In 2018, 1,676,019 Georgian residents were enrolled in Medicare. There are hundreds of Medicare plans to choose from if you live in Georgia.
Whether you want to switch plans to get more coverage or don’t know if you’re eligible for a Medicare Advantage Plan, there’s a lot to know about Medicare.
Medicare is a government funded insurance program for people over age 65. Younger adults who have a disability may also qualify for Medicare plans in Georgia. Many seniors are automatically enrolled in original Medicare (Part A and Part B).
Medicare Part A covers hospital services, such as:
- inpatient hospital care
- limited home health care
- hospice care
Medicare Part B covers medical services and preventative care, such as:
- doctor’s appointments
- lab tests
- diabetes screening
- outpatient hospital care
Medicare Part D is a prescription drug plan that will cover the cost of medications. You may choose to enroll in Part D to supplement the coverage provided by parts A and B.
Medicare plans in Georgia also include Special Needs Plans (SNPs). These plans provide coverage for people living with chronic health conditions or who have other special health needs.
Medicare Advantage Plans
Medicare Advantage Plans (Part C) are all-in-one plans that provide complete health coverage. They are available through private health insurance providers.
A Medicare Advantage plan will cover both hospital and medical costs, as well as medications. Some Medicare Georgia plans will include additional coverage for vision or dental needs, fitness programs, or hearing aids.
The following insurance companies offer Medicare plans in Georgia:
- Aetna Medicare
- Anthem Blue Cross and Blue Shield
- Clear Spring Health
- Clover Health
- Kaiser Permanente
- Lasso Healthcare
- Sonder Health Plan, Inc.
These companies offer plans many counties in Georgia. However, Medicare Advantage plan offerings vary by county, so enter your specific ZIP code when searching for plans where you live.
Many seniors are automatically enrolled in original Medicare when they turn age 65, but you’ll have to apply for a Medicare Advantage plan. To be eligible for a Medicare Advantage plan in Georgia you need meet these requirements:
- be a U.S. citizen or permanent resident of Georgia
- be enrolled in original Medicare Part A and Part B
- have paid Medicare payroll deductions
You may also be eligible for a Medicare Advantage plan in Georgia if you have a disability or a chronic illness such as amyotrophic lateral sclerosis (ALS) or end stage renal disease (ESRD). Georgians receiving pensions from the Railroad Retirement Board or from Social Security may also qualify for a Medicare Advantage plan.
As you approach retirement, you’ll have an initial enrollment period when you can enroll in Medicare. This initial period starts 3 months prior to your 65th birthday, and extends an additional 3 months after your birthday.
The Medicare annual enrollment period is from October 15 to December 7. During this time, you can choose a new plan.
There’s also an open enrollment period for Medicare Advantage from January 1 until March 31. During this open enrollment period, you can switch from original Medicare to Medicare Advantage, or change to a different Medicare Advantage plan.
You may also be able to apply for Medicare Georgia during a special enrollment period. You may qualify for special enrollment if your employer insurance has changed, or if you have a disability.
When choosing between plans and carriers, you’ll first want to think about exactly what you need.
Before you enroll in a Medicare Plan in Georgia, make a comprehensive list of all your medications and how much you’re paying for these prescriptions. You’ll also want to think about how frequently you visit your doctor.
Depending on your known medical expenses, a Medicare Advantage plan or Part D (prescription coverage) may make sense for you.
If you’re very happy with your current physician, call your doctor’s office to find out what insurance providers are accepted. If you’re considering a Medicare Advantage plan, many of the carriers will only work with in-network doctors.
Read reviews of the carriers in your area to find highly recommended plans. You can find out how a plan performs by accessing the CMS star ratings system. This is a one- to five-star rating system where a high rating means the plan performed well during the past year. Plans change from year to year, so check the ratings.
You can find more information about Medicare plans in Georgia by contacting the following organizations. They’ll be happy to provide you with more information about Medicare Georgia and help you find the plan that’s right for you.
- GeorgiaCares: Get help from the Georgia Medicare Savings Program called GeorgiaCares. As part of the State Health Insurance Assistance Program (SHIP), GeorgiaCares provides information about Medicare, free counseling services, and assistance enrolling in a Medicare plan in Georgia. They can be reached by telephone at 866-552-4464.
- Division of Aging Services: The Division of Aging Services of Georgia can provide help and support to seniors in Georgia. You can speak to someone by telephone at 404-657-5258.
- Georgia Drug Card. This assistance program makes medications more affordable for Georgia residents. Contact 404-657-3127 for more information.
You can also find out how to enroll in a Medicare plan in Georgia, and explore your coverage options by calling 800-633-4227.
Are you ready to enroll in a Medicare Advantage plan in Georgia, and find the best plan for you for 2021?
- Visit Medicare.gov to see a list of the Medicare Georgia plans in your area, then visit the carrier’s website for more information about specific plans.
- Narrow your search by checking CMS star ratings, using your zip code, and determining your budget as you evaluate Advantage plans.
- Enroll online, use a paper form, or call the carrier directly to enroll in a Medicare plan.
Medicare plans in Georgia can help you cover the cost of your health services. Whether you’re about to qualify for Medicare for the first time, or want to increase your coverage, take some time to evaluate your options.
You may get enough coverage with original Medicare Georgia, or choose to add Plan D. Depending on your situation, a Medicare Advantage plan may help save you money every month, provide additional services that suit your needs, or give you more flexibility.
This article was updated on October 7, 2020 to reflect Medicare costs in 2021.
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