-potter. You can also add us to your plan if you sign up directly to the Marketplace. Just add Daniel Potter as your agent, NPN 180-32-692.
Frequently Asked Questions
Question 1: Will you sell my information to call centers so that I get spammed by 100’s of emails and calls?
Answer 1: NEVER! We will never send you spam mail or spam you with phone calls. We will never give your information out to marketing organizations. We are a Georgia based, family owned agency that has local employees and we care about you having a good experience when you work with us. That means no spam.
Question 2: Does my insurance cost more through you? How are you paid?
Answer 2: Your insurance will not cost any more when you go through us. Major medical plan pricing is set by the marketplace and cannot be changed. We are paid a commission by the insurance company we help you enroll with. We are an independent agency so we are not required to sell one product vs another. We help you find the best product for your situation by looking at the full range of options in Georgia.
Question 3: What is a major medical plan?
Answer 3: A “Major Medical Plan”, also known as a “Qualified Health Plan” is a plan that is certified by the Healthcare.gov Marketplace to provide coverage for “essential health benefits” as well as a plan that has limits on cost-sharing and covers pre-existing conditions. These are the most comprehensive plans available on the market in Georgia and are the best option for most individuals and families. Beware that there are many plans out there that do not meet these requirements and people are often tricked into buying them. We often get calls from people who bought some other type of plan and did not find out how it worked until it was too late.
Question 4: Can I get a PPO health insurance plan?
Answer 4: No (with one exception). The Major Medical plans offered in Georgia for Individuals and Families are limited to HMO options. However some carriers have large networks and do not require referrals to see a specialist. There are 8 insurance companies offering major medical plans in Georgia so there are lots of good options for 2024.
How to pick the most appropriate plan to meet your needs
- Run your quote HERE. Be sure to save your quotes using your proper name.
- Enter your preferred Doctors & Hospitals when given the chance during the quoting process.
- The key with any plan is to confirm that your doctor is in-network before you apply. All plans but one are HMO Networks, meaning there is NO out of Network Coverage except for true emergencies.
- Choose your Plan then 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 you. As long as you use the link found in this email to quote & apply, we can pop into your application on the page you are stuck on and finish the application with you over the phone if you need help.
Confused, still have questions after saving your quotes?
Click here to schedule a time to talk to Daniel
Prepare for your Appointment – To make the most out of your appointment time with us you can run your quotes, including entering your providers, and saving your quotes under your proper name so that we can quickly pull up your quotes to discuss with you at your phone appointment.
You need an agent you can trust! Check out our Google reviews HERE to see why our clients value our help so much.
Aetna (Aetna CVS HMO Network)
Key Metro Atlanta Hospitals In-Network (check with providers)
Emory
Piedmont
Wellstar – New for 2024
Children’s HealthCare of Atlanta
2980+ Primary Care, 18,660 Specialist, 161 Urgent Care in Network
Our thoughts for 2024
Aetna is a top pick for us in 2024. They have a great hospital and doctor network, great CVS benefits and excellent customer service. Their main markets in Georgia are expanding for 2024 and now include Albany, Athens, Atlanta, Augusta, Brunswick, and Savannah. With CVS being their parent company they offer strong pharmacy benefits and choices. Aetna customer service has been some of the best in the industry for years and our clients have been happy with the insurance and service.
Key Albany Network – Phoebe North, Phoebe Putney, Phoebe Sumter, Phoebe Worth and Crisp Regional Hospital.
Key Savannah Network – Appling Healthcare, Evans Memorial, Liberty Regional Medical, Wayne Memorial, Candler, Landmark Hospital, Memorial Health Uni, Select Specialty Hospital, Effingham County hospital and Optim Medical.
Key Athens Network – Piedmont Hospital
Key Augusta Network – Doctors Hospital of Augusta and Augusta University Medical Center
Key Brunswick Network – Southeast Georgia Health System – Brunswick Campus
Pros
- No referral required – PCP selection required.
- Aetna Insurance Card gives 20% discount on CVS Health Products in retail CVS stores.
- Free $25 allowance per quarter for Over the Counter (OTC) items at CVS! New benefit for 2024!
- Free CVS MinuteClinic in network nationwide (on most plans).
- Free CVS MinuteClinic Virtual Care (on most plans).
- Large pharmacy network – CVS, Costco, Publix, Walmart, Walgreens and more!
- Expanding to Athens, Augusta and Brunswick for 2024!
Cons
- Missing some major hospitals in Atlanta.
Recommended plans in each category
-
- Bronze – AetnaCVSHealth Bronze S
- Silver – AetnaCVSHealth Silver S
- Gold – AetnaCVSHealth Gold S
Alliant (Alliant Health Plans network)
Key Hospitals In-Network outside of Atlanta (check with providers)
Northeast Georgia Medical Center
Piedmont
WellStar
Other rural hospitals
Our thoughts for 2024
Alliant will be a good choice for many in rural counties, especially in North Georgia and when there are not many other options.. They offer some benefits like dental and chiropractic care as options to some plans. They still have PPO options (however the cost to use the PPO network is HIGH) for those that need out of network coverage and they have very rich platinum plans. They have on and off exchange plans.
In 2024 Alliant will have even more competition from other carriers in many rural counties.
Pros
- No referral Required
- PPO & HMO Networks (Plans are only offered In select counties)
- Live It health lifestyle program allows you to earn rewards
- Only Platinum plans in Georgia
Cons
- Very expensive to actually use the PPO benefits
- Not available in Metro Atlanta Counties
- Missing Children’s HealthCare of Atlanta hospitals and other major hospital systems in Georgia
Recommended plans in each category
-
- Bronze – SoloCare No Referral HMO Standard Expanded Bronze
- Silver – SoloCare No Referral HMO Standard Silver
- Gold – SoloCare Gold No Referral HMO 2300
- Platinum-SoloCare No Referral HMO Standard Platinum
Ambetter (4 different networks for 2023 so look closely at plan name)
Key Metro Atlanta Hospitals In-Network (check with providers)
Bronze, Silver, Gold Network:
Emory Hospital
Northside Hospital
Piedmont Hospital
WellStar Hospital
Grady Health System
Three Ambetter Select Networks (Chatam, Cobb, Clayton, Cherokee, Fulton, Henry, Newton and Rockdale counties):
1.) Wellstar Select – Only WellStar Hospital
2.) Plus Select Piedmont – Only Piedmont Hospital
3.) St. Joseph Candler Select – Only St. Joseph’s Candler Hospital
Our thoughts for 2024
Ambetter continues to be a top option for 2024. They are the largest Marketplace carrier in the entire United States. Many of our clients use Ambetter because their “Core Bronze, Silver and Gold” network is the largest network available on a Georgia Marketplace plan. Ambetter has been doing a good job in Georgia over the past years but we did notice more customer service complaints in 2023. They offer great pricing, industry best Healthy Reward programs, huge network with multiple options, strong dental and vision options and mid tier customer service.
Pros
- No referrals required
- Largest Overall Network in Georgia
- Large number of Rural hospitals
- Free Telemedicine and Virtual Care on most plans
- Easy to use Health Program with potential rewards of $500 – My Health Pays
- Offers some lower cost Off Exchange plans for those that do not qualify for a subsidy
- Dental and Vision with no waiting period (but limited network)
Cons
- Plans have different networks and can be confusing, look closely at the plan name
- No Children’s HealthCare of Atlanta
- No Northeast Georgia Medical Center
Recommended plans in each category
-
- Bronze – Everyday Bronze
- Silver – Focused Silver
- Gold – Everyday Gold
- Dental and Vision plans – Great benefits with no waiting period however the network is not large.
Anthem Blue Cross (Pathway X Network-HMO)
Key Metro Atlanta Hospitals In-Network (check with providers)
Emory
Northside – back in network
Children’s HealthCare of Atlanta
Our thoughts for 2024
Anthem is a top 3 pick for 2024 if you want Northside and Emory in network. They have a strong doctor network overall, good customer service and their pricing is middle of the pack. Anthem has historically been a good health insurance provider and they have put a renewed focus on customer service and satisfaction over the past years. They are removing the referral requirement for their Pathway X network for 2024! They are adding a new network “Blue Value” that will still require referrals but will be lower in price.
They are also introducing a new benefit call Paytient that will give all their members a line of credit to pay for health services (0% apr for up to 36 month).
Pros
- Anthem Blue Cross name is familiar.
- New Paytient benefit that gives members a 0% APR line of credit for medical bills.
- Their Pathway X network will not require referrals for 2024!
- They will have more competitive pricing overall than they did in 2023.
Cons
- New Blue Value network requires referrals.
- Walgreens is not in network.
- Disputes with hospitals in the past.
Recommended plans in each category
-
- Bronze – Pathway X 7500
- Silver – Pathway X 6450
- Gold – Pathway X 1350
CareSource (Marketplace Network-HMO)
Key Metro Atlanta Hospitals In-Network (check with providers)
Northside
Piedmont
WellStar
Grady
Children’s HealthCare of Atlanta
Our thoughts for 2024
CareSource is appealing due their low price, large hospital network and unique benefits. They continue to improve in Georgia and are going to be price leader in many counties. They are the only carrier to have a combo dental, vision and fitness benefit. The fitness program is robust and includes a home kit, on demand online workouts and membership access to a large network including LA Fitness, Snap Fitness, Anytime Fitness, Planet Fitness and more! They also offer a good pediatric vision benefit.
Pros
- Referrals not required
- Large Hospital network in Metro Atlanta
- 5th year in Georgia, network is growing and pricing is competitive
- Free Telehealth on most plans
Cons
- Emory is missing from their hospital network
Recommended plans in each category
-
- Bronze – Marketplace Bronze First
- Silver – Marketplace Low Premium Silver
- Gold – Marketplace Core Gold
Cigna HealthCare (Cigna Connect Network-HMO)
Key Metro Atlanta Hospitals In-Network (check with providers)
Northeast Georgia Medical *New for 2023*
Piedmont
Wellstar
Children’s HealthCare of Atlanta
Grady
Our thoughts for 2024
Cigna was the best priced carrier for 2023. However their customer service and network options suffered. For 2024 they are not nearly as well priced. They offer numerous benefits (Virtual care, enhanced complex care management, Healthy Reward program) and some specialized benefits for Diabetes. If you have diabetes, Cigna will be a top option for 2024. These plans have limits on the cost of insulin, free diabetes supplies, management training and some labs and exams.
Other notable hospitals in network: Flint River Hospital, St. Josephs Hospital, Candler Hospital, Upson Regional Medical Center.
Pros
- No referral Required
- Special plan for people with Diabetes
- Special plan for people with Asthma/COPD
- Walgreens, Rite Aid, Costco, Publix pharmacies in network
- Added Northeast Georgia Medical
- Good dental and vision options
Cons
- Offered in limited counties in Georgia for 2024.
- Network lists not always accurate.
- Customer Service needs work.
Recommended plans in each category
-
- Cigna Connect Bronze 6500
- Cigna Connect Silver 3700
- Cigna Connect Gold 500
Kaiser (Signature HMO Network Only)
Key Metro Atlanta Hospitals In-Network
Emory Saint Joseph’s Hospital and Emory Decatur
Northside (for maternity only)
Children’s HealthCare of Atlanta
Our thoughts for 2024
Kaiser is unique in the health insurance market as they are the only company that is not only an insurer but also a health care provider. Kaiser leverages this fact to provide both insurance and care that is tailored for the best possible patient outcomes. Kaiser is expanding their capabilities in Georgia and we think they will be a major player for years to come. If you do not mind getting integrated into the Kaiser system they can be a good choice for 2023. Kaiser is also offering pediatric and adult vision and dental options.
Pros
- Kaiser has a stable network of providers that work directly for Kaiser
- They are the only insurance company that is a healthcare provider, so Kaiser has many of their own doctors and facilities and Doctors are incentivized based on patient outcomes and patient happiness!
- 20 year collaboration with Emory hospital
- Away from Home travel Hotline – 951-268-3900 or kp.org/travel and Cigna collaboration for out of network urgent and emergency care
- Member benefits like ClassPass, self-care apps Calm and myStrength, Wellness coaching, online healthly lifestyle programs and reduced rates on health and wellness services
- Available off-exchange as well.
Cons
- Typically, you can only see Kaiser doctors
- Limited Hospitals in network
- Only sold in limited counties
Recommended plans in each category
-
- Bronze – KP GA Signature Standard Bronze
- Silver –KP GA Signature Standard Silver
- Gold – KP GA Signature Standard Gold
Oscar (Oscar Network-HMO)
Key Metro Atlanta Hospitals In-Network (check with providers)
Northside
Emory
Wellstar
Grady
Southern Regional Medical Center
Our thoughts for 2024
Oscar continues to improve in Georgia and they are the low cost option for 2024! Their network keeps expanding and their benefits are getting better. Plus, with their “Oscar Care Teams” they are working to provide a good customer experience. They have a strong hospital network. They offer very competitively price plans along with benefits such as $3 prescriptions, Healthy Reward program, super easy to use online account and app, an excellent Diabetes plan and they require no referrals. Their free virtual care is very fast as well!
Pros
- No referral Required
- You are assigned a Care Team
- Oscar offers free, fast telemedicine through App
- Competitive pricing
- Easy to use and useful technology
- Special plan for people with Diabetes
Cons
- Available in limited counties
- No Children’s HealthCare of Atlanta in network
- 1 star rated on the Marketplace
Recommended plans in each category
- Oscar Bronze Classic Standard
- Oscar Silver Simple PCP Saver
- Oscar Elite Saver Plus
United HealthCare (United HealthCare GA Individual Exchange Benefit Plan network)
Key Metro Atlanta Hospitals In-Network (check with providers)
Northside
Piedmont
Children’s HealthCare of Atlanta
Limited Wellstar (North and South Fulton)
Our thoughts for 2024
The only thing holding UHC back in 2024 is their pricing is still high. They are a top-tier, trusted insurance company and we look forward to their continued presence in the market. They will be a good option for those who use Northside and Piedmont. They are also a good option in Augusta and Savannah.
Augusta Network – Piedmont/University Hospitals, HCA, Augusta University
Savannah Network – St. Joseph’s/Candler
Pros
- Most plans have $0 Primary Care visits and $0 Virtual Urgent Care
- Member Benefits – Free 1 year Peloton Digital membership, Free AARP membership, up to $100 health reward program
- Low Cost Prescriptions at Walgreens
- Dental and Vision on select plans
Cons
- Referrals are Required from your listed PCP to see other in-network doctors
- Hospital network is limited
- Expensive
Recommended plans in each category
-
- UHC Bronze Value
- UHC Silver Value
- UHC Gold Standard
Dental and Vision
Dental Options for 2023:
1.) You can run your own quotes and easily apply for dental/vision with top companies like Delta Dental, Nationwide and the Standard by clicking the link below:
Run Dental and Vision Quotes and Apply Here!
2.) You can get a stand alone plan through United Health Care – This is a great option and UHC offers very versatile options such as no waiting periods, see any doctor regardless or network, different coverage and price points, etc… contact us for a quote.
3.) If you want a dental only plan through the marketplace we recommend one of the Anthem offerings. Note all the stand alone dental options in the marketplace have a waiting period. Stand alone vision is not offered.
4.) A combo dental/vision plan on the Marketplace with either Ambetter, CareSource or UHC can be great options. There is not as much flexibly with the plan options or network on these but they offer GREAT value.
We always recommend checking with your dental or vision office if it is important that they remain in network!
Schedule your Phone or Video Appointment
Need Help? Schedule a phone or video appointment with us today! Just pick a date and time from our calendar , it is easy! Click here to schedule: https://calendly.com/ga-health-insurance/daniel-meeting?month=2022-10
Here is our link to view plan pricing and apply: https://www.healthsherpa.com/?_agent_id=daniel-potter. Feel free to schedule an appointment or call anytime if you run into trouble or have questions!
Do you want to sign up directly on the marketplace? We can still be your agent! Just enter Daniel Potter and my NPN #18032692 as your agent that is helping you. Please let us know if you apply this way so we can follow up on your application status!
If you want to know a little bit more about us please feel free to check out our website https://ga-health-insurance.com/ and check out our Google Reviews so you can see what people think of our services. We look forward to working with you to help you have a smooth transition into your new plan.
Sincerely,
Daniel Potter // Georgia Health Insurance, Inc.
P: 770-452-9335 F: 770-452-9335