Best Medicare Advantage Plans in Georgia for 2020
Some of the best Medicare Advantage Plans in Georgia for 2020 help Medicare beneficiaries pay for hospital stays, doctor visits, preventive care, and lab tests. Medicare Advantage Plans in Georgia cover Medicare Part A and Part B benefits, so you must be enrolled in Medicare Part A and Medicare Part B to qualify. Many include prescription drug coverage. As a Medicare beneficiary, here’s what you need to know to find the best health insurance coverage.
Overview and Changes for Medicare Advantage Plans in Georgia for 2020
- Starting in 2020, insurance companies that provide Medicare Advantage plans in Georgia will be able to add some supplemental non-health related benefits to certain beneficiaries, such as providing help with making structural changes to the home when needed. This is designed to help those who might need help with widening doorways or installing ramps for their homes.
The Centers for Medicare and Medicaid Services approved a 2.53% payment increase to Medicare insurers that offer Medicare Advantage plans in Georgia.
The Medicare program consists of four parts:
- Medicare Part A (hospital costs)
- Medicare Part B (medical services)
- Medicare Part C in Georgia (Medicare Advantage Plan)
- Medicare Part D (prescription drugs)
When you become eligible for Medicare, you have two ways you can receive your Medicare Part A and Medicare Part B benefits:
- Original Medicare
- Medicare Advantage
The federal government administers Original Medicare. With Medicare Advantage, you buy the plan from a private insurance company that has contracted with the government to provide Medicare benefits.
Best Medicare Advantage Plans in Georgia: When Can You Enroll?
Before you can join a Medicare Advantage Plan in Georgia, you must be enrolled in Medicare Part A and Part B. There are specific times you can enroll in Medicare Advantage, change, or drop your plan:
- Medicare Initial Coverage Election Period ICEP — when you are first eligible for Medicare Part A and Part B. For most Georgians, this is the three months before they turn 65 and three months after they turn 65. This seven-month window is also your Medicare enrollment period.
- Medicare Annual Election Period AEP — Between Oct. 15 and Dec. 7, you can switch between Original Medicare and Medicare Advantage or switch between MA plans (with or without drug coverage.)
- Medicare Advantage Disenrollment Period MADP — Jan. 1 through Feb. 14. Previously the only time you could disenroll from Medicare Advantage and return to Medicare Part A and Part B. MADP has been replaced by the Medicare Advantage Open Enrollment Period.
- Medicare Advantage Open Enrollment Period MA OEP — From Jan. 1 to Mar. 31, you can move from one Medicare Advantage Plan (with or without Part D coverage) to another Medicare Advantage Plan (with or without Part D coverage). You can also return to Original Medicare during this time.
- Medicare Special Election Periods SEP — when exceptional circumstances exist such as moving out of your Georgia Medicare Part C plan’s coverage area, you are dual-eligible for Medicare and Medicaid, you live in an institution, or you qualify for Medicare’s Extra Help program.
Best Types of Medicare Advantage Plans in Georgia for 2020
Medicare Part C in Georgia for 2020 must cover all of the services covered by Original Medicare, but plans can apply different restrictions. It’s critical that Georgia beneficiaries carefully compare the different types of Medicare Advantage Plans so they can get the best coverage.
Health Maintenance Organization (HMO) plans in Georgia
HMOs require you to get your care from a network of providers. With HMO Medicare Advantage plans, a primary care physician (PCP) delivers most of your care:
- Specialist referral required from PCP — services not covered if no referral
- Out-of-network services not covered (some emergency exceptions)
- No or low deductible and copayments
- Typically covers prescription drugs
Preferred Provider Organization (PPO) plans in Georgia
PPOs also have preferred doctor networks. Under PPO Medicare Advantage Plans in Georgia, you are free to receive care from any in-network providers:
- Requires no specialist referral
- Costs outside of the service area covered but at a lower level
- Typically has deductibles and copayments
- Usually includes prescription drug coverage
Private Fee-for-Service (PFFS) plans in Georgia
With PFFS, each Medicare Advantage Plan in GA determines how much it pays health care providers and how much you pay:
- Might have network restrictions
- No referrals or PCPs
- Copayments and coinsurance apply
- Might cover prescription drugs
Special Needs Plans (SNPs) in Georgia
Membership in SNPs is limited to specific groups:
- Those living in institutional conditions such as a nursing home or who require nursing care at home
- A beneficiary who is dual-eligible for Medicare and Medicaid
- Those who have chronic health conditions such as end-stage renal disease ESRD, chronic heart failure, diabetes, or HIV/Aids
Special Needs Plans SNPs tailor their coverage to beneficiaries who have a specific disease. The SNP coordinates your care:
- Usually requires primary care doctor
- Requires referrals
- Must cover prescription drugs
- Can join at any time
Enrollment Figures for Georgia Medicare Advantage Plans
Medicare Advantage enrollment in Georgia grew by 10% between 2015 and 2016. Here are more statistics:
- Residents who have Medicare Advantage in Georgia: 33%
- Medicare beneficiaries getting their Part A and Part B benefits through Original Medicare: 68%
- Breakdown by type of Medicare Advantage Plan in Georgia in 2016: 32% HMOs, 66% PPOs, and 2% PFFS
- Number of Georgia residents under age 65 eligible for Medicare: 18%
The number of Medicare Advantage plans available in Georgia for 2020 varies by county. As might be expected, the counties with higher population offer the most Medicare Advantage policies. The five largest Georgia counties are:
Do Medicare Advantage Plans in Georgia Cover Prescription Drugs?
Unlike Medicare Part A and Part B, which don’t cover drug costs, most Medicare Advantage policies have prescription drug plans built into them. Known as MAPD plans, each plan has its own list of covered drugs (formulary). The drugs are categorized into drug tiers ranging from generic drugs to specialty drugs.
Rates for Medicare Advantage Prescription Drug Plans differ because the prescription drug tiers, copayments, deductibles, and network restrictions vary by plan. Also, each company’s formulary is different, so covered medications will vary. When evaluating Medicare Advantage plans in Georgia, you need to compare not only the rates, but you also need to compare the formulary and out-of-pocket expenses for which you’re responsible.
Network Restrictions for Medicare Advantage plan in Georgia for 2020
HMOs and PPOs are the two kinds of Medicare Advantage policies that usually have network restrictions. Here’s how they handle costs outside of the network:
- Out-of-network: PPOs cover out-of-network services, although usually at lower rates compared to in-network services. Health Maintenance Organization HMO plans usually do not cover out-of-network services except in emergencies.
- Travel: HMOs and Preferred Provider Organization PPO plans cover emergency or urgently needed care regardless of network.
- Moving across state lines: Medicare Advantage plans require you to change your plan if you move across state lines. Moving triggers an SEP for your new plan.
Added Benefits of a Medicare Advantage Plan in Georgia
Many Medicare Advantage Plans in Georgia for 2020 offer additional benefits. Extra benefits can include:
- Wellness programs such as SILVER SNEAKERS
- Routine vision and dental and hearing
- Diet, nutrition, and healthy living counseling
When you compare premiums for Medicare Plans in Georgia, take into consideration what extra benefits the plan includes.
Georgia Medicare Resources
Before choosing a Medicare Advantage Plan, compare your total out-of-pocket costs between each of your options. Although some plans have a $0 premium, they might have high cost-sharing amounts. Our licensed agents can help you find the best Medicare Advantage Plan and rate in your area.
We Can Help You Find the Best Medicare Advantage Plan In Georgia for 2020
If you are interested in a Medicare Part C plans in Georgia, we can help. We have helped citizens from Athens to Columbus, Savannah, Atlanta, Augusta and other Georgia residents all also have used our service to find coverage.
We work with top-rated companies like Humana, Cigna, Aetna, Blue Cross Blue Shield and more to provide coverage. To compare Medicare Advantage plans in Georgia, select “Georgia” from our drop-down menu now. You can find the lowest-priced and top choice for you.