Affordable Independent Health Insurance & Health Care in Atlanta (buy, bankrupt)

[theotherhand]

I need practical advice on how to access affordable healthcare and get decent independent health insurance in Atlanta.

I have a family member who just moved there. He's self-employed and low-income. In his prior state he was eligible for expanded Medicaid, but that isn't an option in Georgia. He's in generally good health, early-40s, but is having some symptoms that need to be diagnosed and treated before they could get worse. He's trying to get an ACA Marketplace insurance plan, but it'll be a month or so before we can get the application processed.

I'm looking for recommendations for two things:

1. What are the best independent health insurance plans for the Atlanta area? (Defining "best" not necessarily as the lowest premium, but as a good network and reasonable deductible). Plans offered on the ACA Marketplace are preferable, but I'll take recommendations for off-marketplace plans as well. Are there any insurance providers, plans or networks we should avoid?

2. What are the best options for emergency, urgent and routine care for a cash-pay patient? Is there a good public hospital that works with low-income patients? Affordable urgent care facilities or testing labs? Free or sliding-scale clinics? If he needs an ER I want him to be able to choose one that won't bankrupt him.

Thanks for any advice you can offer!

[ATLTJL]

What kind of work does he do?

My advice would be to look for trade groups that other people who do the type of work he does belong to. Often, these trade groups arrange group insurance plans that their members can buy into.

I had a friend in the same exact scenario: a private practice physician. Tough to imagine a doctor having trouble with health insurance, but they're just like us and out of luck when they don't work for a large hospital or practice. He found coverage through a trade alliance of independent physicians. Many professions offer similar groups. I'd explore that before trying to go out on my own.

He may have to wait for open enrollment, but that's just a few months away.

[theotherhand]

Originally Posted by ATLTJL

What kind of work does he do?

My advice would be to look for trade groups that other people who do the type of work he does belong to. Often, these trade groups arrange group insurance plans that their members can buy into.

I had a friend in the same exact scenario: a private practice physician. Tough to imagine a doctor having trouble with health insurance, but they're just like us and out of luck when they don't work for a large hospital or practice. He found coverage through a trade alliance of independent physicians. Many professions offer similar groups. I'd explore that before trying to go out on my own.

He may have to wait for open enrollment, but that's just a few months away.

He's an actor. He hopes to be eligible for SAG insurance next year but needs to get enough hours to qualify. I don't think there's any other trade group option available.

Open enrollment may be our best option, if the political winds don't change things by then. My biggest concern is he has some immediate health issues that may need to be addressed before then, and open enrollment insurance won't kick in until 2018.

I understand about your physician friend. My last GP was an independent practitioner and could only get coverage after the ACA was enacted because he had cancer as a pre-existing condition. Ironic, and a sad commentary on the state of healthcare options in this country.

[JMatl]

Originally Posted by theotherhand

He's an actor. He hopes to be eligible for SAG insurance next year but needs to get enough hours to qualify. I don't think there's any other trade group option available.

Open enrollment may be our best option, if the political winds don't change things by then. My biggest concern is he has some immediate health issues that may need to be addressed before then, and open enrollment insurance won't kick in until 2018.

I understand about your physician friend. My last GP was an independent practitioner and could only get coverage after the ACA was enacted because he had cancer as a pre-existing condition. Ironic, and a sad commentary on the state of healthcare options in this country.

Not sure where your brother lives, but the Grady Clinic on Clairmont next to PDK could be an option.

A good friend relied on them between jobs last year, and received excellent care. They will also take income into consideration, and offered a sliding scale of co-pays based on that since he resides in DeKalb (this also applies to Fulton residents).

I wish him the best of luck.

[theotherhand]

Thanks for the info! I'll let him know about this clinic. I believe he resides in Fulton County.