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Georgia Short-Term Health Plans
Georgia short-term insurance defaults to the new federal regulations as the state has no specific laws governing temporary policies. In October 2018, the Trump administration relaxed the rules imposed by the Affordable Care Act (ACA), popularly known as “Obamacare,” allowing individual states to create their own rules.
Prior to these regulatory changes, short-term health care options were limited to just three months’ duration, and renewals of the policies were prohibited. In October 2017, Trump signed an Executive Order to promote healthcare choice and competition.
Federal agencies were directed to “consider proposing” new regulations. These new directives would reverse an Obama-era rule limiting the plans to 90 days with no renewal and would return to previous guidelines for temporary coverage.
In August 2018, the Trump administration issued a final rule clearing the way for short-term health insurance plans that don’t comply with the ACA. As Trump stated, “short-term, limited-duration insurance” could help millions of Americans who don’t want or need major medical health insurance which provides a full range of benefits required by federal law.
As a result, states defaulting to federal guidelines may offer plans with terms of up to 364 days, with an option to renew for up to three years. Historically, Georgia has been opposed to the ACA, and the state legislature has sought to obstruct the law so adopting less restrictive policies comes as no surprise.
In addition to the changes promoted by the White House, Congress enacted the Tax Cut and Jobs Act, which had a revised ACA provision. The new law repealed the unpopular “individual mandate,” which required uninsured Americans to pay a fine unless they qualified for an exemption.
These changes in legislation and procedures has given consumers far more options for healthcare, especially for young and healthy consumers. Georgia short-term health plans allow more residents to find affordable coverage outside of the ACA’s marketplace exchange.
Many people turn to temporary healthcare plans while they’re waiting for coverage to begin or when experiencing an unpredictable life situation such as divorce or the death of a spouse. Consumers find that premiums are often much lower due to limitations on benefits and covered medical services.
Georgia Health Insurance – What Isn’t Covered
The lower premiums paid for temporary policies are largely because these plans don’t qualify as major medical coverage due to exclusions. Additionally, insurers don’t have to guarantee coverage to everyone who applies, allowing them to reject those individuals with preexisting conditions or limiting services.
Under new federal rules, short-term plans must carry a disclosure that they don’t comply with the ACA, and don’t qualify as “minimum essential coverage” (MEC). MEC is a set of government-mandated benefits that plans must meet for inclusion in marketplace exchanges.
Georgia short-term health plans carry lifetime or term benefit limits so when the policy ends, it doesn’t trigger a Special Enrollment Period (SEP), allowing individuals to seek coverage in the marketplace exchange. While short-term insurance plans are an alternative to the more expensive “Obamacare” options, it precludes individuals from seeking coverage outside of Open Enrollment when their coverage ends.
Consumers will likely find that short-term health plans have much lower monthly premiums due to the limitations of covered services. The benefits offered typically appeal to those who are young, in very good health, and use little in the way of medical services or prescriptions.
Many Georgia consumers who don’t require regular doctor visits or many prescriptions may consider the trade-off worth the offset in the cost of the policies. It’s also important to note that temporary plans don’t guarantee coverage and that applicants may be rejected based on their health history.
A major difference is that short-term plans don’t cover preexisting conditions such as asthma, stroke, hypertension, diabetes, chronic obstructive pulmonary disease (COPD), arthritis, and others. Another drawback is if a health condition is diagnosed while on a short-term plan as it likely will be deemed a preexisting condition and render the insured ineligible for plan renewal or another temporary policy.
For many individuals, short-term health plans have become an important option for healthcare coverage, especially as ACA’s major medical premiums increase.
Georgia Short-term Plans
More than 80 short-term plans are offered in Georgia with terms of six months, one year, or three years. Deductibles can range from $1,000 to $10,000 or above.
Coinsurance provision can be as low as 10 percent and up to 50 percent or higher. Policy maximums range from $500,000 to $2 million.
Georgia consumers should refer to short-term health plans for more details and carefully evaluate the benefits and limitations before applying.
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