From Atlanta to Savannah, your best Medicare plan awaits.

Georgia’s mild winters, charming small towns, and always-near city amenities make it a wonderful place to call home—especially if you’re retiring. With taxes and cost of living lower than the national average and an extensive healthcare system, Georgia is a practical choice.  

Even more, your options for Medicare coverage abound in The Peach State. This article will give you the right foundation for understanding and choosing the right Medicare program for you.

Did you know that you can use the Insurify Medicare comparison tool to find the right Medicare plan for you? Start with your ZIP code, and you’ll be comparing plans in your area in just 60 seconds. Fast, easy, and confidential!

 

 

How Much Does Medicare Cost in Georgia?

The cost of Medicare in Georgia varies depending on where you live, your healthcare needs, and how you set up your Medicare health plan. If you add extra coverage options, like stand-alone dental care, you should also factor that into your overall costs. 

The Cost of Original Medicare in Georgia

Original Medicare has standardized costs across the nation. One great thing about standardized expenses is that you can seek care from any healthcare provider who accepts Medicare no matter where you are in the country

Medicare Part A is premium-free for most people. To qualify for premium-free, you need to have earned 40 work credits—about 10 years of work history. People with fewer than 40 work credits but with at least 30 pay $259 a month in Medicare Part A premiums. People with fewer than 30 credits pay $471.

The Medicare Part B premium is $148.50 for most beneficiaries. The Part B premium works on a sliding scale. Individuals who make more than $87,000 in income a year and couples who make more than $174,000 a year will pay more. 

Monthly premiums are just one part of the cost of Medicare. Deductibles—$1,484 for Medicare Part A and $203 for Medicare Part B—will also be part of your expenses. Co-payments and coinsurance are the final pieces of the puzzle. Medicare Part B has a steady coinsurance rate of 20 percent, while Part A coinsurance depends on your inpatient care. 

Original Medicare is expensive on its own. Many Medicare beneficiaries opt to purchase an additional Medicare Supplement plan to help cover those costs.    

The Cost of Medigap Plans in Georgia

Medigap, or Medicare Supplement Insurance, offers additional coverage for deductible, co-pay, and coinsurance costs. Some plans, like Medigap K and L, put limits on your out-of-pocket costs. The extent of coverage depends on the type of Medigap plan—there are 10 types as of 2021.

Each Medigap plan of one kind is virtually identical to any other Medigap plan of the same kind. Medigap Plan G is the same on paper as any other Medigap Plan G policy. However, plans differ in cost depending on the insurance company fulfilling the plan.  

Beyond costs, some insurance companies offer better websites, apps, and customer service. Take time to explore the company website and customer reviews of any prospective Medigap provider you’re considering. 

Learn More: Can Medigap Plan G Save You Money?

The Cost of Medicare Advantage in Georgia

Georgia Medicare Advantage plans at a glance:

Medicare Advantage plans can be used as an alternative to Original Medicare. You still need to sign up for Original Medicare and cover Medicare Part B premiums to join.

The advantages of Medicare Advantage are extended coverage benefits and possibly lower costs. All Medicare Advantage plans must cover everything that Original Medicare covers, but many plans offer more health coverage than Original Medicare. This can include:

  • Dental
  • Vision
  • Hearing
  • Prescriptions
  • Wellness programs

Many plans also offer you limits on your out-of-pocket costs. But before enrolling in a plan, you should examine the plan’s details very carefully. No plan is exactly alike, and even subtle differences can have a big impact on you depending on your health needs. 

Finally, keep in mind that choosing Medicare Advantage means you cannot enroll in a Medigap plan

The Cost of Prescription Drug Plans in Georgia

Georgia prescription drug plans at a glance

There are stand-alone Medicare Part D plans for people in Original Medicare or a Medicare Advantage plan that doesn’t include prescription coverage. These plans must cover a selection of medications outlined by the Centers for Medicare & Medicaid Services (CMS).

Beyond that required selection, plans differ as to the additional medications covered. Each plan has its own formulary or pricing schedule for medications. The formulary is broken down into four tiers.

  • Tier I covers inexpensive generics.
  • Tier II covers expensive generics and inexpensive brand names.
  • Tier III covers expensive brand names.
  • Tier IV covers specialty drugs.

You should expect to pay a deductible and coinsurance rates with your Medicare Part D plan in addition to the monthly premium

Cost of Special Needs Plans in Georgia

Georgia Special Needs Plans at a glance:

Special Needs Plans are designed for people with certain illnesses or people with low income. These plans make Medicare affordable for people who would not otherwise be able to afford their healthcare. Health conditions that may qualify you include:

  • HIV/AIDS
  • Dementia
  • Chronic heart disease
  • Diabetes
  • Kidney failure (ESRD)
  • Lou Gehrig’s disease (ALS)

People living in a nursing home, skilled nursing facility, or other long-term care institution can also qualify for a Special Needs Plan.

Special Needs Plans work like Medicare Advantage, except that they always include prescription drug coverage. Most SNPs are HMOs (health maintenance organizations), meaning you’ll need to work with a primary care physician and get referrals to see specialists.

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What Is Medicare?

Medicare is the federal health insurance program founded in 1966. It was created to help seniors access affordable health services. Over the decades, Medicare has evolved to serve more people and more health needs. While the Medicare system is large and complicated, there are many options for tailoring your healthcare to your exact requirements. 

Medicare is broken down into a few parts. Some of these parts can work in tandem. Some cannot. Here is a table to help break things down:

Medicare Parts
Official Name Commonly Called What It Covers What It Works With
Medicare Part A Original Medicare Inpatient care, such as hospital visits; Medicare Part A is one half of Original Medicare Medigap, Medicare Part D
Medicare Part B Original Medicare Outpatient care, such as doctor’s visits; Medicare Part B is the other half of Original Medicare Medigap, Medicare Part D
Medicare Supplement Insurance Medigap Deductibles, co-payments, and/or coinsurance costs associated with Original Medicare Original Medicare, Medicare Part D
Medicare Part C Medicare Advantage Inpatient and outpatient care; it must cover everything that Original Medicare covers Medicare Part D
Medicare Part D Medicare Prescription Drug Plan Prescription medications Original Medicare, Medigap, Medicare Part C

Who Qualifies for Medicare in Georgia?

Your eligibility depends on either your age or your health condition. First, you must be either an American citizen or a permanent resident of the U.S. for at least five consecutive years. Next, you must meet one of the following criteria:

  • Be 65 years of age or older
  • Be diagnosed with kidney failure (end-stage renal disease, or ESRD)
  • Be diagnosed with Lou Gehrig’s Disease (ALS)
  • Be disabled and drawing from SSDI for at least 24 months

If you are unsure if you qualify for Medicare, you should contact the Social Security Administration at 1 (800) 772-1213. TTY users call 1 (800) 325-0778.

How Do I Choose Between Original Medicare and Medicare Advantage?

The most crucial choice you’ll make with Medicare is whether to use Original Medicare (preferably with a Medigap plan) or Medicare Advantage. There are different advantages and disadvantages of using each type, and Medicare plans are not one-size-fits-all. 

Below is a chart covering the fundamental contrasts between the two types.

Plan Type Advantages Disadvantages
Original Medicare
  • Extensive network of providers
  • Large service area across the U.S.
  • Low monthly premiums
  • Many Medigap plan options to help cover costs
  • No caps on out-of-pocket coverage
  • Must purchase add-ons like Medigap, prescription drug coverage, and stand-alone dental, vision, and hearing 
Medicare Advantage
  • Can purchase a comprehensive plan to cover medical, medication, vision, dental, and hearing
  • Many plan options, including types of plans like HMO, PPO, or PFFS (private fee-for-service)
  • A smaller network of providers
  • Small service area restricted to your state or a region within your state
  • Premiums can be more expensive

Don’t forget that you are allowed to change your Medicare plan at least once a year during the Open Enrollment Period. That runs from October 15 to December 7 each year. You can add, drop, or switch plans during that time. If your current plan has some problems, don’t hesitate to see what else is available to you. Keep in mind that you can compare Medigap, Medicare Advantage, and Medicare Part D plans side-by-side using the Insurify Medicare comparison tool.

How Do I Apply for Original Medicare in Georgia?

You should apply for Original Medicare as soon as you are eligible—during your Initial Enrollment Period. Luckily, enrolling is easy! You can apply through the Social Security Administration in one of three ways:

  1. Logging into your Social Security account at SSA.gov
  2. Calling Social Security at 1 (800) 772-1213; TTY users call 1 (800) 325-0778
  3. Applying in person at your local Social Security office

How Do I Apply for Medicare Advantage in Georgia?

You can apply for Medicare Advantage after you’ve first enrolled in Original Medicare (Parts A and B). You may also want to choose a backup Medigap plan (in the event you wish to return to Original Medicare after trying a Medicare Advantage plan).

Once you’ve got that taken care of, it’s time to search. Try the Insurify Medicare comparison tool to gather plan information and compare healthcare providers in your area. Once you find the right plan, you can often apply online or over the phone. 

What’s the Best Medicare Advantage Plan in Georgia?

The best Medicare Advantage plan depends on the person using the plan. Everyone has different health needs and preferences. Getting clear on your needs is very important. 

Take some time to reflect on what you like and dislike about your current healthcare. You’ll also want to make a list of your medications. And don’t forget to speak with your doctor, who may have lots of advice. 

Finally, you do have free, unbiased resources to help you. You can speak to a counselor with the State Health Insurance Assistance Program (SHIP) by calling 1 (866) 552-4464.

Learn More: Best Medicare Advantage Plans in Georgia 

 

 

FAQ: Georgia Medicare

When is the best time to sign up for Medicare?

You should sign up for Medicare as soon as you are able. That would mean during your Initial Enrollment Period (IEP). Your IEP begins three months before your 65th birthday—unless you qualify for Medicare earlier than 65.  If you have questions about your eligibility, you can talk to a Medicare representative at 1 (800) MEDICARE. 

Who qualifies for Georgia Medicaid?

Many people can qualify for Medicaid. You must be a Georgia resident, and you must be either a U.S. citizen or permanent resident of at least five consecutive years. Finally, you must meet income and asset limits.  Elderly people and those with disabilities and blindness, as well as people receiving care in an institution, such as a skilled nursing facility, are often eligible. 

What are the income limits for Georgia Medicaid?

For regular Medicaid, the income limit is $783 a month for a single person and $1,175 for a couple. In addition to income limits, you’ll have asset limits—$2,000 for singles and $3,000 for couples.  Assets do not include your primary residence, one vehicle, and personal belongings. If you are unsure if you qualify, you can call. 

Conclusion: Compare Georgia Medicare Plans Before You Buy

Whether you’re signing up for the first time or changing your old Medicare plans, navigating the Medicare world can be a bit tricky. Remember that finding the right fit is all about two things:

  • Understanding your options
  • Understanding your needs and preferences

Taking the time now to research and compare will save you potential headaches in the future. Don’t forget about the Insurify Medicare comparison tool—with just your ZIP code, you’ll discover all the options in your area.  

The Easy Way to Get More Out of Medicare

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Updated April 27, 2021

J.J. Starr is a health and finance copywriter who enjoys helping readers find the information they need. In addition to her background in banking and financial advising, she is also a poet with an MFA from New York University. She lives in Amherst, Massachusetts. You can learn more at jjstarrwrites.com.