Insurance - St. Mary's Hospital and Health Care System

Insurance resources, and the plans that contract with St. Mary's Hospital, are listed below.  Choose from the option that best describes your current insurance situation.  For questions, please contact our business office at 706.389.3496.

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St. Mary’s Hospital is contracted with the following Managed Care, Medicare, Medicaid and Health Insurance Exchange plans. 

Commercial Managed Care Contracts

  • Aetna U.S. Healthcare – all commercial plans
  • Blue Cross Blue Shield of Georgia - all commercial plans
  • ChoiceCare PPO - Humana
  • Cigna - all commercial plans (includes Great West)
  • Coventry - all commercial plans (excluding CoventryOne HMO)
  • Evolutions
  • First Health Network PPO
  • Humana - all commercial plans
  • MultiPlan PPO
  • Novanet
  • PHCS (Private Healthcare Systems)
  • United Healthcare - all commercial plans

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Medicare and Military Plans

    • Advantra (Coventry Medicare)
    • Aetna HMO & PPO (All Plans)
    • Blue Cross & Blue Shield HMO & PPO
    • Care Improvement Plus
    • EON Health Plan (All Plans)
    • PruittHealth Premier
    • Tricare (all plans)
    • Cigna HealthSpring 
    • Humana HMO and PPO (All Plans)
    • Medicare A & B
  • United Healthcare (All Plans)
  • Wellcare Medicare
  • VA – Veterans Choice Program

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Medicaid and Medicaid CMO's

  • Amerigroup Community Care
  • Medicaid of Georgia
  • Peach State Health Plan
  • Wellcare

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Health Insurance Exchanges

  • Ambetter (HMO) (Peachstate product)
  • Blue Cross Blue Shield (Pathways)
  • Humana (NPOS)
  • United Healthcare Compass (HMO)

 

If you do not see your plan listed, or if you have questions, please contact our Business Office at 706.389.3496.
For information about financial assistance, please see our financial assistance page.

Updated 4.19.16

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Do You Need Health Insurance?

 

Open Enrollment for 2016 health coverage ended January 31, 2016.

If you didn’t enroll by January 31, 2016, you can’t enroll in a health insurance plan for 2016 unless you qualify for a Special Enrollment Period.

The Open Enrollment Period for 2017 is November 1, 2016 — January 31, 2017

Here’s a quick rundown on the most important things to know about the Health Insurance Marketplace, sometimes known as the health insurance “exchange”, created as part of the Affordable Care Act. Follow the links for more information on each topic.

The Health Insurance Marketplace helps uninsured people find health coverage. When you fill out the Marketplace application you'll find out if you qualify for:

  • Private health insurance plans. Discover whether you qualify for lower costs based on your household size and income. Plans cover essential health benefits, pre-existing conditions, and preventive care. If you don’t qualify for lower costs, you can still use the Marketplace to buy insurance at the standard price.
  • Medicaid and the Children’s Health Insurance Program (CHIP). These programs provide coverage to millions of families with limited income. If it looks like you qualify, we’ll share information with your state agency and they’ll contact you. Many but not all states are expanding Medicaid in 2014 to cover more people.

No matter what state you live in, you can use the Marketplace. Some states operate their own Marketplace. In some states, the Marketplace is run by the Federal government. Find the Health Insurance Marketplace in your state.

Most people must have health coverage in 2015 or pay a fee. If you don’t have coverage in 2016, you’ll pay a penalty of either 2.5% of your income, or $695 per adult ($347.50 per child) — whichever is higher.  In some cases, you might qualify for an exemption from the requirement to have health insurance

You’re considered covered if you have Medicare, Medicaid, CHIP, any job-based plan, any plan you bought yourself, COBRA, retiree coverage, TRICARE, VA health coverage, or some other kinds of health coverage.

If you’re eligible for job-based insurance, you can consider switching to a Marketplace plan. But you won’t qualify for lower costs based on your income unless the job-based insurance is unaffordable or doesn’t meet minimum requirements. You also may lose any contribution your employer makes to your premiums.

If you have Medicare, you’re considered covered and don’t have to make any changes. You can’t use the Marketplace to buy a supplemental or dental plan.

Marketplace open enrollment for 2015 ends February 15, 2015.

Ready to apply? Learn the 4 ways you can apply for coverage.

Questions? Call 24 hours a day, 7 days a week: 1-800-318-2596 (TTY: 1-855-889-4325)

 

Get answers about the Health Insurance Marketplace & ObamacareInfórmese acerca del mercado de seguros médicos y sus nuevas opciones de cobertura. .

 

Learn more at

  • www.healthcare.gov (A federal government website managed by the U.S. Department of Health & Human Services)
  • Enroll America (A nonpartisan 501(c)(3) organization whose mission is to ensure that all Americans are enrolled in and retain health coverage)
  • Understanding health insurance - a glossary and summary of insurance terms from MB&CC