Medicare Advantage Plans in Georgia
There are several types of Medicare Advantage plans in Georgia, also known as MA plans or Medicare Part C. Below are general attributes of different plans to help you identify the best type for you.
Many Medicare recipients reap the benefits of having a Medicare Advantage plan. With a Medicare Advantage plan, you will not give up your Original Medicare benefits. Every Medicare Advantage plan in Georgia must provide coverage that meets or exceeds the provisions of Original Medicare.
Top-rated Medicare Advantage Plan Companies in Georgia
Here are some of the private insurance companies offering Medicare Advantage plans for 2022:
- Aetna Medicare
- Anthem Blue Cross and Blue Shield
- Clear Spring Health
- Clover Health
- Kaiser Permanente
Popular Medicare Advantage Plan Types in Georgia
Best network flexibility: Medicare Advantage PPO
- PPO (preferred provider organization) offers an extensive network with the option to go out-of-network at a higher cost
- No referrals are needed to see a specialist
- Monthly premiums range from $0 to $100
Best for lowest out-of-pocket: Medicare Advantage HMO Plan
- An HMO must use network providers unless it is an emergency, contributing to lower out-of-pocket costs
- Need to select a primary care physician and obtain referrals for most specialist services
- No monthly premiums
Best for low-income or health conditions: Medicare Advantage D-SNP
- Restricts membership to Medicare beneficiaries with certain diseases or limited financial resources
- D-SNPs – a type of SNP (special needs) plan contracted with Medicaid to manage the benefits coordination between Medicaid and Medicare for dual-eligible beneficiaries
Georgia Enrollment Facts:
Number of enrollees in Medicare Advantage in Georgia: 606,211
The number of enrollees by type of Medicare Advantage plan:
Local HMO: 177,941
Local PPO: 279,162
Regional PPO: 143,872
Percentage of enrollees in Medicare Advantage in Georgia: 46%
Number of enrollees in Medicare Advantage nationwide: 19,838,319
Percentage of enrollees in Medicare Advantage nationwide: 42%
How much does a Medicare Advantage Plan in Georgia cost?
Plan availability and pricing will fluctuate from one county to the next. In many areas, HMO plans are available with no monthly premium. Although you may be able to buy PPO plans with no premium as well, this is becoming less common.
The average monthly premium for MAPD in Georgia: is $17.35
How much do Advantage Plans cost in Georgia?
PPO Plan $0 to $17.35
HMO Plan $0.00
When can I enroll in a Medicare Advantage plan?
Initial Enrollment Period
- Seven months that starts three months before the month you turn 65 and ends three months later
- The Initial Enrollment Period is for people new to Medicare. During this period, you can enroll in Medicare Part A and Medicare Part B.
- To ensure you have Medicare coverage on your 65th birthday, sign up during the three months before your birthday month. After you enroll in Part B, you can apply for Medicare Part C.
Open Enrollment Period – aka Annual Election Period
October 15 – December 7
During the Open Enrollment Period, beneficiaries can join, change or leave health plans, including Medicare Advantage and prescription drug plans.
Submit your request by December 7 to ensure coverage begins January 1.
Medicare Advantage Open Enrollment Period
January 1 – March 31
If you have a Georgia Medicare Advantage plan and want to change to another MA plan, you can do so during the Medicare Advantage Open Enrollment Period. If you revert to Original Medicare, you can also sign up for a Part D plan.
Special Enrollment Periods – Special Circumstances
Timing depends on the special circumstance.
Special circumstances may qualify you for a Special Enrollment Period. Examples include:
- Changing to a location outside your plan’s service area or to a place where you have new plan options
- Loss of coverage, such as Medicaid or an employer group plan
- Leaving a plan that has ended its contract with Medicare
5-star Special Enrollment Period
December 8 – November 30
Once during the Special Enrollment Period, you can change your MA plan, Part D plan, or Medicare Cost Plan and join another that has earned a 5-star rating. This rating is assigned by Medicare based on assessments of excellent quality and performance. Ratings take into account feedback from members and healthcare practitioners.
Special Enrollment Periods if you get “Extra Help.”
Timing and the changes you can make depend on your qualification for Extra Help, a program that helps people with low income and resources.
Qualification Special Enrollment Period What You Can Do Eligible for Medicare and Medicaid January – March, April – June, July – September Join, switch or drop MA or Part D Eligible for help paying for drug plan January – March, April – June, July – September Join, switch or drop Part D Enrolled in or lose eligibility for State Pharmaceutical Assistance Program (SPAP)One time per calendar year Enroll in Medicare drug plan or MAPD plan.
Medicare Advantage Highlights:
Highlights of your typical Georgia Medicare Advantage plan:
- The administration, customer service, and benefits disbursements go through the private insurance company that sold you the plan rather them Medicare direct.
- If a Medicare Advantage premium is charged, you pay it directly to the health insurance company while you continue to pay your Part B premium to Medicare.
- The standard monthly Part B premium paid to Medicare is $164.90 in 2023.
- The annual Part B deducible is $226 in 2023.
- Additional coverage may include vision, dental and hearing services, and wellness programs.
- Benefits are tied to a network of healthcare providers.
- You may have the option to buy a Medicare Advantage Prescription Drug (MAPD) plan, which covers Medicare Part A, Part B, and prescription drug coverage.
Ready to Learn More?
We help educate Medicare beneficiaries on their Medicare Advantage options and help them go through the process of reviewing and comparing plans. We work with most of the nation’s top-rated Medicare Advantage carriers. Call us today, or request a quote online to learn more about plan options.
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