Medicare plays a key role in providing health and financial security to beneficiaries residing in Georgia. With more than 1.7 million Georgia beneficiaries enrolled in Medicare, we’ll cover some very important information below about Medicare in Georgia. We want to help you better understand your options and make the decision-process as seamless as possible once you’re ready to enroll in Medicare or discover different coverage options.

Who Qualifies for Medicare in Georgia?

Medicare covers most Georgia residents who are 65 or older, and it also covers disabled Georgia residents. In general, Medicare enrollment in Georgia works the same way as it does in the rest of the country. If you qualify for Original Medicare, also known as Part A and Part B, it will help cover 80% of your health care costs.

When you’re first eligible for Medicare, you have a 7-month Initial Enrollment Period to sign up for Part A and/or Part B. If you’re eligible for Medicare when you turn 65, you can sign up during the 7-month period that:

  • Begins 3 months before the month you turn 65
  • Includes the month you turn 65
  • Ends 3 months after the month you turn 65

In most cases, if you don’t sign up for Part B when you’re first eligible, you’ll have to pay a late enrollment penalty. You’ll be responsible for paying this penalty for as long as you have Part B, and you could have a gap in your health coverage.

Once you reach Medicare eligibility, you can begin choosing additional coverage options to help pay for the remaining 20% of your medical expenses through Medicare Advantage (Part C), Medigap, and/or a Medicare Prescription Drug (Part D) plan.

Who Qualifies for Medicare

Georgia Medicare Enrollments

1,003,486

Original Medicare Plans
(Part A and B)

753,936

Medicare Advantage & Other Health Plans

1,314,355

Stand-alone Medicare
Part D (Drug plans)

1,757,422

Total Medicare Beneficiaries
in Georgia

Georgia Medicare Advantage Plans (Part C)

More than 40% of Georgia Medicare beneficiaries select Medicare Advantage plans.

Medicare Advantage plans are private, Medicare-approved insurance companies. They provide all of your Original Medicare benefits and often include extra benefits such as drug, dental, and vision coverage.

The Medicare Advantage Open Enrollment Period runs from January 1 to March 31. During this period, Medicare beneficiaries in Georgia who already enrolled in a Medicare Advantage plan can switch to a different Medicare Advantage plan or drop their Medicare Advantage plan and enroll in Original Medicare.

As of 2020, 127 Medicare Advantage plans are available in Georgia. The average monthly Medicare Advantage premium in Georgia changed from $17.10 in 2020 to $16.18 in 2020. $0 is the lowest monthly premium for a Medicare Advantage plan in Georgia. 100% of people with Medicare have access to a Medicare Advantage plan. According to Centers for Medicare and Medicaid Services (CMS), as of May 2020, there are 750,995 beneficiaries enrolled in Medicare Advantage and other plans in Georgia. All 159 counties in Georgia have Medicare Advantage plans available.

Georgia Medicare Supplement (Medigap) Insurance Plans

Georgia requires Medigap insurers to make their plans available to people under the age of 65; however, the premiums are significantly higher.

Medigap plans are used to supplement Original Medicare, covering some or all of the out-of-pocket costs (for coinsurance and deductibles) that beneficiaries would otherwise incur if they only had Original Medicare on its own. Typically, Medigap plans are popular for those who want little to no copay when they access healthcare services.

In Georgia, Medigap plans are very popular. The Medigap plans available in Georgia follow the same model as most other states throughout the nation. Georgia is one of the few states that prohibit Medigap insurers from increasing premiums as an enrollee gets older, and requires either an issue-age rating or community rating. Georgia also requires Medigap insurers to offer plans to disabled Medicare beneficiaries under age 65 years old; however, the premiums are significantly higher.

It’s recommended that the best time to buy a Medigap policy is during your Medigap open enrollment period. This period lasts for six months and begins on the first day of the month in which you’re both 65 years old or older and enrolled in Medicare Part B. During this period, an insurance company can’t use medical underwriting. After this period, going through underwriting could be a requirement.

Georgia Medicare Prescription Drug Coverage (Part D)

Original Medicare doesn’t cover outpatient prescription drugs. However, Medicare beneficiaries can get prescription coverage via a Medicare Advantage plan, an employer-sponsored plan (offered by a current or former employer), or a stand-alone Part D plan. Medigap plans don’t cover prescription drugs unless they’re covered under Part B.

As of 2020, there are 598,592 Medicare beneficiaries in Georgia enrolled in stand-alone Part D prescription drug plans and 717,735 enrolled in Medicare Advantage Prescription Drug plans. For 2020 coverage, there are 28 stand-alone Part D plans available in Georgia, with premiums ranging from about $15 to $109 per month.

Nearly 96% of people with a stand-alone Medicare prescription drug plan have access to a plan with a lower premium than what they paid in 2019. About 32% of people with a stand-alone Medicare prescription drug plan get Extra Help (also called the low-income subsidy, or LIS).

When deciding on a Part D plan, it’s important to evaluate several factors such as each plan’s premium, formulary, and copays since every plan is different. Learn how you can save money on your out-of-pocket costs with a Medicare Advantage, Part D, or Medigap plan, fill out this form or give us a call

Local Medicare Health Plan Resources in Georgia

  • GeorgiaCares: GeorgiaCares is a public-private partnership, administered by the Georgia Department of Human Services (DHS) Division of Aging Services (DAS). GeorgiaCares provides free, unbiased, and factual information and assistance to Medicare beneficiaries and their caregivers with health and drug plans. GeorgiaCares is the State Health Insurance Assistance Program (SHIP) for Georgia. Contact: Call 1-866-552-4464 and choose option four on the menu. Contact is also possible through the Department of Aging Services or area Agencies on Aging.

The licensed agents that are partnered with Timefor65 can help you compare the availability, benefits, and costs of Medicare plans in your specific region of Georgia. Our process makes it easier for you to access your Medicare eligibility in Georgia so that you receive personalized, affordable, and easy-to-use coverage options and solutions. Fill out the form or give us a call at (866) 327‑0148 anytime to get a free quote or to ask any questions.

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