Do you remember studying your first pay stubs, wondering how it was possible to have so many deductions? It’s difficult to imagine that you’ll ever benefit from those deductions when you first start working. Suddenly, you find yourself approaching 65 and you’re ready to take advantage of your benefits, specifically Medicare.
The Best Medicare in Georgia:
- Best Overall in Georgia: Kaiser Permanente
- Most Affordable in Georgia: WellCare
- Best for Flexibility: Humana
- Best for Complete Care: Aetna
- Best for AARP Members: UnitedHealthcare
What is Medicare?
Medicare is a federal health insurance program. It was originally created as health insurance for people 65 years and older. The program expanded to those under 65 years with permanent disabilities, end-stage renal disease and amyotrophic lateral sclerosis (AMS), also known as Lou Gehrig’s disease.
There are 4 components to Medicare, according to Medicare.gov:
Part A: Commonly called “hospital insurance,” Part A covers you for hospital-related expenses such as inpatient care, overnight hospital stays, care at a skilled nursing facility, home health care and hospice care.
Part B: Known as “medical insurance,” Part B covers you for outpatient expenses for visits to a doctor or nurse, services (X-rays and dialysis), tests and certain equipment.
Part C: Also known as Medicare Advantage, Part C is an all-in-one bundled plan that includes Part A, Part B and usually, Part D. Medicare Advantage allows you to get benefits through private health plans. You need to stay within the provider network if you sign up for Medicare Part C.
Part D: Part D is prescription drug coverage. Prescription drug coverage provides you with reduced prices on medications. Whether you choose Medicare Parts A and B with a Medigap plan or Medicare Part C, be sure that you’ve got adequate prescription drug coverage. Typically, Medicare Part C includes prescription drug coverage, but not always. Check out the 5 best companies for Medicare Part D plans.
If you’re enrolled in Medicare Parts A and B and find that the monthly premiums and copays strain your finances, a Medicare supplement plan can help you out. A Medicare supplement plan (Medigap) helps boost coverage shortfalls in traditional Medicare insurance. Check out Benzinga’s roundup of the 5 best Medicare supplemental insurance companies.
Legalities of Medicare in Georgia
GeorgiaCares.com can help you enroll in Medicare. GeorgiaCares is the state health insurance assistance program (SHIP) — it’s staffed with volunteers who provide free unbiased information to help you with your Medicare enrollment. SHIP-certified Medicare counselors can also meet you for a personal informational session — GeorgiaCares counselors do not sell insurance of any type.
GeorgiaCares SHIP counselors can help you:
1. Understand your choices
2. Enroll in a Medicare plan that meets your needs
3. Apply for financial assistance programs to reduce out-of-pocket expenses
Call 1-866-552-4464 Option 4 for GeorgiaCares assistance.
Types of Medicare Advantage Plans
Medicare Advantage offers 4 common plan types:
HMO: A Medicare health maintenance organization (HMO) plan is a network that provides care and services from doctors, hospitals and other health care providers. You need to choose a primary care physician (PCP) who coordinates your health services. Your PCP needs to refer you if you want to see a specialist.
PPO: A preferred provider organization plan through Medicare is offered by a private insurance company like an HMO. Unlike an HMO, you can see any professional in the network. You don’t need to establish a primary care physician.
PFFS: A private fee-for-service plan is a type of Medicare Advantage Plan. It’s offered by a private insurance company. How much you pay when you get care is set by the plan.
SNP: A special needs plan is only for those with specific diseases or characteristics.
HMO point of service: This plan is an HMO that allows you to go out-of-network for some services.
Medical savings account: This is a combination of a high-deductible plan with a bank account. You use the money Medicare deposits into that account to pay for your health services.
Medicare Advantage plans are similar to traditional health plans but not all companies offer coverage in every state. Check out which companies are the best overall.
How to Sign Up for Medicare in Georgia
Medicare isn’t automatically part of your health insurance arsenal when you turn 65. You need to sign up for Medicare sometimes in the three months before you reach age 65, even if you aren’t ready to start receiving retirement benefits.
You can opt out of receiving cash retirement benefits once you’re in the online application and can apply online for retirement benefits later. You can sign up for Medicare Part A and Part B through the online application. You can also turn down Part B coverage to avoid paying the premium.
Enroll in Medicare through the Social Security Administration. Both SSA.gov and Medicare.gov provide helpful guides and information for enrolling in Medicare, but here are the basic steps:
1. Sign up through ssa.gov.
2. Choose your coverage. Decide whether you want Part A and Part B or Part C.
3. Follow the Medicare checklist, which helps you make sure you’re getting the most out of your coverage.
Average Cost of Medicare Advantage Plans in Georgia
Check out Medicare.gov’s plan finder so you can find plans available in your area. You can select up to 3 plans to compare. You can enter the ZIP code for Marietta (30064) for the following results.
| Plan Name | Company | Annual Premium | Health Deductible | Drug Deductible | Star Rating (Out of 5 Stars) |
|---|---|---|---|---|---|
| Anthem MediBlue Plus (HMO) | Blue Cross and Blue Shield | $1,626 | $0 | $150 | 3.5 |
| Cigna-HealthSpring Preferred (HMO) | Cigna | $1,626 | $0 | $95 | 3.5 |
| HumanaChoice H5216-145 (PPO) | Humana | $2,034 | $0 | $75 | 4 |
| UnitedHealthcare Medicare Advantage Choice (Regional PPO) | UnitedHealthcare | $2,166 | $0 | $195 | 3.5 |
| Kaiser Permanente Senior Advantage Enhanced (HMO) | Kaiser Permanente | $2,478 | $0 | $0 | 5 |
The table is an estimate and doesn’t include copays for doctor visits and maximum out-of-pocket amount.
Best Medicare Insurance Providers in Georgia
There’s a lot to consider when you choose a health plan, and here are some of the best options in Georgia.
- Access to Kaiser medical specialists
1. Best Overall in Georgia: Kaiser Permanente
Top-rated by the Center for Medicare and Medicaid Services (CMS), Kaiser Permanente earns the best overall rating with 5 stars. It offers affordability, choice, convenience and quality to its plan subscribers.
Kaiser Permanente will help you know your costs upfront — plans often include $0 copays for preventive care and a low out-of-pocket maximum. You choose your doctor and you have access to an array of specialists based on your ZIP code.
Kaiser Permanente’s quality is 3rd-party backed by the National Committee for Quality Assurance.
- Medicare Prescription Drug Plans
2. Most Affordable in Georgia: WellCare
WellCare offers the most affordable plans in Georgia.
WellCare Flex Complete costs $2,706 per year with $0 deductibles for health and prescription drugs and $0 co-pay for doctor visits. Plus, if you stay in-network, your maximum out-of-pocket expense is $2,500.
Wellcare offers dental, vision and hearing coverage as well as fitness benefits.
- Medicare Advantage Plans
3. Best for Flexibility: Humana
Humana offers a generous amount of standard coverage, including doctor and specialist visits, preventive care (including vaccines), outpatient services, emergency transportation and medical supplies and equipment.
Humana’s flexibility shows up in its worldwide emergency coverage, an allowance for over-the-counter medications and products, rewards for healthy habits, no need for referrals and access to mail-order pharmaceuticals.
Humana takes it to the next level with its telehealth services as well.
- Member support
4. Best for Complete Care: Aetna
Aetna offers a plethora of Medicare Advantage plans. These plans carry plenty of side benefits. Standard care includes hospital, physician and specialist visits and services, as well as dental, vision and hearing coverage.
Aetna bolsters its offerings with prescription drug home delivery, its ask-a-nurse helpline, meals at home, health coaching and mental health programs. Aetna offers a total approach to your health and wellness and helps you find resources to enhance your life.
You can find things like help around the house, caregiver support and social activities. All in all, Aetna offers coverage and services for the total you.
- Same day coverage available
5. Best for AARP Members: UnitedHealthcare
AARP’s mission is to empower people to choose how they live as they age. AARP’s market knowledge is vast because it focuses on retirement.
Why not take advantage when you’re an AARP member? UnitedHealthcare offers enrollees above-standard health services with things like a 24/7 nurse line, doctor help, house calls and transportation.
It also offers its exclusive RenewActive (fitness opportunities for the body and mind).
Live Your Best Life with Georgia Medicare
Enjoy your golden years by taking care of your health and wellness. Medicare Advantage plans’ varied care and services can help you do that. Use our guide to choose the best provider and plan. Remember that the “best” plan is truly the best when it meets your needs and wants.
Frequently Asked Questions
1) Q: What are the different parts of Medicare?
Medicare has 4 parts named Parts A, B, C, and D. Part A provides hospitalization coverage while Part B provides outpatient coverage, like doctor visits. Parts A and B make up Medicare’s core coverages. Part C is provides private-market Medicare plans, called Medicare Advantage Plans. Part C coverage often includes additional benefits. Medicare Part D provides coverage for prescription drugs. Get a Medicare Insurance Quote through the top providers here.
2) Q: Is Medicare free?
Because there are 4 parts to Medicare, there can be different cost structures. Most people won’t have to pay for Medicare Part A (hospitalization). Eligibility for premium-free Part A is based on your work history during which you paid Medicare taxes. Many people do pay a monthly premium for Medicare Part B, however, which covers outpatient medical services, like doctor visits. Deductibles also apply to services covered under Medicare Parts A and B, so you’ll pay a part of the annual cost.
Medicare Parts C and D are optional coverages and have premium costs of their own. Medicare Part C refers to Medicare Advantage Plans that offer additional coverage in exchange for a monthly premium. Part D, the prescription plan, reduces the cost of medications but also requires a monthly premium. Subsidies may be available for low income households to help reduce overall Medicare costs.
3) Q: Do I need to sign up for Medicare?
If you signed up for Social Security before age 65, you were enrolled in Medicare automatically but benefits will begin at age 65. In most cases, there are penalties for not enrolling at age 65, so it pays to sign up on time. Click here to get a medicare quote in minutes from the best providers.
If you have employer coverage, you may be able to delay Medicare coverage while your work plan is still in force. However, the size of the employer determines whether you’ll pay a penalty for not enrolling at age 65. Employees (and their spouses) of companies that offer group health insurance to 20 or more people are usually exempt from late sign-up penalties if they are covered by the employer’s plan.