ObamaCare in Georgia
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About Obamacare in Georgia
Health Insurance Marketplace in Georgia will help you find health coverage. Once you apply to this program, it will be determined if you qualify for private health insurance, lower cost plans, Medicaid and the Children’s Health Insurance Program (CHIP). If you qualify for private health insurance, your plan will provide basic health coverage, preventative care and some may even have dental coverage. When looking for a plan, you can compare the coverage cost based on your household size and level of income.
If you don’t get health coverage, you will most likely have to pay a penalty on your 2015 income taxes. The penalty fee will be $95 per adult ($47.50 per child) or one percent of your income, whichever is higher. There are some exemptions to the penalty, depending on factors such as income level. You will be considered already covered if you have Medicare, any job-based plan, COBRA, VA health coverage or any other type of health insurance plan, even if you bought it yourself. You can review more details about the Health Insurance Marketplace at: https://www.healthcare.gov.
Individual & Family Coverage
Most health insurance plans in Georgia will provide coverage for doctor visits, emergency care and drug prescriptions. Your plan cannot require higher coinsurance for emergency care provided in an out-of-network hospital, nor can they request pre-approvals. You are also allowed to choose your doctor or pediatrician, even if they are not part of the plan’s network. Another advantage is that referrals are not required for obstetrical or gynecological consultations. Keep in mind that grandfathered plans may have different rules. It is advised that you request a summary of your plan’s benefits and coverage before enrolling, so you can compare different plans.
Small businesses with less than 50 employees are not required to provide health coverage for their employees and they are not subject to a penalty. In case they want to offer coverage, they can buy a plan through the Small Business Health Options Program (SHOP) Marketplace. Enrollment and coverage can begin at any time during the year. Small businesses and non-profit organization can decide what type of coverage they want to offer, as well as what percentage of the employee premium costs they want to cover. If your business has less than 25 full-time employees (or its equivalent) and you make approximately $50,000 per year or less, then your business may be eligible for health care tax credits.
Pre-existing conditions have to be covered by health plans in GA. An insurance company cannot refuse coverage due to a pre-existing medical condition, nor can they charge more to women than men. Even if you were denied insurance in the past, once you get a health plan through the Health Insurance Marketplace, you will receive coverage for conditions like diabetes and cancer. Keep in mind that Medicaid and the Children’s Health Insurance Program (CHIP) are also required to provide coverage in spite of a pre-existing condition. Deductibles, coinsurances and copayments are still applicable when you receive treatment for a pre-existing condition, but your insurance provider cannot charge you mare than if you were receiving treatment for a new condition.