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Medicare in Georgia

When enrolling in Medicare in Georgia, there is more to consider than just the federally run health program that consists of Medicare Part A and Part B. This is sometimes called Original Medicare, and it covers inpatient hospital care (Part A) and doctors’ services (Part B).

Original Medicare is available to eligible beneficiaries in every state, including Georgia. But there are alternatives and supplement plans sold by private insurance companies, and some of those may wind up working better for you, depending on your Medicare needs.

Medicare Advantage plans, also called Medicare Part C, must provide at least the same amount of coverage as Part A and Part B, but many of these feature additional benefits. Many Part C plans include dental, hearing, and vision benefits. Most, though not all, Medicare Advantage plans also include prescription drug coverage and may be referred to as a Medicare Advantage Prescription Drug plan.

Other plans offer benefits that can be added to your existing Original Medicare, Part A and Part B, coverage. Because prescription drug medication is not covered by Original Medicare, you can join a stand-alone Medicare Part D Prescription Drug Plan to obtain this benefit. You may also wish to add a Medicare Supplement (Medigap) policy to your coverage. Medigap plans provide coverage for Original Medicare’s out-of-pocket costs, and other “gaps” in that coverage, but don’t include drug coverage.

The availability of any private Medicare insurance plan in Georgia is likely to vary depending on your location.

Original Medicare for Georgia beneficiaries

Many U.S. citizens and legal residents aged 65 or older qualify for Original Medicare, Part A and Part B, as do younger people with certain qualifying disabilities.

Medicare beneficiaries in Georgia have the potential to be enrolled automatically at age 65 as long as they receive retirement benefits through either the Social Security Administration (SSA) or the Railroad Retirement Board (RRB). Younger people can also be enrolled, if they get SSA disability benefits, or certain RRB disability benefits, for 24 consecutive months.

The red, white, and blue Medicare card arrives by mail approximately three months before your coverage is activated. This card is printed with your Medicare number, along with whatever parts of the Medicare program you’re enrolled in. You’ll also get a “Welcome to Medicare” packet containing educational information concerning the program, including instructions on how you can opt out of Medicare Part B. Because you pay a monthly premium for Part B, you have the option to decline this coverage. However, you need Part B to enroll in other parts of Medicare, and there can be a penalty for late enrollment.

If you’re not automatically enrolled in Original Medicare, you can enroll during the following enrollment periods:

  • Initial Enrollment Period: This is the period (abbreviated IEP) when you’re first eligible to join Medicare. It lasts for seven months, beginning three months before you turn 65, including the month you turn 65, and ending three months later.
  • General Enrollment Period: This is the annual enrollment period (also called the GEP) that runs from January 1 to March 31. You may have to pay a late enrollment penalty for Part A and/or Part B if you didn’t sign up when you were first eligible.
  • Special Enrollment Period: You can’t typically sign up for Part A or Part B outside the IEP and GEP periods unless you qualify for a Special Enrollment Period (SEP). If you’re covered under a group health plan and delay Part B enrollment, you can sign up for Part B using an SEP when that coverage ends, thus avoiding a Part B late enrollment penalty. Additional examples of SEP include, but are not limited to, moving to a new coverage area, becoming eligible for both Medicare and Medicaid or qualifying for the Extra Help program, or changes in institutional status, such as moving into or moving out of a skilled nursing facility.

You can register for Medicare by going to your local SSA office, registering online, or calling:

  • Call Social Security at 1-800-772-1213 (TTY users call 1-800-325-0778), Monday through Friday, from 7AM to 7PM.
  • If you worked for a railroad, call the RRB at 1-877-772-5772 (TTY users call 1-312-751-4701) Monday through Friday, from 9AM to 3:30PM.

Medicare private insurance in Georgia

As stated above, there are private versions of Medicare insurance as well. Some counties in Georgia may offer more plan types than others, and pricing may also vary by company.

Medicare Part C, also called Medicare Advantage, is sold by private insurance companies that have contracted with Medicare to provide your Original Medicare benefits. Part C plans provide coverage that matches Part A and Part B (with the exception of hospice care), and may offer vision, dental, or hearing coverage as added benefits.

Many Medicare Advantage plans include prescription drug coverage as well. These are sometimes known as Medicare Advantage Prescription Drug (MAPD) plans; they offer a way to get all of your coverage through a single Medicare plan.

Medicare Supplement plans, also called Medigap, provide coverage for some of the things that Original Medicare doesn’t cover, like premiums, deductibles, copayments, and coinsurance. Most states, including Georgia, offer up to ten subsidized Medicare Supplement plans, although not every plan is available through each private carrier. Medigap plans can’t be used with Medicare Part C plans, so you wouldn’t need to get both.

Medicare Part D is a stand-alone benefit that offers prescription drug coverage. These plans are sold by private insurance companies but the coverage works alongside your Part A and Part B coverage. Every plan has a formulary, which is a list of drugs covered by that plan. The formulary can vary by plan.

Georgia resources for Medicare beneficiaries offers a list of educational resources for health organizations in Georgia. For your convenience, we have included it resources below.

  • State Health Insurance Assistance Program (SHIP): Toll-free number 1-866-552-4464 | TTY users call 1-404-657-1929 | Website
  • National Institute on Aging Information Center: Toll-free number 1-800-222-2225 | TTY users call 1-800-222-4225 | Monday through Friday, 8:30AM to 5PM ET | Website

Learn more about how Medicare plans work in Georgia, including: