Medicare in Georgia - Plan Options
Georgia residents who are 65 years old or have a qualifying disability can receive medical insurance from Medicare, which is a federal program. Around 1,859,192 people in Georgia were enrolled in Medicare in 2022, almost 17% of the state’s population. This is slightly less than the percentage of the overall U.S. population enrolled in Medicare, about 19%.
While it is true that many Americans enroll in Medicare benefits upon reaching the age of 65, almost 8 million Americans are under 65 years old but still have Medicare coverage. This is because eligibility for Medicare can also be established if someone has received disability benefits for 24 months or has been diagnosed with kidney failure or ALS.
Medicare Plans in Georgia
There are four main types of Medicare plans available to eligible Americans. These include Original Medicare, Medicare Advantage, Medicare Supplement Insurance (Medigap), and Prescription Drug Plans.
Let’s take a look at each plan option:
The Medicare plan most Georgia seniors are familiar with is Original Medicare.
Original Medicare has two parts:
- Hospital insurance (Medicare Part A) covers inpatient services and is free to most enrollees. In addition, you qualify for premium-free Part A if you or your spouse have paid Medicare taxes for at least ten years.
- Medical insurance (Medicare Part B) pays for outpatient services such as doctor visits and home health. You will have a monthly premium to pay for Part B services.
Original Medicare doesn’t cover all of your expenses, nor does it cover prescription drugs. However, you can buy supplemental insurance from private insurance companies to help cover your medications.
Medicare Supplement Plans
These plans are used to fill the coverage gap left by Original Medicare:
- Medicare Supplement Plans (Medigap) in Georgia pay for your share of out-of-pocket expenses such as deductibles and copays
- Prescription Drug Plans (Medicare Part D) cover prescription medication
Eligibility for Medigap and Part D plans requires you to stay enrolled in Parts A and B and be up-to-date on your Part B premium.
Medicare Advantage Plans (Medicare Part C)
Part C plans are another way to receive your Part A and Part B Medicare benefits. Private insurance companies sell Medicare Advantage plans in Georgia.
Here are a few highlights of Medicare Advantage insurance plans:
- Include the same coverage as Medicare Parts A and B
- Frequently feature extra benefits such as gym memberships, transportation, or dental and vision
- Often bundle prescription drug coverage with the health coverage
- Typically require you to use a provider network or get a referral to visit a specialist
- Also have out-of-pocket costs such as deductibles, coinsurance, and copays
Medicare Eligibility in Georgia
The federal government’s Medicare program provides health insurance coverage to Georgia residents who are either U.S. citizens or legal permanent residents of at least five years.
Here are the requirements for Medicare eligibility in Georgia:
- Are age 65 or older
- Are under age 65 and receiving disability benefits through Social Security or the Railroad Retirement Board
- Have end-stage renal disease (ESRD)
- Have Lou Gehrig’s disease (also known as amyotrophic lateral sclerosis or ALS)
How Do I Apply for Medicare in Georgia?
You’re automatically enrolled in Medicare Part A and Medicare Part B if you already receive Social Security benefits or Railroad Retirement benefits. However, you must sign up for coverage if you’re not receiving benefits.
The Initial Enrollment Period is the preferred time for new beneficiaries to sign up for Medicare. Your IEP starts three months before your 65th birthday and ends three months after.
There are three ways you can apply for Medicare in Georgia:
1. Sign up online for Medicare
2. By phone, Call 1-800-772-1213. TTY users can call 1-800-325-0778.
3. In person with the Social Security Administration.
Contact the Georgia Department of Human Services and the State Health Insurance Assistance Program for more information.
Our experienced agents can explain your enrollment options and assist you in getting the right coverage you need.
Ready to Learn More?
Choosing between Medicare Advantage and Medigap is not an easy decision. With Policy Guide’s assistance, you will have access to the knowledge and expertise of professional agents who can help you compare different health plans, quotes, and policies to ensure that you make an informed decision. Let us guide you through this process so that your chosen plan best suits your needs.
Georgia Medicare Resources
Georgia residents are advised to learn about their Medicare choices. Several resources are available to seniors and caregivers in Georgia, such as Area Agencies on Aging (AAAs), local public health agencies, and nonprofit groups. These organizations provide seniors with valuable information and programs to enhance their overall health.
- Northwest Georgia Area Agency on Aging
- Athens Community Council on Aging
- Georgia Action Pact Organization
- Legacy Link Medicare Counseling