Know Your Policy – The Basics of 2019 Health Insurance

Health insurance is essential for peace of mind, and for providing options when you need medical care. While every health insurance policy covers emergency services, there are myriad other health consultations and procedures that can be covered under different plans.

To be able to properly compare the best 2019 health insurance plans with your needs in mind, you’ll need to know exactly what a plan could cover, and why you need one.

It All Starts with the Policy

Every health insurance policy is a form of contract. It is a legally binding agreement between you and an insurance provider that will determine the type of benefits you receive while the policy is active. Before you sign up to a health insurance policy, you will be given information such as treatment services that are covered, where you can avail the services, whether medications are covered, and the type of tests and screenings that are covered by insurance.

In addition, the initial information package will also tell you specifically the type of care that is not covered, and in which circumstances.

For anything not covered by your insurance, you will need to shoulder the total costs. This is why it’s so important to carefully compare your options and choose the most comprehensive plan possible within your budget.

The Basics of Health Insurance Coverage in 2019

You probably already have a health insurance plan that covers you for 2018. You can use this as a base point of reference. Were there medical services that you needed and that wasn’t covered by your policy? Or, did you find that your policy was too expensive and provided more coverage than you actually used?

Buying the right insurance is a delicate balancing act. While you need to ensure that you have the right amount of coverage for emergencies and general medical treatments, you also need to make sure that your insurance is affordable.

Health InsuranceEven with the most basic insurance package, you can usually expect to receive some essential health benefits. These are standard coverage items that come packaged with insurance, and sometimes there will be no additional fees associated with them (outside of your standard premiums/deductible).

The essential insurance benefits can include:

  • Drugs as prescribed by your doctor.
  • Hospitalization.
  • Ambulance services.
  • Emergency care services following an accident etc. (all insurance offers coverage for emergency care).
  • Rehabilitation coverage.
  • Lab services (for blood work, urinalysis etc.)
  • Pediatric services for infants, children, and adolescents.
  • Preventative screenings and immunizations.
  • Counseling and psychotherapy (limited circumstances, so be sure to check your policy).
  • Maternity care, including prenatal and postnatal care.

The above benefits are guaranteed when you purchase insurance that is federally backed. Some states design their own essential health benefits that are offered by insurers. It is important to check the essential benefits whenever you are comparing a policy. If you move around often, then you will need to look for any clauses that would impact your essential health benefits when you are traveling out of state.

Keep in mind that some insurers will offer extended essential benefits that are covered by the policy with minimal or no out of pocket costs at the point of service. If you purchase a premium insurance plan, then you can usually expect to receive extended benefits.

Preventative Services Can Vary from State to State

Preventative services are those designed to protect you from future health problems or to diagnose warning signs that you may be developing a disease or another medical condition. These services vary by age and where you live. States can mandate the basic preventative services that insurers must offer. Again, this is something you need to look at closely in your policy.

Examples of preventative services can include seasonal vaccination, HIV screening, breast cancer and cervical cancer screening, prostate cancer screening, and various cardiac tests used to screen for heart problems.

Coverage Outside of Your Policy is At the Insurer’s Discretion

Your policy will outline all the essential medical benefits, including screening services, as well as consultations and procedures that are covered in your policy. Of course, with medical care being highly complex, there will be times when you are referred for a type of medical service that is not explicitly outlined in your policy.

It is your doctor who ultimately decides what kind of treatment, screening, or procedure is needed in your unique case. If you are using medical services within the network of doctors and hospitals in your policy, then your doctor will have extensive knowledge of the available coverage. If you are going outside of the network (such as with a PPO insurance policy), then your doctor may not have the same kind of understanding of what is covered by your insurance.

Even though your doctor decides upon the care that you need, it will be your insurance company that decides what is covered by your policy. In some cases, care that is not specifically defined in your policy can still be covered. This is entirely at the insurer’s discretion. Insurance companies have extensive knowledge of medical procedures and can usually determine appropriate treatment paths based on medical coding in your health record.

While many people assume that insurers are simply out to make money, you could be surprised by the flexibility they can offer when it comes to your health.

Compare the Best Insurance Coverage Options for 2019

You can enroll for you 2019 health insurance between the 1st of November and 15th of December this year. Now is the time to start considering your options, and Mutual Health Partners is the best place to compare plans while getting access to the most affordable insurance.

Our licensed insurance specialists will present you with the ideal policies based on your needs and your budget. Buy cost-effective health insurance that gives you complete peace of mind today.


Find the Best Georgia Health Insurance for 2019

Health insurance is one of the most important purchases that you will make this year. With the open enrolment period coming up soon, it’s time to compare your Georgia Health Insurance options to find a plan that is both suited to your needs and your budget.

With Mutual Health Partners, you can discover the very best policies for any situation. There will be some minor changes in the marketplace next year, and this helpful guide will be the best starting point to ensure that you are covered for 2019.

Is the Obama Care Era of Health Insurance Over?

For the last few years, you’ve probably been familiar with the Obama Care health insurance rules. Formally known as the Affordable Care Act (ACA), Obama Care is still very much a part of the insurance landscape. There will be minor changes to the rules, but the simple fact is that you will still need health insurance in 2019 if you want complete peace of mind.

The biggest change for the upcoming year is that there will no longer be any Individual Mandate Penalty from the IRS. In previous years, you would be subject to a costly tax penalty if you didn’t have an insurance policy. Even though you won’t be penalized for not having insurance in 2019, it still makes sense to purchase a policy.

Certain provisions of Obama Care, such as essential health benefits, will still be utilized by Federal and State insurance programs. For Georgia health insurance, you can expect to receive the following benefits, even on the most basic policies…

  • Ambulatory services, such as outpatient services.
  • Emergency services resulting from accident or incident.
  • Hospitalization (the duration and amount of coverage depends on your plan.)
  • Maternity and newborn care. Otherwise known as pre and post-natal care.
  • Prescription medications (endorsed by your doctor.)
  • Mental health services including substance abuse services.
  • Laboratory services (blood tests etc.)
  • Pediatric services. This includes dental and vision services for your children or dependents.
  • Preventative service or disease management services, including screening.
  • Rehabilitation services following disease or injury.

As you can see, the essential health benefits are quite extensive. Even the most basic Georgia health insurance will offer coverage for all the categories listed above. Even if you don’t get sick throughout the year, you can still gain value from the essential health benefits. Screening services can help to prevent future diseases and illnesses, and they are determined by age, so you will always get the best tests for the most common risks. If you have children, then pediatric services will be particularly beneficial, even for routine visits with a primary care physician.

The tax penalty for not having insurance may be abolished, but the real impact of not having health insurance can be severe. Always provide a safety net for you and your family by purchasing Georgia health insurance each year.

Is Georgia Health Insurance Going to Cost More in 2019?

Georgia health insuranceDue to changes made by the current administration, health insurance premiums are going to increase in 2019. The exact amount will vary from state to state, and from insurer to insurer. Depending on the type of insurance you need, you may not be impacted by the increased premiums.

If you are purchasing a “Bronze” insurance plan, then premiums will actually be less than those for 2018. If you are purchasing “Silver” or “Gold” tier health insurance for 2019 then the increase is likely to be between 7% and 10%. Note that these changes don’t take any applicable tax credits into account. Due to current tax breaks for families and individuals, you will likely come out slightly better off when all your finances are taken into account.

The Obama Care rules have been relaxed in some areas, so it is now possible to buy emergency health insurance that only provides a bare-minimum amount of coverage. This would be the most affordable type of insurance if you are under the age of 30 and rarely get sick.

Premiums vs Deductibles, Choosing Health Insurance Based on Your Needs

When you compare your Georgia health insurance options for 2019, you will have to decide between high deductibles or high premiums.

  • With a high deductible plan, you will pay more out of pocket costs for medical services. If you don’t visit the doctor often and are in good health, then this could be the most affordable type of plan for you.
  • With high premiums, your deductibles would be less, which could work out better over a year if you visit the doctor and use specialist services more often.

The best health insurance for you depends on your unique scenario. You should consider your current health, your age, and your recent medical history as you are choosing a plan. In some cases, it can be more affordable to pay higher premiums with lower deductibles for regular visits. If you’re young or otherwise healthy, then you’ll spend less money with high deductibles and low premiums.

As with many things in life, there is not a “perfect” plan for everyone. If you want to find the best policy based on your unique needs, then it’s time to talk to the experts at Mutual Health Partners.

Protect Yourself and Your Family with Georgia Health Insurance

The private marketplace open enrolment period will begin on November 1st, and you must purchase your health insurance by December 15th. This will the give you coverage from January 1st, 2019, up until January 1st, 2020.

Mutual Health Partners is the best place to compare different policies. With the help of our licensed insurance experts, you can gain access to the most affordable plans with the perfect level of coverage for your personal or family needs.

Don’t leave yourself at risk in 2019. Georgia health insurance provides a financial safety net while ensuring that you can get the necessary medical care whenever you need it.