A Medicare Supplement plan (also known as a Medigap plan) helps Medicare beneficiaries in Georgia and the rest of the United States pay for health-care costs associated with Original Medicare, Part A and Part B. This may include copayments, coinsurance, deductibles, and other out-of-pocket expenses, such as emergency health coverage when outside of the country.
Medicare beneficiaries in Georgia may have various Medicare Supplement plan options, depending on the zip code they live in. It may help to first understand what Medigap in Georgia covers, and then get help choosing a plan option that fits your situation.
In the vast majority of US states, there are 10 standardized Medigap plans available, each identified by one of 10 letters (A, B, C, D, F, G, K, L, M, and N), with plans of the same letter offering the same benefits. Three states (Massachusetts, Minnesota, and Wisconsin) offer different kinds of Medigap plans.
Keep in mind that Medicare Supplement coverage can only be used to pay for certain costs in Original Medicare; these plans don’t work with Medicare Advantage plans.
To be eligible for Medigap in Georgia you must be enrolled in Original Medicare, Part A and Part B. It’s a good idea to join Medigap during your Medigap Open Enrollment Period, which starts the first day you are both age 65 or older and enrolled in Medicare Part B. This enrollment period lasts for six months. During this time frame, you have a “guaranteed-issue right” to enroll in any Medicare Supplement plan offered in your area by any insurance company. You can’t be turned down for coverage because of pre-existing conditions or required to undergo medical underwriting. If you try to enroll in a Medigap plan in Georgia or change plans after your Medigap Open Enrollment Period has passed, you may be denied coverage or charged more for an insurance policy.
It’s important for you to understand that Medigap plans are meant to supplement rather than replace Original Medicare, so you have to remain enrolled in Original Medicare, Part A and Part B for your health coverage. You’ll also need to keep paying your Medicare Part B premium, in addition to any premium for your Medigap plan. Also, if you want prescription drug coverage, you may want to enroll in a stand-alone Medicare Part D Prescription Drug Plan. Medigap plans in Georgia, like those in the rest of the United States, do not offer coverage for prescription drugs, and prescription benefits are limited under Original Medicare.
It’s a smart idea to familiarize yourself with the 10 standardized Medigap plans prior to making your selection. Here’s a look at the Medigap plans available in Georgia. In this chart, X indicates that the service (or item) is 100% covered; a percentage indicates what percent of the service/item is covered; and a blank cell indicates it is not covered.
|Medicare Supplement Plans|
|Medicare Supplement Benefits||A||B||C||D||F*||G||K||L||M||N|
|Medicare Part A coinsurance and hospital costs up to an additional 365 days after Medicare benefits are exhausted||X||X||X||X||X||X||X||X||X||X|
|Medicare Part B copayment or coinsurance||X||X||X||X||X||X||50%||75%||X||X***|
|First three pints of blood||X||X||X||X||X||X||50%||75%||X||X|
|Medicare Part A hospice care coinsurance or copayment||X||X||X||X||X||X||50%||75%||X||X|
|Skilled nursing facility care coinsurance||X||X||X||X||50%||75%||X||X|
|Medicare Part A deductible||X||X||X||X||X||50%||75%||50%||X|
|Medicare Part B deductible||X||X|
|Medicare Part B excess charges||X||X|
|Foreign travel emergency coverage (up to plan limits)||80%||80%||80%||80%||80%||80%|
|Out-of-pocket limits apply.**|
*Medicare Supplement Plan F offers a high-deductible version in which beneficiaries pay a certain deductible amount before the plan begins coverage. This amount may change from year to year.
**Once you reach the out-of-pocket limits (including the Part B deductible), both Medicare Supplement Plans K and L pay 100% of covered services in the above chart for the remainder of the calendar year.
***Medicare Supplement Plan N pays 100% of the Medicare Part B coinsurance, except for a copayment of up to $20 on doctor visits and up to $50 on emergency room visits that don’t result in an inpatient admission.
Medicare Supplement plans in Georgia with the same letter designation don’t vary in coverage or benefits, as explained earlier. However, each insurance company that offers Medicare Supplement plans can determine its own monthly premium structure. This means that a resident of Atlanta in Fulton County may pay more or less than a resident of Savannah in Chatham County for an identical Medicare Supplement plan, so it may be a good idea to compare all Medicare Supplement plans available in your area, and then select a Medigap plan in Georgia based on your personal needs.
Get more information about Medicare in Georgia through the following resource:
With all the Medigap plan options available in Georgia, it may be a good idea to get help choosing the plan that works best for your needs. You can go about that in a few ways. If you’re ready to browse plan options now, use the plan finder tool to view plan options in your area. Or, if you’d rather speak with someone, contact eHealth to reach a licensed insurance agent.