Medicare Advantage Plans in Georgia
Key Takeaways
- If you are enrolled in Medicare Parts A and BOriginal Medicare is a fee-for-service health insurance program available to Americans aged 65 and older and some individuals with disabilities. Original Medicare is provided by the federal government and is made up of two parts: Part A (hospital insurance) and Part B (medical insurance). , a Medicare Advantage plan is an alternative in Georgia.
- Medicare Advantage (Part C)Medicare Advantage (Medicare Part C) is health insurance for Americans aged 65 and older that blends Medicare benefits with private health insurance. This typically includes a bundle of Original Medicare (Parts A and B) and Medicare Prescription Drug Plan (Part D). replaces Parts A and B while providing at least the same coverage and often additional coverage like hearing and vision.
- While Original Medicare has a set cost structure, prices vary with Medicare Advantage, which generally offers an affordable option when you see in-network providers.
- You have the option to switch to Medicare Advantage in Georgia when you are enrolled in both Parts A and B for the first time.
- You also can enroll in Medicare Advantage during the Medicare Open Enrollment Period, also called the Annual Enrollment Period (AEP).
If you’re a U.S. citizen living in Georgia who is at least 65 years old, you are eligible for Medicare.
And if you’re eligible for Medicare, you’re eligible for Medicare Advantage.
Medicare is a federal program offering health insurance to all who qualify in the form of Parts A and B of Original Medicare. If you have Parts A and B, you qualify to switch to a Medicare Advantage plan offered by a Medicare-approved private insurance company that replaces Original Medicare while offering at least the same coverage as Parts A and B, and often offering more.
In 2024, every Georgia resident on Medicare has access to a Medicare Advantage plan with a $0 monthly premium.
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Georgia Medicare Advantage Plan Coverage
Since Medicare Advantage plans in Georgia offer at least the same coverage as Parts A and B of Original Medicare, it’s a good idea to review what Parts A and B cover.
- Commonly called “hospital insurance,” Medicare Part A provides coverage for inpatient hospital stays, usually without requiring a monthly premiumA premium is a fee you pay to your insurance company for health plan coverage. This is usually a monthly cost. .
- Commonly called “medical insurance,” Medicare Part B provides coverage for outpatient services and needs like doctor visits and durable medical equipment. Part B usually requires a monthly premium.
Differences Between Medicare Advantage and Original Medicare
In Georgia, Medicare Advantage and Original Medicare cover you in different ways. Medicare Advantage plans provide coverage within a specific network in Georgia, while Original Medicare is accepted nationwide by any provider that accepts assignmentIf your doctor or healthcare provider accepts an assignment, it means they agree to receive the Medicare-approved amount as the full amount for any services provided. Your healthcare provider will submit the claim to Medicare, and your out-of-pocket costs are usually less if your doctor accepts Medicare assignments. .
In part because private insurance companies contract with a network of local providersA doctor or medical facility that is licensed to treat an illness or injury and other conditions. to offer coverage for those on Medicare Advantage in Georgia, Medicare Advantage plans are able to provide more coverage than Original Medicare at affordable rates.
The following aren’t offered by Original Medicare but are provided by at least some Medicare Advantage plans in Georgia:
- Dental coverage
- Vision coverage
- Hearing coverage
- A stipend for over-the-counter supplies
- Transportation for routine medical appointments
- An out-of-pocket maximumThe maximum amount of money an individual will pay towards out of pocket expenses like deductibles, copayments, and coinsurance. (offered by all Medicare Advantage plans)
GA Medicare Advantage Plan Costs
In Georgia, the average monthly premium for a Medicare Advantage plan in 2024 is $16.50. Some Medicare Advantage plans have no monthly premium, and some go a step further and help pay some of your Part B deductible.
While Medicare Advantage (Part C) replaces Original Medicare as your plan, your Medicare coverage is still regulated by the federal Medicare program, and you are still responsible for your Part B premium. In 2025, the standard monthly premium for Part B is $185. You also are still responsible for your Part A deductible, but 99% of people don’t have a Part A deductible because they have paid Medicare taxes for at least 10 years.
The cost structure for Original Medicare in terms of deductibles as well as the formula for coinsurance and copayments is standard across the board, although what you pay will vary based in part on what your provider charges. The cost structure for Medicare Advantage in Georgia varies from plan to plan, although there are a couple of constants:
- Every Medicare Advantage plan provides the protection of an out-of-pocket maximum, which — as the name suggests — spells out the maximum money you’ll have to pay “out of pocket” over the length of the plan (usually one year). This can provide peace of mind by defining the worst-case scenario. Original Medicare doesn’t have an out-of-pocket maximum.
- Every Medicare Advantage plan, regardless of the uniqueness of its cost structure, offers coverage at least equal to Parts A and B of Original Medicare. For example, Part A covers inpatient hospital stays and Part B covers medically necessary durable medical equipment. That means Part C covers both of those things, though your related out-of-pocket costs may vary depending on your particular plan.
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Medicare Advantage Plan Eligibility and Enrollment in Georgia
You are eligible for Medicare Advantage in Georgia if you have enrolled in both Parts A and B of Original Medicare.
Still, you need to know when you can enroll and how to enroll.
In a nutshell, your first chance to enroll in a Medicare Advantage plan in Georgia arrives when you are first enrolled in both Parts A and B.
- If that’s during the Initial Enrollment Period that surrounds your 65th birthday, you have until three months after your birthday month to switch to Medicare Advantage.
- If that’s during the annual General Enrollment Period that runs from January 1 to March 31 each year, you’ll have the option from April 1 to June 30 to switch to Medicare Advantage.
- If that’s during a Special Enrollment Period, then you have the option during that period to switch to Medicare Advantage.
When you are eligible to switch to Medicare Advantage, a GoHealth licensed insurance agent can guide you through the process.
Are There Georgia Medicare Advantage Plans With Prescription Drug Coverage?
The majority of Medicare Advantage plans in Georgia include prescription drug coverage.
Medicare Advantage allows you to bundle Part D drug coverage. Original Medicare allows you to add a stand-alone Part D drug coverage.
Part D drug coverage is administered by private insurance companies with guidance from the Medicare program. A GoHealth licensed agent can help you find a Medicare Advantage plan in Georgia with drug coverage or find a stand-alone drug plan to pair with Original Medicare.
Medicare Learning Guides
Healthcare is personal. So is choosing insurance. If you are new to Medicare, a beneficiary researching options, or a caregiver, we have tailored Medicare Guides for you.
Before 65 Guide
Understanding health insurance before age 65, especially when considering early retirement
Medicare Plans Guide
Costs, coverage and enrollment details for each Medicare plan
Medicare Beneficiary Guide
For those currently enrolled in Medicare
Low Income and Medicare Guide
For individuals with a qualifying income status
A Caregiver's Guide
For individuals with a qualifying income status
Still have questions? GoHealth has the answers you need.
Call Today Sources
- FACT SHEET. CMS.gov.
- Medicare Costs. Medicare.gov.
This website is operated by GoHealth, LLC., a licensed health insurance company. The website and its contents are for informational and educational purposes; helping people understand Medicare in a simple way. The purpose of this website is the solicitation of insurance. Contact will be made by a licensed insurance agent/producer or insurance company. Medicare Supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. Our mission is to help every American get better health insurance and save money.
Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.