Georgia Medicare Supplement Plans (Medigap)
For senior citizens residing in Georgia, there are Medicare Supplement Plans offered by private insurance companies to work alongside Original Medicare. The purpose of a Medicare Supplement Plan is it provides coverage for the charges left over from straight Medicare.
Out of pocket (OOP) costs associated with deductibles, coinsurance and copayments are included in these insurance benefits. Your Georgia Medicare and Medicare Supplement Plans are broken down into parts and plans and will be broken down and explained here.
Georgia Medicare Benefits Explained
Medicare is made up of 4 parts:
- Part A: is your hospital and inpatient procedure benefits.
- Traditional Medicare Part B: is your outpatient benefits which include doctor’s office visits.
- Medicare Part C: considered a Medicare Replacement Plan or Medicare Advantage Plan. Will replace your Medicare Part A and Medicare Part B coverage and in some cases includes additional benefits.
- Medicare Part D: provides prescription drug coverage which isn’t included with Traditional Medicare coverage.
In addition to the 4 part of Medicare benefits, seniors in Georgia can purchase a Medicare Supplement Plan. There are ten different letter plans available that provide added coverage for what costs aren’t covered by Medicare. This includes coverage for some deductibles, copays, coinsurance and other medical expenses.
What Benefits Does Medicare Include in Georgia?
If you are hospitalized, Medicare Part A will pay for the first 60 days. Additionally, it covers any inpatient procedures, medications, bloodwork, and diagnostic imaging. Medicare Part B covers your outpatient medical costs, including ER visits, doctor bills, outpatient procedures, blood work, diagnostic imaging/testing and durable medical equipment (DME).
Whether you are using your Medicare Part A or Part B benefits, both only cover medical costs at 80%. The remaining 20% not covered by Medicare is left for the beneficiary to pay.
Requirements for Medicare Supplement Plans in Georgia
To be considered eligible for a Medicare Supplement Plan there are some requirements that must be met:
- You must be 65 years of age.
- Must already be carrying Medicare Part B health insurance.
- You need to enroll during what is called your Open Enrollment Period (OEP). Your OEP is a total of 7 months that begins 3 months prior to your 65th birthday and the following 4 months.
Failing to enroll during your OEP results in what is known as the Part B penalty. The penalty will increase your monthly premium each month. As of 2018, the premium is $134.00 and the longer you wait, the higher the penalty will be.
Eligibility for Disability in Georgia for the Disabled under 65
If you currently receive disability benefits from Social Security, have End Stage Renal Disease (ESRD) or carry certain Railroad Retirement Benefits, after 24 months you’re automatically enrolled in Medicare Parts A and B. Some private health insurance carriers offer plans to those under 65 who are currently on disability.
Federal law does not require insurance providers to offer Medicare Supplement Plans for those who are disabled and under age 65 however, Georgia law permits it. If you’re on disability in Georgia, call us today for more information concerning plans available to you.
How to Enroll for Georgia Medicare Supplement Plans
You have a 7 month Open Enrollment Period (OEP) in which it’s the best time to secure a Medicare Supplement Plan. Your OEP begins the 1st day of the month after turning 65 and currently carrying Medicare Part B. You then have the next 6 months to enroll without penalty.
For example, if your birthday was February 22nd and your Medicare Part B effective date was March 2rd, then your OEP begins April 1st.
When you enroll during your OEP you’re granted what is called the Guaranteed Issue (GI) right. With the GI right your eligibility for a Medicare Supplement Plan is, “guaranteed”, regardless of any pre-existing medical conditions.
This ensures the beneficiary that the insurance carriers cannot deny them a Medicare Supplement policy, increase the premium rates or perform medical underwriting. To avoid any additional OOP costs included in your monthly premiums, it’s imperative you enroll during the OEP to ensure your GI.
Georgia Medicare Supplement Plan Premiums
Each private insurance carrier across the country determines their own premium rates. The different factors considered for premium cost include your age, sex, and location. Therefore, an individual living in Atlanta, GA vs. an individual living in Cumming, GA will have different premium rates. Just as a female in one city vs. a male in a different city will have varying rates.
There are also 3 different pricing methods the insurance providers use for premium determinations. These methods are called community-rated pricing, issue-age rated pricing, or attained-age-rated pricing. The different methods used can be better explained and you can click here for more info.
Top Medicare Supplement Plans in Georgia
Private insurance carriers across the nation carry the individual Medicare Supplement Plans. Regardless of which company you decide to obtain coverage through, your benefits within the 10 letter plans remain the same.
What the various insurance companies decide to charge for the monthly premiums will be the only difference from carrier to carrier. Of the 10 letter plans available within the Medicare Supplement Plans, the top 3 with the best coverage offered are with Plans F, G, and N.
Considered the most popular of the Supplement Plans, Plan F provides the best overall, coverage. Plan F provides 100% coverage of the deductibles for Medicare Part A and Medicare Part B. Additionally, Plan F covers for the remaining 20% not covered by Traditional Medicare, Part B’s coinsurance and copayments and has the added bonus of foreign travel coverage.
There’s also a Plan F High Deductible version that provides the same great benefits at a lower cost with just a, “higher deductible”.
Plan N is another popular plan in Georgia. It’s cheaper and is considered a cost-sharing plan. It covers Medicare Part A deductible but not Medicare Part B’s deductible. There is no coverage for excess charges which physicians in Georgia are allowed to charge. Also, with Plan N, a small copayment is required for office and ER visits.
Plan G is quite comparable as well as popular as Plan F, with the only difference being there is no Medicare Part B deductible coverage with Plan G. It will, however, cover any Part B excess charges.
Georgia Medicare Advantage Plans
Like the Medicare Supplement Plans, Medicare Advantage Plans are also offered by the private health insurance companies however, it cannot be combined with the supplemental plans.
Often times, the Medicare Advantage Plans are referred to as a Medicare Replacement Plan as it takes over coverage and provides the same benefits as Traditional Medicare.
While premiums are typically cheaper than a Medicare Supplement Plan, Advantage Plans come with policy limitations. Cancellation restrictions and coverage limitations are just a couple of examples.
You can avoid these restrictions by opting for a Medicare Supplement Plan which tends to be cheaper in the long run as overtime your OOP costs are higher with an Advantage Plan.
As Medicare Supplement Plans don’t provide prescriptions drug coverage, it’s necessary to consider obtaining this specific coverage. By obtaining a Prescription Drug Plan (PDP), you’ll save thousands of dollars of OOP costs associated with prescription drugs.
Along with some of the previous policies mentioned, unfortunately, there is also a penalty for failing to obtain a PDP. The Part D penalty starts after your 7 months initial enrollment period (IEP). After your IEP your premiums are once again increased based on how long you went without drug coverage.
For most seniors residing in Georgia, the most comprehensive coverage includes:
- Traditional Medicare
- a Medicare Supplement Plan
- and a Prescription Drug Plan combined
How to Sign Up for Medicare in Georgia
If you’re already enrolled in the federal Medicare program, signing up for a Medicare Supplement Plan in Georgia is simple!
To ensure you have the absolute best insurance coverage, including all the additional plans needed to minimize the most OOP costs, we can help! Call us today or fill out our online forms. We have numerous, licensed insurance agents available to answer any questions you may have.
Medicare Resources in Georgia
Georgia, as with every state, has a Medicare Savings Program specifically designed to help Seniors cover their Medicare costs. Whether using the Centers for Medicare and Medicaid services or the SHIP center, both are designed to help seniors with counseling regarding their insurance benefits and also help to obtain financial aid.
Did Georgia approve the Medicare expansion
No, Georgia is one of 15 states that did not approve the expansion of coverage.
Georgia residents already on Medicare can obtain additional health care coverage for less OOP cost by obtaining a Prescription Drug Plan in addition to a Medicare Supplement Plan.
There are a variety of different plans available and we can make sure you not only fully understand but also take advantage of all the options available to go along with your Medicare benefits. Give us a call, or use our online rate form to compare rates in your area now.