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Georgia Individual Health Insurance HSA Information Page

What is the difference between Georgia indvidual HSA health insurance and other types of Georgia individual health insurance plans?

Before we begin to try to understand the different types of Georgia health insurance, there is a bit of information we need to be familiar with. All insurance plans have certain things in common. It would be helpful to understand what they are so you can see how they apply to each type of insurance.

Deductible-This is the portion of any health charges that you pay before the insurance company pays anything (many plans waive the deductible for physician office visits, instead using an office visit co-pay). ALL plans have a deductible. It may be vary form $0 to $10,000, but it's always included in the plan benefits.

Coinsurance- After the deductible is met, you enter into a period of coinsurance. It's just what the name says. Two entities are paying the health costs during the coinsurance period. When you see the term 80/60 it means that if you stay in network, you pay 20% and the insurance company pays 80% of the charges. Out of network, you pay 40% and the insurance company pays 60%. There is normally a stop loss of $1000 or more that the insured has to pay. In other words, if your plan reads 80/20 through $5000, you would be responsible for 20% of $5000 after the deductible has been met. Then the insured's liability would stop and the insurance company would pay the rest.

Not all plans have coinsurance. Often, you won't find coinsurance in an HMO or POS plan, and often it won't be in an H S A eligible plan.

After the deductible and coinsurance have been met, the insurance company has the liability of any other covered health charges during the plan year.

There are 2 more terms you should be familiar with and that is the network.

NETWORK - A group of providers, doctors, hospitals, labs, etc. that have a relationship with the insurance company and have established specific pricing for services. This is the way that insurance companies manage their costs.

OUT OF NETWORK - An out of network provider is any physician, hospital, lab, etc. who does not participate (or "accept") your insurance plan. In the event that you utilize one of these providers, your "out of network" benefit would apply, if your plan includes an out of network benefit. Your out of pocket costs and deductibles are usually higher when utilizing this benefit. This benefit is also known as a type of Indemnity benefit.

Now that you have a general definition of insurance terms, let's look at the different types of plans.

H S A-The health savings account, formerly known as an MSA (Medical Savings Account), was established by Congress in an effort to make people more responsible for their health care costs.

The HSA insurance plan itself is a high deductible plan that utilizes a PPO or HMO network. There are no copays for doctor's office vsits or prescriptions - all goes toward the deductible and then is paid at coinsurance amounts once the yearly deductible has been met.

The HSA savings account portion is separate. As an incentive for a person to manage their health care costs, Congress allowed an insured to pay into a special HSA savings account up to the amount determined by the Government for each year. This is regardless of the deductible taken. This payment would be paid by the insured and deducted from the insured's income on a before tax basis. The insured would then be allowed to use this account to pay for medical and related expenses. The money could even be used to cover medical charges not covered by their health plan.

To further simplify, the H S A comes in two parts. One is a high deductible health plan for which you would pay a monthly premium. The second is a hedical saving account, where you could pay into the account up to a certain amount year. This amount is determined each year by the government. This account is your money. If you use the money to pay medical expenses, it is never taxed. If you do not use the money in this account, It will remain your money and essentially becomes like an IRA. The difference is between an I R A and an H S A is the H S A funds can be withdrawn at any time to pay medical expenses without penalty. Also, any excess funds must remain in the H S A account until age 65 in order to be withdrawn without penalty. Any monies withdrawn after age 65 will be subject to regular income tax at the time of withdrawal.

Here are some of the other types of insurance plans that are available in Georgia:
HMO Individual and Group Health Insurance Plans
Open Access HMO Individual and Group Health Insurance Plans
POS Individual and Group Health Insurance Plans
Open Access POS Individual and Group Health Insurance Plans
Indemnity Individual and Group Health Insurance Plans
PPO Individual and Group Health Insurance Plans

We hope this information is helpful to you. If you would like further information or have questions, please feel free to contact us at Insurance Now and we will spend whatever time is needed to help you make sure that you select the right plan for you.


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Suite 113
Atlanta, GA 30338

Call Holly, Chris or Bob at
(770) 396-9517
Outside of the Atlanta area,
call toll-free: 1-877-711-8376.
fax: 770-396-4318
Email: holly@insurance-now.com