Coventry Health Insurance of Georgia (GA) | Health Insurance Georgia | If I am an Individual, How come I Enrolled in a Group Health Insurance Georgia Plan?

Health Insurance Georgia

If I am an Individual, How come I Enrolled in a Group Health Insurance Georgia Plan?

Many people become confused about the terminology used on health insurance Georgia products. Many plans are classified as either individual or group health insurance Georgia policies. However, you can purchase an individual policy for your family, and enrolled in a group plan as an individual. That sounds pretty contradictory, doesn't it?

An individual health insurance Georgia policy refers to a policy that one person can purchase from the open market. This means that the person chooses which health insurance Georgia provider they wish to buy a policy from. They decide on the plan, and they purchase their own policy. That person can add their family members, or dependents, if they wish. They would then have an individual family health insurance Georgia policy for his or her family. It is considered individual because one individual chooses and purchases one policy, regardless of how many people end up covered by that particular health insurance Georgia policy. So, one individual can have an individual health insurance Georgia policy that includes himself, his spouse, and two children, an individual health insurance Georgia family policy.

A group health insurance Georgia policy is one that an employer or organization offers to qualified members. Usually, a business owner or the head of an organization will choose a health insurance Georgia provider and they will work together to choose a health insurance Georgia plan. That business owner, or organization head, will then inform the members which plan they have chosen, and the member can then enroll in the plan. Therefore, the member does not really choose the health insurance Georgia policy itself. They only choose whether to enroll or not. The health insurance Georgia carrier contracts with the business owner on prices and administration fees. Usually, the employer will pay at least a portion of the premiums for the member. The member may be responsible to pay additional costs related to adding dependents or family members. Therefore, an individual who does not have any dependents, and who enrolls in a group health insurance Georgia plan, will be enrolled in a group plan as an individual.

The two different kinds of plans are often similar. The main difference is in how the health insurance Georgia policy originates. Also, health insurance Georgia companies are prohibited from denying coverage to any individual qualified member of the group, whether a business or organization. This means that even an individual with a chronic medical condition and poor health would be approved for coverage at the same premium price as a healthy individual. When purchasing an individual policy, the health insurance Georgia company is allowed to deny coverage if the individual has poor health or many chronic medical problems, and is also allowed to raise premiums based on many different factors. Some of the factors that would lead to denial or increased premiums are pre-existing conditions, chronic medical conditions, being overweight, smoking, and age, for example. There is also a possibility that any health insurance Georgia plan will have a waiting period for treatment of a pre-existing condition. This means that once the health insurance Georgia policy is in effect, it may not pay benefits on medical services related to a medical problem that was already in place when the health insurance Georgia policy became effective. This may or may not occur, but is a possibility. Sometimes the waiting period can be as long as eighteen months. Other times, if you have had continuous health insurance Georgia coverage, there may not be a waiting period at all.

Now you are clear on group versus individual health insurance Georgia plans!

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