Medicare in Georgia

InsureMeNow Simplifies Benefits and Features of Medicare Plans for Georgia Residents

Georgia Medicare Plans

Medicare enrollment in Georgia reached nearly 1.7 million by the end of 2018, which was about 16% of the state’s population enrolled in Medicare.

 

In this state about 82% of Medicare beneficiaries qualify based on age while remaining 18% qualify for Medicare as the result of a disability. Medicare is a health insurance program for seniors of 65 years of age and above. These plans are managed by the federal government and help seniors pay for medical expenses like hospital, nursing, doctor visits, prescription drugs, hospice care and preventive services. Enrollment in the Medicare plans can be done by individuals three months prior to turning 65 and ends three month after their 65th birthday. This is the time to enroll for the plan and is called as Initial Enrollment Period and if one misses this period then one can apply during the General Enrollment Period which is a duration from January 1 to March 31 every year. Permanently disabled adults are eligible for Medicare plans irrespective of their age.

Medicare Part A

Medicare Part A is a part of Original Medicare that along with hospitalization coverage also covers post-hospital skilled nursing and short-term home health care, as long as it is medically necessary. It also covers hospice services such as palliative care, counseling, social services, short-term respite care, physical therapy and pain relief. However, Part A does not cover long-term care like extended stays in nursing home and hence individuals looking for such coverage need to look for long-term care insurance plan.

Medicare Part B

Medicare Part B is also a part of Original Medicare that covers things both in and out of the hospital. It includes coverage of any care administered by physicians. Part B coverage provides access to a variety of outpatient medical services like doctor’s visits, lab testing, ambulance rides, home health care, and some chiropractic care too along with preventive care coverage like flu shots, mammograms and more.

Medicare Advantage Plans

Medicare beneficiaries in Georgia may select a Medicare Advantage plan in place of traditional Medicare plan in order to obtain additional benefits. These health plans options are approved by Medicare and are offered by private companies. Medicare Advantage Plans include all of Part A and Part B coverage. It means this plan covers at least all of the services that Original Medicare covers. Some Advantage plans may even offer additional benefits in Georgia like routine vision or dental, hearing, and wellness programs, and some plans even offer prescription drug coverage as well. Each Medicare Advantage Plan may charge different copayments, coinsurance and deductibles. Individuals can avail Medicare Advantage plan if they have Original Medicare plan and if they live in the service area of the plan and they do not have end stage renal disease. Plans that include prescription drug benefits are known as Medicare Advantage Prescription Drug plans, and they allow you to get your Part A, Part B, and Part D benefits through a single plan.

Medicare Part D

In Georgia, Medicare beneficiaries have the option of enrolling in Medicare Part D that help them with their prescription drug costs. Medicare prescription drug coverage can be availed by beneficiaries in two ways, either through Original Medicare and enrolling in a stand-alone Medicare Prescription Drug Plan that works alongside your Original Medicare benefits or if they have Medicare Part C then they can enroll in a Medicare Advantage plan that includes this coverage. This plan is also known as Medicare Advantage Prescription Drug plans that give them the option to get their Medicare health and prescription drug benefits covered under a single plan. Since Medicare Part D is available through private insurance companies, so costs and availability may differ between insurance carrier and locations.

Medicare Part D Prescription Drug Coverage

Individuals who wish to obtain coverage for their prescription drugs can avail this plan, though every plan has its own list of covered drugs. The drug list of every plan includes coverage of specific generic and brand-name prescription drugs and all plans need to cover certain categories of medications, but the specific drugs covered in each category may vary by insurance company and by plan. Thus, individuals must always check the list before enrolling in a Medicare Prescription Drug Plan or Medicare Advantage Prescription Drug plan to ensure their specific medications are covered. All the plans have to cover at least two drugs from each category and most of the medications from the anti-psychotics, anti-depressants, immunosuppressants, anti-convulsant, cancer, and HIV/AIDS categories.

Medicare Supplement Plans (Medigap) in Georgia

Medicare beneficiaries in Georgia looking for help in paying health-care costs associated with Original Medicare like copayments, coinsurance, deductibles, and other out-of-pocket expenses, such as emergency health coverage when outside of the country can opt for a Medicare Supplement plan also known as Medigap plans. Beneficiaries in Georgia have different plan options depending upon their location. Individuals first need to develop an understanding on Medigap plans and then they should accordingly select a plan that best fits them. Individuals need to understand that these plans are meant to supplement the Original Medicare plans rather than replacing them.

Georgia Medicare Savings Programs

Medicare beneficiaries in Georgia whose income falls below a certain limit may qualify for assistance from a Medicare Savings Program. These programs help them pay for their premiums, deductibles, and other health costs that Medicare doesn’t cover.

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