Finding Medicare Plans in Georgia
Whether you’re new to Medicare or have been enrolled for a while, sorting through the Medicare plans available in Georgia can be time consuming. Georgians have a variety of options to choose from, so we’ve done the research to help you find the right plan for your needs.
Who’s Eligible for Medicare Plans in Georgia?
Medicare is a federally sponsored program that provides healthcare benefits to those who qualify, based on either age or disability. Most people are first eligible for Medicare plans in Georgia once they reach 65 years of age. Certain people younger than 65 can also qualify if they’ve been receiving Social Security Disability Insurance (SSDI) for 24 months or have have Amyotrophic Lateral Sclerosis (ALS) or End-Stage Renal Disease (ESRD).
To qualify, you must be a permanent resident or citizen, having lived in the US for the past 5 years. You or your spouse must also have worked for 10 years in a job that contributed to Medicare via Social Security deductions.
We can help you determine your eligibility and options. Speak with a licensed insurance agent by calling the number above.
What Medicare Plans are Available in Georgia?
Original Medicare Part A and Part B
Original Medicare is the governmental portion of Medicare and has two parts:
Part A (Hospital Insurance) covers inpatient services, like hospital care, hospice, and care received at a skilled nursing facility.
Part B (Medical Insurance) covers outpatient medical services, like ambulance services, and certain supplies, like blood sugar monitors and walker. Part B also covers some preventive services, like flu shots, cardiovascular screenings, and a one-time “Welcome to Medicare” visit.
It’s important to recognize that Original Medicare doesn’t cover everything. That’s why there are plan options available through private insurance companies contracted with Medicare, so that you find the coverage you want.
Medicare Advantage Plans (Part C)
Medicare Advantage plans are available through Medicare-approved private insurance companies and work as an alternative to Original Medicare Parts A and B. These plans must offer the same coverage as Original Medicare and can also come with additional benefits, such as dental, vision, and prescription drug coverage. Medicare Advantage plans that include prescription drug coverage are called Medicare Advantage Prescription Drug (MAPD) plans.
In order to qualify for a Medicare Advantage plan, you must first be enrolled in both parts of Original Medicare (Parts A and B). If enrolled, you will continue paying your Part B premium along with the premium charged by the Part C plan selected.
For more information about Medicare Advantage plans, click here.
Medicare Prescription Drug Plans (Part D)
Prescription drugs are not covered by Original Medicare nor Medigap plans. Medicare Prescription Drug plans are available through Medicare-approved private insurance companies to provide this coverage. These plans assign each medication to a certain tier, each tier with an associated copay/coinsurance. Part D plans provide a drug formulary for you to see which tier(s) your medications fall into. This will help you determine which plan is right for you and your prescription needs.
Any beneficiary who is eligible for Original Medicare, Part A and/or Part B can sign-up for Medicare Part D if they are a permanent resident of the Medicare Prescription Drug Plan service area. Medicare Prescription Drug coverage is optional, but if you don’t enroll in Part D as soon as you’re eligible, you might pay a late-enrollment penalty if you enroll later.
You can get Medicare Part D coverage with a stand-alone Medicare Prescription Drug Plan if you’re enrolled in Original Medicare, or, with a Medicare Advantage Prescription Drug Plan (MAPD). A MAPD is a Medicare Advantage plan that provides prescription drug coverage. Monthly plan premiums and out-of-pocket expenses for prescription drugs will vary from plan to plan, as different insurers offer different types of plans.
For more information about Part D plans, click here.
Medicare Supplement Plans (Medigap)
Medicare Supplement plans, offered by Medicare approved private insurance companies, work alongside Original Medicare to fill in coverage gaps. Medigap plans can reduce out-of-pocket expenses by covering things that Original Medicare doesn’t cover, like deductibles, coinsurance, and copays.
For more information about Medicare Supplement plans, click here.
When Can I Enroll in a Plan?
Medicare Advantage and Medicare Prescription Drug Plans
Most people are first eligible to sign up for Medicare plans in Georgia during their Initial Enrollment Period (IEP). Your IEP starts three months before the month of your 65th birthday and continues through the following three months. This means you have a total of seven months to enroll.
You can then make changes to your Medicare Advantage or Medicare Prescription Drug coverage during the Annual Election Period (AEP). This period occurs from October 15th to December 7th every year.
Key Fact: The General Enrollment Period provides you an opportunity to enroll in Original Medicare if you missed your IEP. This period occurs every year from January 1st to March 31st. Then, you’ll have an opportunity to select a Medicare Advantage Plan from April 1st through June 30th.
Medicare Supplement Plans
Enrolling during your Medigap Open Enrollment Period ensures access to the Medicare Supplement plan of your choice. For Medigap plans, your Initial Enrollment Period is a six-month period that starts at the beginning of the month you are both 65 or older and enrolled in Medicare Part B.
Important Note: If you fail to enroll during your Medigap Open Enrollment Period, carriers can increase premiums or deny you coverage entirely.
Special Enrollment Periods
Certain life events, including moving into or out of a care facility, losing your insurance, or moving outside of your current plan’s coverage area, may qualify you for a Special Enrollment Period. A Special Enrollment Period allows you to make changes to your Medicare Advantage and Medicare Prescription Drug plan outside of the periods mentioned above. Our licensed insurance agents can help determine if you qualify for a Special Enrollment Period.
How Can I Compare Plans?
Our goal is to make it convenient for you to compare the Medicare plans available and find the right coverage for your needs. You can do this online by using the form below, or by calling us and speaking with a licensed insurance agent.
Additional Medicare Resources in Georgia
Georgia Cares is the State’s Health Insurance Assistance Program (SHIP). It provides free, confidential counseling and resources to Medicare beneficiaries and their representatives.
Georgia’s Medicare Savings Program is available to help pay medical expenses, like premiums and deductibles, for Medicare beneficiaries whose income falls below a certain level.
Sources: Medicare.gov; georgia.gov