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.

Medicare Plan Options for Georgia Residents

Once you’ve met Medicare eligibility in Georgia, you can choose from several plan options to ensure you have the Medicare coverage that meets your healthcare needs.

Original Medicare

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 additional health insurance from private insurance companies.

Medicare Supplement Plans

These plans are used to fill the coverage gap left by Original Medicare:

  • Medicare Supplement Plans (Medigap) 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

Ready to learn more?

Choosing between Medigap insurance plans is not an easy decision. However, educating yourself about the differences between the two types of insurance coverage, comparing different plans and policies, and talking to a licensed insurance agent will help you make the right choice.